The impact of submandibular duct relocation on drooling and the well-being of children with neurodevelopmental disabilities

• Published in: International journal of pediatric otorhinolaryngology Vol. 88; pp. 173 - 178
• Main Authors: Kok, Saskia E, van der Burg, Jan J.W, van Hulst, Karen, Erasmus, Corrie E, van den Hoogen, Frank J.A
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.09.2016
• Subjects: Adolescent; Adult; Caregivers; Cerebral Palsy - complications; Cerebral Palsy - psychology; Child; Child, Preschool; Children and adolescents; Developmental Disabilities - complications; Developmental Disabilities - psychology; Female; Humans; Interpersonal Relations; Male; Otolaryngology; Pediatrics; Prospective Studies; Quality of life; Self Concept; Sialorrhea; Sialorrhea - etiology; Sialorrhea - psychology; Sialorrhea - surgery; Sublingual Gland - surgery; Submandibular duct rerouting; Submandibular Gland - surgery; Surveys and Questionnaires; Ear, Nose, and Throat; visual analogue scale; submandibular duct relocation; Gross Motor Functional Classification System; VAS; ENT; submandibular duct rerouting; CP; SMDR; QoL; Quality of Life; children and adolescents; cerebral palsy; GMFCS; sialorrhea; Submandibular duct rerouting; Children and adolescents; Sialorrhea; Quality of life
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2016.06.043

Abstract Objective The aim of this study was to evaluate the impact of a reduction in drooling after bilateral submandibular duct relocation (SMDR) with sublingual gland excision on daily life and care, as well as social and emotional consequences in children and adolescents with neurodevelopmental disabilities. Methods This prospective cohort study included 72 children and adolescents (46 males, 26 females) with moderate to severe drooling, and their caregivers. Mean age at the time of surgery was 15 years 2 months (SD 4y 3mo). Fifty-two children were diagnosed with cerebral palsy and 20 had other non-progressive developmental disabilities. A caregiver questionnaire to document the impact of drooling on daily care and economic consequences, social interaction and emotional development and self-esteem was administered before, and 8 and 32 weeks after surgery. Results Following bilateral SMDR the mean Visual Analogue Scale (VAS, 0-100) scores demonstrated a significant (p<0.001) reduction in the severity of drooling from 81 at baseline to 28 and 36 after 8 and 32 weeks, respectively. This was accompanied by a decrease in the amount of daily care required and reduced economic consequences. In addition, an increase in social contact with other children and adults was reported by caregivers after surgery. Conclusion Bilateral SMDR with sublingual gland excision provides a significant positive reduction in daily care of children suffering from drooling. Caregivers also report positive changes in their child’s social interaction and sense of self-esteem.