168 CHAPTER 8 ABSTRACT Objectives To evaluate if drooling recurrence after surgery of the submandibular ducts is due to surgical failure or other variables. Methods Historic cohort with prospective collected data of all patients with severe drooling who underwent unsuccessful submandibular duct surgery with subsequent reintervention between 2003 and 2018. A reference cohort was used for comparison of clinical variables. Results Six males and 4 females were included (cerebral palsy n=8, neurodevelopmental disorders n=2). All patients underwent submandibular gland surgery as a primary intervention (duct ligation n=8, submandibular duct relocation n=2) followed by reintervention (submandibular gland excision n=7, parotid duct ligation n=3). One patient underwent tertiary surgery (parotid duct ligation after re-intervention by submandibular gland excision). Three patients were successful after re-intervention. No difference was found between both re-intervention techniques. There was significantly more severe dental malocclusion (50% vs. 21%, P value = 0.047) and severe speech disorders (80% vs. 42%, P value = 0.042) in the current cohort when compared to the reference cohort. Conclusion Recurrence of drooling surgery is most likely not caused by surgical failure of the primary intervention, because re-intervention (submandibular gland excision) did not lead to more success. Dysarthria and dental malocclusion might negatively influence treatment outcome.
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