{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:41:19Z","timestamp":1783021279842,"version":"3.54.6"},"reference-count":13,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,12]],"date-time":"2023-02-12T00:00:00Z","timestamp":1676160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of this study was to evaluate our institutions airway management and complications after submandibular duct relocation (SMDR). We analysed a historic cohort of children and adolescents who were examined at the Multidisciplinary Saliva Control Centre between March 2005 and April 2016. Ninety-six patients underwent SMDR for excessive drooling. We studied details of the surgical procedure, postoperative swelling and other complications. Ninety-six patients, 62 males and 34 females, were treated consecutively by SMDR. Mean age at time of surgery was 14 years and 11 months. The ASA physical status was 2 in most patients. The majority of children were diagnosed with cerebral palsy (67.7%). Postoperative swelling of the floor of the mouth or tongue was reported in 31 patients (32.3%). The swelling was mild and transient in 22 patients (22.9%) but profound swelling was seen in nine patients (9.4%). In 4.2% of the patients the airway was compromised. In general, SMDR is a well-tolerated procedure, but we should be aware of swelling of the tongue and floor of the mouth. This may lead to a prolonged period of endotracheal intubation or a need for reintubation which can be challenging. After extensive intra-oral surgery such as SMDR we strongly recommend a extended perioperative intubation and extubation after the airway is checked and secure.<\/jats:p>","DOI":"10.3390\/jcm12041473","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T01:48:56Z","timestamp":1676252936000},"page":"1473","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Postoperative Airway Management after Submandibular Duct Relocation in 96 Drooling Children and Adolescents"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4773-5461","authenticated-orcid":false,"given":"Saskia E.","family":"Kok","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Lemson","sequence":"additional","affiliation":[{"name":"Department of Paediatric Critical Care, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-5599","authenticated-orcid":false,"given":"Frank J. A.","family":"van den Hoogen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,12]]},"reference":[{"key":"ref_1","first-page":"CD008624","article-title":"Interventions for drooling in children with cerebral palsy","volume":"11","author":"Walshe","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S1015-9584(08)60024-X","article-title":"Efficacy of relocation of submandibular duct in cerebral palsy patients with drooling","volume":"30","author":"Puraviappan","year":"2007","journal-title":"Asian J. Surg. \/Asian Surg. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1046\/j.1365-2273.1997.00022.x","article-title":"The surgical management of drooling\u2014A 15 year follow-up","volume":"22","author":"ODwyer","year":"1997","journal-title":"Clin. Otolaryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S2352-4642(18)30022-1","article-title":"The age of adolescence","volume":"2","author":"Sawyer","year":"2018","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1111\/j.1469-8749.2010.03713.x","article-title":"Botulinum toxin versus submandibular duct relocation for severe drooling","volume":"52","author":"Scheffer","year":"2010","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1111\/dmcn.14199","article-title":"Submandibular gland botulinum neurotoxin A injection for predicting the outcome of submandibular duct relocation in drooling: A retrospective cohort study","volume":"61","author":"Kok","year":"2019","journal-title":"Dev. Med. 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Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1097\/01.CCM.0000133019.52531.30","article-title":"Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation","volume":"32","author":"Gajic","year":"2004","journal-title":"Crit. 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