Review Articles

Surgical Management of Sialorrhea: A Systematic Review and Meta-analysis

Corresponding Author

Sam D. Schild MD

[email protected]

State University of New York, Brooklyn, New York, USA

Sam D. Schild, MD, Department of Otolaryngology–Head and Neck Surgery, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Suite MSC 126, Brooklyn, NY 11203, USA. Email: [email protected]Search for more papers by this author

Alisa Timashpolsky MD,

Alisa Timashpolsky MD

State University of New York, Brooklyn, New York, USA

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Daniel P. Ballard MD,

Daniel P. Ballard MD

State University of New York, Brooklyn, New York, USA

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Sylvia Horne MD,

Sylvia Horne MD

State University of New York, Brooklyn, New York, USA

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Richard M. Rosenfeld MD, MPH, MBA,

Richard M. Rosenfeld MD, MPH, MBA

State University of New York, Brooklyn, New York, USA

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Ann W. Plum MD,

Ann W. Plum MD

State University of New York, Brooklyn, New York, USA

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Sam D. Schild MD,

Corresponding Author

Sam D. Schild MD

[email protected]

State University of New York, Brooklyn, New York, USA

Alisa Timashpolsky MD,

Alisa Timashpolsky MD

State University of New York, Brooklyn, New York, USA

Search for more papers by this author

Daniel P. Ballard MD,

Daniel P. Ballard MD

State University of New York, Brooklyn, New York, USA

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Sylvia Horne MD,

Sylvia Horne MD

State University of New York, Brooklyn, New York, USA

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Richard M. Rosenfeld MD, MPH, MBA,

Richard M. Rosenfeld MD, MPH, MBA

State University of New York, Brooklyn, New York, USA

Search for more papers by this author

Ann W. Plum MD,

Ann W. Plum MD

State University of New York, Brooklyn, New York, USA

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First published: 26 January 2021

https://doi.org/10.1177/0194599820985165

Citations: 14

This article was presented at the AAO-HNSF 2020 Virtual Annual Meeting & OTO Experience; September 13, 2020.

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Abstract

Objective

Chronic sialorrhea commonly occurs in patients with neurodevelopmental disorders. While conservative management can provide sufficient symptom control, surgical intervention is often required. One of the most common procedures utilized is submandibular gland excision (SMGE), with or without parotid duct ligation or rerouting (PDL or PDR). This study aims to compare these surgical approaches and their outcomes.

Data Sources

PubMed, Web of Science, and Embase.

Review Methods

This systematic review includes studies of patients with chronic sialorrhea treated with SMGE alone or SMGE plus PDR or PDL and reports on postintervention outcomes and complications. Two independent investigators assessed study eligibility, rated quality, and extracted data for analysis. A random effects model was used for meta-analysis of pooled data.

Results

Of 3186 studies identified, 21 met inclusion criteria, with 708 patients: 103 underwent SMGE alone (15%); 299 (42%), SMGE and PDL; and 306 (43%), SMGE plus PDR. Overall, a majority of patients had significant improvement, with very good to excellent control of symptoms after surgery: SMGE, 82% (95% CI, 73%-89%); SMGE and PDL, 79% (95% CI, 73%-85%); and SMGE and PDR, 85% (95% CI, 75%-92%). Importantly, there was no significant difference in outcomes with the addition of PDL or PDR. Reported complications included sialocele, parotitis, dental caries, and dry mouth.

Conclusion

Our systematic review identified consistent positive outcomes with SMGE for patients with chronic sialorrhea but no additional benefit when PDR or PDL was performed as a concurrent procedure.

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Volume165, Issue4

October 2021

Pages 507-518

Surgical Management of Sialorrhea: A Systematic Review and Meta-analysis

Abstract

Objective

Data Sources

Review Methods

Results

Conclusion

References

Citing Literature

References

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Surgical Management of Sialorrhea: A Systematic Review and Meta-analysis

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Objective

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Citing Literature

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