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n South African Journal of Child Health - Surgical management of sialorrhoea : a review and outcome report from Red Cross Hospital, Cape Town
Aim. To review the surgical management of sialorrhoea (submandibular duct transposition with or without bilateral excision of the sublingual salivary glands : the 'drooling procedure', DP) at Red Cross War Memorial Children's Hospital, Cape Town.
Patients and methods. A retrospective review of the medical records of patients who had undergone a DP between 1996 and 2003, to ascertain the results of the procedure and complications. Subsequently a questionnaire was sent to all patients with a recognisable postal address to ascertain long-term satisfaction with the procedure.
Results. Forty-six patients had had a DP, and 32 of the medical records were available for analysis. In 23 cases a comment had been recorded on the result of the procedure; 18 (78%) had shown 'marked' improvement and 5 (22%) 'a little' improvement. The medical records indicated that 2 patients had had immediate postoperative problems : one patient was slow to commence oral feeding and another required a single high dose of intravenous steroids to resolve marked oedema of the floor of the mouth. In the longer term, one patient developed a ranula (a mucus inclusion cyst). Ten postal questionnaires, were returned; of these 8 reported an improvement in the symptoms.
Discussion. Short-term improvement was recorded in 78% of patients, and although only 10 questionnaires were returned, 8 of these indicated satisfaction with the procedure. It is impossible to draw conclusions, however, as the large number of patients (36 of the original 46) lost to follow-up could have had a poor outcome. There is need for prospective studies on the long-term outcome of the DP.
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