Burton M J
Department of Otolaryngology, Radcliffe Infirmary, Oxford.
Dev Med Child Neurol. 1991 Dec;33(12):1110-6. doi: 10.1111/j.1469-8749.1991.tb14835.x.
As with all branches of surgery, selection of the appropriate operative procedure for a particular patient involves careful weighing of all the alternatives and full discussion with the patient and carers. Each of the procedures described has its devotees and detractors. For an individual patient, however, the risks of each, the likely postoperative course and the results of the surgery--both in terms of the expected chance of improvement in drooling and the presence or otherwise of residual scarring or taste--must be balanced to determine the optimum plan for treatment. The long-term results of submandibular duct transposition for drooling in the author's own institution have recently been reported. An initial improvement in the drooling of all patients was maintained for at least two years in 17 of 20 patients. Only two patients experienced complications requiring further surgery (ranulas in each case). It is suggested that these very satisfactory results, achieved without external scarring and without compromising the sense of taste, support the contention that submandibular duct transposition is the surgical treatment of choice for children and young people with cerebral palsy who drool excessively.
与所有外科分支一样，为特定患者选择合适的手术程序需要仔细权衡所有备选方案，并与患者及其护理人员进行充分讨论。所描述的每种手术都有其支持者和反对者。然而，对于个体患者而言，必须权衡每种手术的风险、术后可能的病程以及手术结果——包括流涎改善的预期几率以及是否存在残留瘢痕或味觉问题——以确定最佳治疗方案。作者所在机构关于下颌下腺导管移位术治疗流涎的长期结果最近已有报道。20例患者中有17例，所有患者流涎的初步改善至少维持了两年。只有两名患者出现需要进一步手术的并发症（均为舌下囊肿）。有人认为，这些非常令人满意的结果是在没有外部瘢痕且不影响味觉的情况下取得的，这支持了下颌下腺导管移位术是治疗流涎过多的脑瘫儿童和青少年的首选手术治疗方法这一观点。
