Surgical Management of the Drooling Child.
Surgical Management of the Drooling Child.
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DOI：
10.1007/s40136-018-0188-2
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发表时间：
2018
影响因子：
0.6
通讯作者：
Bateman N
中科院分区：
文献类型：
--
作者：
Lawrence R;Bateman N
我们的目标是目前最先进的选择在外科治疗流口水的儿科人口。虽然流口水的儿童和保守的管理方案的临床评估进行了讨论，这次审查的重点是最新的证据，手术干预治疗儿童流口水。在流口水的管理方面的进展，进一步的经验和结果与肉毒杆菌毒素注射的使用进行了讨论。此外，最新的证据基础唾液管结扎和搬迁程序。最后，经口下颌下腺切除术治疗流口水可能会通过降低手术发病率而得到普及。流口水的孩子应该由多学科团队（MDT）提供基于证据的逐步方法进行管理。神经发育正常的儿童应通过父母的安慰进行保守治疗。有许多干预措施可用于神经肌肉发育受损的流涎儿童。当保守措施失败时，治疗方案包括肉毒杆菌毒素注射和外科手术，如唾液管结扎、唾液管移位和唾液腺切除。管理必须针对儿童的个人需求和合并症，以最大限度地提高治疗效果。
Our goal is to present the most up-to-date options in the surgical management of drooling in the paediatric population. While the clinical assessment of the drooling child and conservative management options are discussed, this review focuses on the most recent evidence for surgical interventions to treat drooling in children. In terms of advances in the management of drooling, further experience and outcomes with the use of botulinum toxin injections is discussed. Moreover, the latest evidence-base for salivary duct ligation and relocation procedures are presented. Finally, the trans-oral approach to submandibular gland excision for the management of drooling may gain popularity through the aim of reducing surgical morbidity. The drooling child should be managed with an evidence-based stepwise approach delivered by a multidisciplinary team (MDT). Children with normal neurological development should be treated conservatively through parental reassurance. There are numerous interventions available for the drooling child with impaired neuromuscular development. When conservative measures fail, treatment options include botulinum toxin injections and surgical procedures such as salivary duct ligation, salivary duct relocation and salivary gland excision. Management must be targeted to the individual needs and comorbidities of the child to maximise treatment outcomes.