Surgical Options for Sialorrhea Management in Children with Cerebral Palsy

  • Christopher Tsang
  • Steven Cook
  • Udayan ShahEmail author
Living reference work entry


Sialorrhea is a condition that affects many children with cerebral palsy. It can lead to a myriad of problems, ranging from irritation of the peri-oral skin to recurrent aspiration causing respiratory compromise. There exist several medical and surgical options for the treatment of this condition. Behavioral and physical therapy can help in milder cases, especially in children with better neurocognitive ability. Botulinum toxin injections have been shown to be helpful in decreasing salivary gland output. Surgical interventions include salivary duct diversion, salivary duct ligation, salivary gland removal, or a combination of the aforementioned procedures. The most refractory cases involving recurrent aspiration may necessitate a tracheostomy for pulmonary hygiene, or a laryngotracheal separation, which physically separates the airway from the digestive tract. No one treatment is guaranteed to work, and proper management requires tailoring the therapy to the individual child.


Sialorrhea Salivary Drooling Aspiration 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Christopher Tsang
    • 1
  • Steven Cook
    • 1
    • 3
  • Udayan Shah
    • 1
    • 2
    • 3
    Email author
  1. 1.Division of Pediatric Otolaryngology, Department of SurgeryNemours Alfred I. DuPont Hospital for ChildrenWilmingtonUSA
  2. 2.Department of Otolaryngology - Head and Neck Surgery and PediatricsWilmingtonUSA
  3. 3.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

Section editors and affiliations

  • Freeman Miller
    • 1
  • Steven Bachrach
    • 2
  1. 1.AI DuPont Hospital for ChildrenWilmingtonUSA
  2. 2.Al duPont Hospital for ChildrenWilmingtonUSA

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