THE SURGICAL-MANAGEMENT OF DROOLING - A 15 YEAR FOLLOW-UP

Drooling is rarely seen in the normal child after the age of 6 months, but an estimated 10% of children with neurological impairment suffer significant interference with everyday living due to excessive droolin g. Submandibular duct relocation is a procedure that involves the diss ection and re-routing of the submandibular ducts to the posterior tons illar pillar. This procedure has been carried out on 53 patients over the past 15 years at the Childrens Hospital, Dublin. All patients have been followed up with a detailed questionnaire to determine symptomat ic improvement. parent satisfaction and complications. Parental satisf action regarding this procedure is high, with 94% of parents stating t hat their child had benefited from the operation and over half the par ents reported complete cessation of all drooling within 3 months of th e operation. The major complication of post-operative pneumonia presum ed secondary to salivary aspiration occurred in three children. These patients all made a full recovery. Early minor complications occurred in two children. involving post-operative submandibular gland swelling , and the late complication of a ranula was seen in four patients. We believe this is a safe and highly successful procedure that can signif icantly improve the quality of life of these children.