Does the addition of sublingual gland excision to submandibular duct relocation give better overall results in drooling control?

Abstract

Submandibular duct relocation plus or minus excision of the sublingual glands are relatively simple procedures with low morbidity. Between 1981 and 2005, 71 submandibular duct relocation and 29 submandibular duct relocation plus excision of the sublingual glands procedures were conducted.

Objectives: To compare both procedures including operative time, length of hospital stay, postoperative complications, drooling scores and parental satisfaction.

Study design: Prospective study.

Setting: Paediatric tertiary referral centre.

Participants: Patients referred with excessive drooling after failure of conservative methods.

Exclusion criteria: patients with recurrent aspiration pneumonias or dental caries. Two patients were lost to follow up and excluded from the study.

Results: Operative time and length of hospital stay were increased in the submandibular duct relocation plus sublingual gland excision group. Drooling scores and parental satisfaction results were excellent, 93% of parents in the submandibular duct relocation group and 89% of parents in the duct relocation plus sublingual glands excision were satisfied and would recommend the procedure. There was no statistical difference (P = 0.643) in drooling scores between the two procedures. Postoperative morbidity was higher with the addition of sublingual gland excision, with postoperative haemorrhage occurring in 13.7% and 36% of parents expressing concern over postoperative pain, compared with 3% postoperative haemorrhage rate with submandibular duct relocation and only 12% of parents expressing the same concerns.

Conclusion: We conclude that both procedures are effective in drooling control, but the addition of sublingual gland excision increases morbidity and we are no longer excising these glands with submandibular duct relocation.