Four-duct ligation in children with drooling.
OBJECTIVE
The objective of this study is to assess the improvement in drooling in children undergoing 4-duct ligation procedure for excessive drooling and to study its effect on their quality of life.


METHODS
A prospective, nonrandomized interventional study was done between November 2009 and September 2011. Thirty drooling children of both sexes aged 4 to 15 years underwent 4-duct ligation, that is, ligation of bilateral submandibular ducts and bilateral parotid ducts. Comparison of preoperative and postoperative drooling scores using Thomas-Stonell and Greenberg classification was done. Glasgow Children's Benefit Inventory Score was used to assess the improvement in the quality of life.


RESULTS
Success rate in terms of improvement in drooling was 93.33%. A complication rate of 16.67% was found. The mean improvement in total drooling score after 12 months was 4.43. The paired t test applied on preoperative and postoperative combined drooling scores showed P < .001. The mean Glasgow Children's Benefit Inventory score was 36.15. In the postoperative period, transient swelling of cheeks, transient swelling of submandibular glands, change in the consistency of saliva, cheek abscess, collection of saliva in the cheek, and parotid duct fistula were observed.


CONCLUSIONS
Four-duct ligation causes marked improvement in drooling and significantly increases the quality of life in drooling children. It has few complications, which can be managed effectively.
Otorhinolaryngology and Head and Neck Surgery, LHMC and Associated Hospitals, New Delhi, India. pristinelife80@gmail.com
Ningthoujam Pinky
NP
Chanu
Jatinder Kumar
JK
Sahni
Satinder
S
Aneja
Shakuntala
S
Naglot
D000293:Adolescent; D002610:Cheek / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D010306:Parotid Gland / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D018987:Salivary Ducts / Q000601:surgery*; D012798:Sialorrhea / Q000523:psychology / Q000601:surgery*; D013363:Submandibular Gland / Q000601:surgery*; D016896:Treatment Outcome