The drooling patient: evaluation and current surgical options.

Drooling is a common stigmatizing problem necessitating increased care in the neurologically damaged child or adult. Appropriate physiotherapy frequently reduces drooling but rarely eliminates it. The goal of surgical therapy is to minimize drooling while specifically avoiding the complication of xerostomia. During the past 4 years, 37 of 46 patients assessed have undergone surgery specifically intended to reduce drooling. Good results have been obtained with bilateral transtympanic neurectomy procedures; it is the surgical procedure of choice in the more retarded patient. Encouraging results have been obtained in six patients with bilateral submandibular duct relocation; because of increased operative morbidity, it is the procedure of choice in the less retarded child.