Contemporary surgical management of severe sialorrhea in children.

The causes of severe sialorrhea (drooling) are reviewed, and in particular in children in whom it can become a life-long disability. The history of medical and surgical treatments is discussed. A major advance has been the surgical relocation of the submandibular gland ducts with removal of sublingual glands. The results of this operation, technical considerations, and its outcomes in 16 children are presented. There were no significant complications. Caregivers judged the efficacy with a median score of "75%" improvement. The technique has become the most logical and reliable surgical treatment for drooling, with very good control in most cases. In contrast to "Botox" its effects are permanent.