Treatment of patients with sialorrhea. A systematic review
Keywords:
Drooling, sialorrhea, botulinum toxin, salivary duct ligation, salivary duct relocation, salivary gland resectionAbstract
Introduction: Sialorrhea, defined as the unintentional and passive loss of saliva from the oral cavity due to a dysfunction in the coordination of the swallowing mechanism, is a relevant medical problem that generates important disability and negative effects on the physical health and quality of life of patients with chronic neurological disabilities. Various approaches have been described to manage this condition, including oral motor therapy, behavior modification with biofeedback, drug therapy with anticholinergic medications or botulinum toxin, and a wide range of surgical treatments. Objective: To provide a thorough overview of sialorrhea and its different treatment modalities. Methods: We analyzed by PubMed, MD consult, and Ovid-SP data bases. Discussion: We describe the initial evaluation of the patient with sialorrhea and the subjective and objective methods to evaluate its severity. The diverse treatment modalities for this pathology as well as their results are described. Conclusions: Sialorrhea is a complex pathology that requires a multidisciplinary management. Multiple treatment modalities exist and they should be considered according to the severity of the problem. Oral motor training should be considered as the first line of treatment. Botulinum toxin is effective in cases in which conservative measures are not sufficient. Surgical treatment is the last resource; diverse effective surgical techniques have been developed.
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