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Retroductal Submandibular Gland Instillation and Localized Fractionated Irradiation in a Rat Model of Salivary Hypofunction
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Bilateral submandibular duct relocation by high-frequency radiosurgery.

Gábor Katona1, Zsuzsa Csákányi, Anikó Lorincz

  • 1Department of Otorhinolaryngology and Bronchology, Heim Pál Hospital for Sick Children, Budapest, Hungary.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|February 6, 2008
PubMed
Summary

Radiosurgery effectively reduced excessive drooling in neurologically impaired patients. Most patients experienced significant improvement, with parents satisfied with the safe and efficient radiosurgical bilateral submandibular duct relocation procedure.

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Pediatric Surgery

Background:

  • Excessive drooling (sialorrhea) is a common challenge in neurologically impaired children and young adults.
  • Conservative treatments and oral-motor training often fail to adequately manage persistent drooling.
  • Surgical intervention is considered when non-invasive methods are unsuccessful.

Purpose of the Study:

  • To evaluate the efficacy and safety of radiosurgical bilateral submandibular duct relocation for treating excessive drooling.
  • To assess patient outcomes and parental satisfaction following the procedure.
  • To compare the duration and characteristics of radiosurgery with traditional techniques.

Main Methods:

  • A retrospective review of 14 pediatric and young adult patients who underwent radiosurgical bilateral submandibular duct relocation and sublingual gland excision between 2000-2007.
  • Assessment of oral-motor function and drooling severity using a 4-degree scale preoperatively and postoperatively.
  • Patient follow-up included a questionnaire study and case note review over an average of 8-26 months.

Main Results:

  • A significant reduction in sialorrhea was achieved in 79% of patients.
  • Improvement in drooling was observed within an average of 3 weeks post-surgery.
  • Parental satisfaction was high (71%), with a willingness to recommend the procedure.
  • Complications included transient sublingual swelling and ranula formation.
  • Radiosurgery offered a shorter operative time (48 min) compared to the cold knife technique.

Conclusions:

  • Radiosurgical bilateral submandibular duct relocation is a safe and effective treatment for excessive drooling in neurologically impaired individuals.
  • The procedure offers advantages over traditional methods, including precision, safety, and reduced surgical time.
  • Radiosurgery presents a viable new therapeutic option for managing sialorrhea in this patient population.