Four-Duct Ligation for the Treatment of Sialorrhea in Children

Khan, Waqas Ullah; Islam, Alvi H.; Fu, Ann; Blonski, Diane C.; Zaheer, Salaha; McCann, C; Joseph, Melissa; Perlin, Rebecca; Khan, Rajab; Campisi, Paolo

doi:10.1001/jamaoto.2015.3592

Cited by 22 publications

(31 citation statements)

References 15 publications

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“…Studies reviewed indicated surgical management of sialorrhoea is effective (Khadivi et al, ; Khan et al, ; Kok et al, ; Puraviappan et al, ; Stamataki et al, ; Stern et al, ). Unfortunately, apart from children with CP, there have been very few clinical studies based on patients with any other sialorrhoea‐related neurological disorders.…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, apart from children with CP, there have been very few clinical studies based on patients with any other sialorrhoea‐related neurological disorders. Side effects were also reported, such as ranula, sialoadenitis, transient swelling of the mouth floor, pneumonia and operative urinary retention (Khadivi et al, ; Khan et al, ; Kok et al, ; Puraviappan et al, ). Dry mouth and dental caries were also reported in one study (Stern et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Dry mouth and dental caries were also reported in one study (Stern et al, ). Retrospective studies have indicated that there can be some gradual return of sialorrhoea (Khan et al, ; Stamataki et al, ). Although evidence in relation to the results of surgical intervention is of low quality and varied, the majority of patients still experience subjective improvements after surgery, and a positive improvement in social interaction in addition to increased self‐esteem (Kok et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…The surgery includes rerouting or blocking the flow of saliva by inducing atrophy of the glands via ligation, or stopping saliva production by removing the salivary glands (Osorio, Moreira-Pinto, Oliveira, Ferreira-de-Sousa, & Cidade-Rodrigues, 2009;Reed, Mans, & Brietzke, 2009). It seems that surgeries are generally carried out on children with CP (Khadivi et al, 2013;Khan et al, 2016;Kok et al, 2016;Puraviappan, Dass, & Narayanan, 2007;Stamataki, Behar, & Brodsky, 2008;Stern, Feinmesser, Collins, Shott, & Cotton, 2002).…”

Section: Surgery (Seementioning

confidence: 99%

“…Studies reviewed indicated surgical management of sialorrhoea is effective (Khadivi et al, 2013;Khan et al, 2016;Kok et al, 2016;Puraviappan et al, 2007;Stamataki et al, 2008;Stern et al, 2002).…”

Section: Surgery (Seementioning

confidence: 99%

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A systematic review of noninvasive and invasive sialorrhoea management

Varley

Denieffe

O’Gorman

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To review published literature pertaining to the management of sialorrhoea while also highlighting the significance of the multidisciplinary approach. Background Sialorrhoea is a common and troublesome problem among certain neurological patients. It is distressing for patients and caregivers, and can be challenging for healthcare professionals. Various sialorrhoea management approaches have been documented. However, there is no clear consensus on best management practices. Therefore, it is necessary to systematically review and synthesise various approaches so as to provide an understanding of the efficacy of management approaches. Design Systematic literature review using PRISMA checklist (see Appendix S1). Method Five databases (ScienceDirect, Wiley Online Library, CINAHL, Cochrane Library and PubMed) were searched (years 2001–2018) following inclusion criteria. Out of 1,294 identified records, 29 studies met the inclusion criteria. Results Various management approaches identified, ranging from noninvasive, such as speech therapy aiming to enhance swallowing behaviour, to invasive treatment including anticholinergic medication, botulinum toxin injection and surgical techniques. However, in the majority of cases, there is no scientific evidence‐based management protocol leading to favourable results, and the evidence base for intervention effectiveness remains weak. Conclusions The multifactor nature of sialorrhoea and its associated complications presents challenges for the medical care team. None of the management strategies stand alone as the best modality; therefore, it is proposed that management strategies follow a multidisciplinary approach to meet the diverse needs of patients. Relevance to clinical practice A comprehensive understanding of different sialorrhoea management approaches will enable healthcare professionals to identify the signs and symptoms regarding sialorrhoea, and to assist in effective management implementation. This will help to improve the management of sialorrhoea, hence, to improve quality of life of patients and provide formative scope to the development of an integrated care pathway.

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