{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:45:16Z","timestamp":1783604716366,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T00:00:00Z","timestamp":1602115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The best surgical option to treat drooling in neurodisabilities is still under debate. The aim of this study was to describe the technique of subtotal functional sialoadenectomy (SFS) (ie four\u2010duct ligation (4\u2010DL) together with bilateral sublingual gland excision) and its long\u2010term outcomes, in comparison with 4\u2010DL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Unit of Pediatric Surgery of Bambino Ges\u00f9 Children's Hospital (Rome).<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Seventy\u2010five patients surgically treated for drooling between 2002 and 2012, with at least five years of follow\u2010up, divided into two groups: 4\u2010DL group (19 patients) underwent four\u2010duct ligation, and SFS group (56 patients) underwent subtotal functional sialoadenectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Primary end points were the evaluation of drooling improvement after surgery (parameters: Drooling Severity and Frequency Scale, DSFS; no of bibs\/day; no of shirts\/day; no of pneumonia\/year; use of antidrooling drugs) and the comparison between two different surgical techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age at surgery was 10\u00a0years (1\u201035). Long\u2010term outcomes showed significant improvement in DSFS and in no of shirts\/day in both groups. Significantly better results were found in the SFS group than in the 4\u2010DL group as far as DSFS (<jats:italic>P<\/jats:italic> value .045), no of bibs\/day (<jats:italic>P<\/jats:italic> value .041), no of shirts\/day (<jats:italic>P<\/jats:italic> value .032) are concerned. Reoperation rate for recurrence was 42% in the 4\u2010DL group and 0% in the SFS group (<jats:italic>P<\/jats:italic> value\u00a0&lt;\u00a0.0001). Six patients (8%; 2 in the 4\u2010DL group and 4 in the SFS group) experienced perioperative complications, while 4 patients (5%; 2 in the 4\u2010DL group and 2 in the SFS group) recorded long\u2010term complications, with no difference between groups neither need for surgical treatment. No surgery\u2010related mortality was recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our experience, subtotal functional sialoadenectomy ensured significantly greater long\u2010term effects than four\u2010duct ligation for drooling treatment in neurologically impaired child, with equal complication rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13650","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T01:05:29Z","timestamp":1600823129000},"page":"222-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Subtotal functional sialoadenectomy vs four\u2010duct ligation for the treatment of drooling in neurologically impaired children: Long\u2010term follow\u2010up"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2815-2121","authenticated-orcid":false,"given":"Francesco","family":"De 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