title: The impact of submandibular duct relocation on drooling and the well-being of children with neurodevelopmental disabilities.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of a reduction in drooling after bilateral submandibular duct relocation (SMDR) with sublingual gland excision on daily life and care, as well as social and emotional consequences in children and adolescents with neurodevelopmental disabilities.
  
  
  METHODS
  This prospective cohort study included 72 children and adolescents (46 males, 26 females) with moderate to severe drooling, and their caregivers. Mean age at the time of surgery was 15 years 2 months (SD 4y 3mo). Fifty-two children were diagnosed with cerebral palsy and 20 had other non-progressive developmental disabilities. A caregiver questionnaire to document the impact of drooling on daily care and economic consequences, social interaction and emotional development and self-esteem was administered before, and 8 and 32 weeks after surgery.
  
  
  RESULTS
  Following bilateral SMDR the mean Visual Analogue Scale (VAS, 0-100) scores demonstrated a significant (p < 0.001) reduction in the severity of drooling from 81 at baseline to 28 and 36 after 8 and 32 weeks, respectively. This was accompanied by a decrease in the amount of daily care required and reduced economic consequences. In addition, an increase in social contact with other children and adults was reported by caregivers after surgery.
  
  
  CONCLUSIONS
  Bilateral SMDR with sublingual gland excision provides a significant positive reduction in daily care of children suffering from drooling. Caregivers also report positive changes in their child's social interaction and sense of self-esteem.
authors: Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands. Electronic address: saskia.kok@radboudumc.nl.
authors: Saskia E
authors: SE
authors: Kok
authors: Department of Social Sciences/Pedagogical and Educational Sciences, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands; Department of Pediatric Rehabilitation, St. Maartenskliniek, Hengstdal 3, 6574 NA, Ubbergen, The Netherlands. Electronic address: j.vanderburg@maartenskliniek.nl.
authors: Jan J W
authors: JJ
authors: van der Burg
authors: Department of Rehabilitation, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands. Electronic address: karen.vanhulst@radboudumc.nl.
authors: Karen
authors: K
authors: van Hulst
authors: Department of Pediatric Neurology, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands. Electronic address: corrie.erasmus@radboudumc.nl.
authors: Corrie E
authors: CE
authors: Erasmus
authors: Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands. Electronic address: frank-kno.vandenhoogen@radboudumc.nl.
authors: Frank J A
authors: FJ
authors: van den Hoogen
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D002547:Cerebral Palsy / Q000150:complications* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011446:Prospective Studies; D012649:Self Concept; D012798:Sialorrhea / Q000209:etiology / Q000523:psychology* / Q000601:surgery*; D013361:Sublingual Gland / Q000601:surgery*; D013363:Submandibular Gland / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Children and adolescents; Quality of life; Sialorrhea; Submandibular duct rerouting