The effect of submandibular duct rerouting in the treatment of sialorrhea in children.

Sialorrhea is an indication of an upset in the coordinated mechanism control of facial tone and palate musculature. Disturbance in this coordination results in excess pooling of saliva in the anterior mouth and resultant drooling. In addition to the hygienic problems associated with drooling, sialorrhea also interferes with speech clarity and nutrition. It may also cause increased infections and dehydration, and may provide for further isolation of the afflicted from the mainstream of life. Current therapeutic modalities are reviewed and compared with submandibular duct rerouting. Twenty-five consecutive pediatric patients in whom submandibular duct rerouting was performed are evaluated for postoperative drooling and submandibular gland function. The procedure was found to have low morbidity and to be effective in control of sialorrhea in pediatric patients.