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Drooling.

Devyani Lal1, Andrew J Hotaling

  • 1Department of Otolaryngology, Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|November 14, 2006
PubMed
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Managing drooling, a common issue in cerebral palsy, involves a multidisciplinary team approach. While botulinum toxin A shows promise, surgical relocation of salivary ducts is currently the most effective long-term solution.

Area of Science:

  • Neurology
  • Otolaryngology
  • Rehabilitation Medicine

Background:

  • Drooling (involuntary saliva spillage) is a significant morbidity in cerebral palsy and neurodegenerative disorders.
  • It leads to substantial medical, social, and psycho-social handicaps, including stigmatization and emotional distress.

Purpose of the Study:

  • To review recent advancements in the management of drooling.
  • To evaluate various therapeutic and surgical interventions for drooling.

Main Methods:

  • Review of recent publications on drooling management.
  • Analysis of anticholinergic drugs, surgical options, biofeedback, behavioral therapy, speech therapy, and team-based approaches.
  • Evaluation of botulinum toxin A and surgical interventions like duct relocation.

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Main Results:

  • Botulinum toxin A injections show encouraging short-term results.
  • Nonsurgical options include oromotor therapy, which is highly useful.
  • Anticholinergic drugs are limited by adverse effects and noncompliance.
  • Bilateral submandibular duct relocation with sublingual gland excision demonstrates long-term safety and efficacy.

Conclusions:

  • A multidisciplinary team approach is crucial for successful drooling management.
  • Oromotor therapy is the most effective non-surgical treatment.
  • Surgical intervention, specifically bilateral submandibular duct relocation with sublingual gland excision, is the current optimal surgical option for drooling.