• Twenty mentally retarded patients with a considerable drooling problem underwent transtympanic sectioning of selected preganglionic parasympathetic nerve fibers to the major salivary glands. Following surgery, cessation of troublesome sialorrhea occurred in 15 of 20 patients; but by six months postoperatively, only ten patients remained controlled. The best results obtained were in a subgroup of five patients who underwent bilateral Jacobson nerve and chorda tympani nerve section. In four of these patients, sialorrhea was controlled after a minimum follow-up of two years. Parasympathetic denervation of the major salivary glands via a transtympanic approach is offered as a primary modality of therapy in those mentally retarded patients judged to have considerable sialorrhea. Sacrifice of both chorda tympani nerves appears to enhance the surgical results.
Michel RG, Johnson KA, Patterson CN. Parasympathetic Nerve Section for Control of Sialorrhea. Arch Otolaryngol. 1977;103(2):94–97. doi:10.1001/archotol.1977.00780190074008
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