Parasympathetic Nerve Section for Control of Sialorrhea

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 trouble-some sialorrhea occurred in 15 to 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.