The medium to long-term effects of two-duct ligation for excessive drooling in neurodisabilities, a cross-sectional study

Int J Pediatr Otorhinolaryngol. 2021 Nov:150:110894. doi: 10.1016/j.ijporl.2021.110894. Epub 2021 Aug 27.

Abstract

Objectives: This study aims to evaluate the medium to long-term (1-12 years) effectiveness of two-duct ligation (2-DL) in patients with nonprogressive neurodisabilities.

Methods: Main outcomes included a Visual Analogue Scale (VAS), Drooling Severity (DS) and Drooling Frequency (DF), collected at baseline, 32 weeks postintervention and 1-12 years postintervention. Secondary outcomes were adverse events (AEs), and satisfaction.

Results: Forty-two patients were analyzed (mean age 17 years, mean baseline VAS 82). VAS decreased significantly from baseline to long-term (n = 30. Mean difference -36.5, CI -47.0 to -26.0, p ≤ 0.001; -26.1, CI -36.2 to -15.9, p ≤ 0.001). However, long-term VAS significantly increased compared to VAS at 32 weeks (+10.4, CI 1.0-19.8, p = 0.031). Out of 42 patients, 64% would recommend 2-DL to peers.

Conclusion: There is a significant subjective 2-DL effect on drooling severity in the medium to long-term as reported by patients and caregivers, but there is also a certain degree of recurrence in this time span, and 33% of the patients required subsequent treatment. However, the majority of patients and/or caregivers would recommend 2-DL to peers.

Keywords: Cerebral palsy; Drooling; Duct-ligation; Neurodevelopmental disorder.

MeSH terms

  • Adolescent
  • Cerebral Palsy*
  • Cross-Sectional Studies
  • Humans
  • Neoplasm Recurrence, Local
  • Sialorrhea* / etiology
  • Sialorrhea* / surgery
  • Submandibular Gland
  • Treatment Outcome