Delsing Corinne P A, Adriaansens Carleen, van Hulst Karen, Erasmus Corrie E, van den Hoogen Frank J A
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Philips Van Leijdenlaan 15 (route 377), Postbus 9101, Nijmegen, 6500 HB, the Netherlands.
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Philips Van Leijdenlaan 15 (route 377), Postbus 9101, Nijmegen, 6500 HB, the Netherlands.
Int J Pediatr Otorhinolaryngol. 2023 Jan;164:111377. doi: 10.1016/j.ijporl.2022.111377. Epub 2022 Nov 11.
Submandibular gland excision (SMGE) is suitable for the management of drooling in patients with non-progressive neurodisabilities. We aimed to investigate the long-term effects of SMGE.
Patients who had SMGE between 2007 and 2018 were included. Main outcomes were a Visual Analogue Scale (VAS), Drooling Severity (DS), and Drooling Frequency (DF) collected at baseline, 8 weeks, 32 weeks and with a median of 313 weeks after SMGE (long-term). Secondary outcomes were satisfaction with the procedure, Drooling Quotient (DQ) and adverse events (AEs).
We included thirty-five patients in the long-term analysis with a mean age of 14.5 years. A baseline VAS score of 80.4 was found, which improved on the long-term (mean difference -21.8, t(26) = 4.636, p < 0.0005)). DS and DF decreased significantly at the long-term compared to baseline (Z = -4.361, p < 0.0001 for DS, Z = -3.065, p = 0.002 for DF). Twenty-three out of 35 (66%) patients would recommend the procedure to peers.
This study indicates a long-term stable effect on drooling after SMGE in patients with anterior drooling. Recurrence of drooling occurs due to unknown reasons, nevertheless most caregivers and/or patients are still satisfied and would recommend the procedure to others.
下颌下腺切除术(SMGE)适用于治疗非进行性神经功能障碍患者的流涎问题。我们旨在研究SMGE的长期效果。
纳入2007年至2018年间接受SMGE的患者。主要结局指标为在基线、术后8周、32周以及SMGE术后中位时间313周(长期)收集的视觉模拟量表(VAS)、流涎严重程度(DS)和流涎频率(DF)。次要结局指标为对手术的满意度、流涎商数(DQ)和不良事件(AE)。
我们纳入了35例患者进行长期分析,平均年龄为14.5岁。发现基线VAS评分为80.4,长期来看有所改善(平均差值-21.8,t(26)=4.636,p < 0.0005)。与基线相比,长期时DS和DF显著降低(DS:Z = -4.361,p < 0.0001;DF:Z = -3.065,p = 0.002)。35例患者中有23例(66%)会向同龄人推荐该手术。
本研究表明,SMGE对前位流涎患者的流涎问题有长期稳定的效果。流涎复发原因不明,不过大多数照料者和/或患者仍感到满意,并会向他人推荐该手术。