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Submandibular Gland Excision in Pediatric Patients
Christopher L Kalmar1, Vijay A Patel2, Zachary D Zapatero1
1Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia.
The Journal of Craniofacial Surgery
|November 2, 2021
Summary
Children undergoing submandibular gland excision for ptyalism (excessive salivation) face higher risks. This condition is linked to more complications, longer procedures, and increased respiratory issues compared to other reasons for the surgery.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Surgical Outcomes Research
Background:
- Submandibular gland excision in children is often necessitated by ptyalism (excessive salivation).
- These children frequently present with comorbidities, notably neurodevelopmental disorders and respiratory challenges.
- Understanding the perioperative profile is crucial for managing this specific pediatric surgical cohort.
Purpose of the Study:
- To analyze the perioperative outcomes of pediatric submandibular gland excision.
- To specifically investigate the profile of children undergoing this procedure for ptyalism.
- To compare outcomes between ptyalism and other indications for submandibular gland excision.
Main Methods:
- Utilized the American College of Surgeons National Surgical Quality Improvement Program Pediatric dataset (2012-2018).
- Subclassified indications for submandibular gland excision using ICD-9 and ICD-10 codes.
- Analyzed complications, readmissions, and reoperations using statistical methods.
Main Results:
- 304 pediatric patients underwent submandibular gland excision; ptyalism was the primary indication (56.9%).
- Ptyalism cases were associated with younger age, longer operative times, and significantly higher rates of adverse events, readmissions, and medical complications, including pneumonia.
- Children with ptyalism exhibited higher rates of respiratory comorbidities, such as chronic lung disease, oxygen dependence, and tracheostomy.
Conclusions:
- Pediatric submandibular gland excision for ptyalism identifies a distinct patient group.
- This cohort experiences a greater burden of preoperative risk factors and postoperative adverse events.
- Outcomes for excision due to neoplasms were not significantly different from baseline adverse event rates.
