Submandibular excision with and without parotid duct ligation for sialorrhoea

In this case series with retrospective review we compared the outcomes of patients with sialorrhoea who had a submandibular excision (SE) alone and those who had submandibular excision with parotid duct ligation (SE + PL) between 2012 and 2018. Primary endpoints of complication rates and caregivers' perceptions of success were collected. A total of 41 submandibular excisions were performed for sialorrhoea (26 patients underwent SE, while 15 underwent SE + PL). Significant differences in the groups existed at baseline with patients in the SE plus PL group being more likely to have a tracheostomy (p = 0.015), to use sublingual atropine (p = 0.038) and respiratory medications (albuterol p = 0.0075, gentamicin p = 0.018), to have more pneumonias six months prior to the procedure (p < 0.001), and more hospitalisations six months prior to the procedure (p = 0.046). More postoperative surgical site complications were associated with ligation (p = 0.012). There was no difference in systemic infection (p = 0.25), and no difference in caregivers' perceptions of success in reducing sialorrhoea (18/24 SE compared with 10/14 SE + PL, p = 1.00). There were more surgical site complications in those undergoing SE plus PL than in those who had SE alone. Given this data, parotid duct ligation may not yield additional benefit when combined with submandibular excision.