Bilateral transcervical submandibular gland excision for drooling: A study of the mature scar and long-term effects

Eur J Paediatr Neurol. 2016 Sep;20(5):738-44. doi: 10.1016/j.ejpn.2016.05.001. Epub 2016 May 11.

Abstract

Aim: Several surgical techniques are available to treat drooling in neurologically disabled children and adolescents, with bilateral submandibular gland excision being the only transcervical procedure. External scars can be a reason to decline for this surgical approach. We investigated which factors influenced caregiver satisfaction by evaluating the long-term scar in relation to treatment outcome.

Methods: We identified a historical cohort, in which all neurologically disabled patients who underwent bilateral submandibular gland excision for drooling between January 2009 and December 2013 were identified (n = 41). The Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate observer and clinician satisfaction. All included patients were contacted by telephone and completed a digital questionnaire that included digital images of the scars.

Results: Of the caregivers that responded the questionnaire 76% (19/25) were satisfied with the overall outcome. Twenty-four (96%) caregivers considered the scars acceptable. Caregiver satisfaction was not correlated to the appearance of scars, but was significantly correlated with the decrease in drooling severity on a visual analogue scale (p = 0.035) and decrease in lower respiratory tract infections (p = 0.042).

Interpretation: The appearance of scars does not influence satisfaction after bilateral submandibular gland excision for drooling. As expected, satisfaction is correlated to the treatment outcome.

Keywords: Cerebral palsy; Drooling; Mental retardation; Surgery.

MeSH terms

  • Adolescent
  • Caregivers
  • Child
  • Cicatrix
  • Female
  • Humans
  • Male
  • Sialorrhea / surgery*
  • Submandibular Gland / surgery*
  • Surveys and Questionnaires
  • Treatment Outcome