Bilateral submandibular duct rerouting: assessment of results on drooling in cerebral palsy cases

Drooling is a physiological phenomenon in infants which becomes unusual and even pathologic after 18 months of age. Cerebral palsy (CP), the most common etiology for physical disability, mostly occurs in cases of normal-intelligence kids who are socially active and therefore their disorders require special attention. One of the major problems kids with CP face is excessive drooling and several therapeutic methods have been suggested to treat this problem. In this study described herein, bilateral submandibular duct rerouting (BSMDR) surgery was performed to investigate its effect on drooling in children with CP.

From March 2007 to April 2011, 16 children aged 6-16 years old with cerebral palsy who suffered from excessive drooling were recruited. A thorough physical examination was performed and a questionnaire was completed for each case. Those who met the inclusion criteria and provided an informed consent were selected for BSMDR surgery. They were followed-up twice, 10 days and 6 months after the operation to evaluate the degree of drooling or other possible side effects of the surgery.

Sixteen patients entered the study and underwent surgery. On the first follow-up visit 87.50% presented overall improvement, of which 56.25% showed good to excellent improvement in contrast to 31.25% who exhibited fair improvement. On the second follow-up an overall improvement was observed in 81.25%, of which 43.75% showed good to excellent improvement compared to 37.50% with fair improvement.

Considering that during both the first and second follow-up visit only two cases (12.5%) did not respond to treatment, it could be concluded that BSMDR surgery is an effective treatment for reducing drooling in CP children.