Saliva control surgery in children with disability

The long-term impact of saliva control surgery in children with disability:

Publication date: Available online 2 March 2019

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Susan M. Reid, Christine Westbury, David Chong, Bruce R. Johnstone, Angela Guzys, Dinah S. Reddihough

Abstract

Sialorrhoea is a common problem in children with disability, often negatively affecting socialisation, self-esteem, and burden of care. Saliva control surgery is one available option to manage this problem, particularly when more conservative methods have failed. As little is known about the long-term impact of surgery, we followed up 62 patients who had combined bilateral submandibular duct translocation and bilateral sublingual gland excision at our paediatric hospital between 1994 and 2014. Eligible individuals were identified through a search of ICD procedure codes. When contact with families was successful, they were invited to complete a 14-item questionnaire designed specifically for this study. The results indicated that long-term outcomes of surgery were very good; 13/62 (21%) individuals no longer had a drooling problem and another 30 (48%) experienced only mild to moderate drooling. Although 84% families reported some or major improvement in drooling, 9 families reported that they would not go through the experience again due to a difficult recovery period, lack of effectiveness of the intervention, changes to saliva consistency that caused coughing and gagging, and dental decay. None of the collected variables were predictive of good or poor outcome. The study taught us that surgical intervention is effective in the long term in the majority of cases and can be recommended to other families who attend our saliva control clinic.