title: Laser intraductal photocoagulation of bilateral parotid ducts for reducing drooling of cerebral palsied children: a preliminary report.
abstract: Previous reports suggested that surgical treatment was effective to reduce abnormal, profuse drooling in children with low cognitive function, but with risk of complications. Laser photocoagulation might be an option to simplify the procedure and decrease complications. Our study considered whether laser photocoagulation could improve drooling in children with cerebral palsy (CP). CP children with drooling were recruited from the pediatric rehabilitation clinic, all of whom had persistent profuse drooling after 6 months of conservative treatment. They received neodymium:yttrium aluminum garnet (Nd:YAG) laser for intraductal photocoagulation to bilateral parotid ducts, and were followed up for 2 to 3 months. Each patient was assessed before and after the procedure by: 1) questionnaire-based semiquantitative assessment of drooling severity and frequency (Thomas-Stonell and Greensberg 1988); 2) quantitative assessment of saliva amount by collection of stimulated saliva for 2 minutes in cooperative children. Six CP children with severe drooling received laser photocoagulation, five of them had remarkable decrease of drooling 1 month later. Patients had cool liquid intake soon after the procedure, and were discharged on the second day after treatment. A period of transient face swelling ranged from 6 to 37 days. No antibiotic treatment was indicated nor were any complications noted after the procedure. As a result of these studies, it is suggested that laser intraductal photocoagulation of bilateral parotid duct could be used as a simple and effective procedure for reducing drooling in CP children, and would avoid complications from conventional surgery.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Childrens Hospital, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, R.O.C.
authors.forename: A M
authors.initials: AM
authors.lastname: Wong
authors.forename: C J
authors.initials: CJ
authors.lastname: Chang
authors.forename: L R
authors.initials: LR
authors.lastname: Chen
authors.forename: M M
authors.initials: MM
authors.lastname: Chen
mesh_terms: D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D010306:Parotid Gland / Q000601:surgery*; D018987:Salivary Ducts / Q000601:surgery*; D012472:Salivation / Q000502:physiology; D012798:Sialorrhea / Q000209:etiology / Q000601:surgery*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome