Title

Transoral submandibular ganglion neurectomy: An anatomical feasibility study

Document Type

Journal Article

Publication Date

5-1-2015

Journal

Annals of Otology, Rhinology and Laryngology

Volume

124

Issue

5

DOI

10.1177/0003489414557019

Keywords

botulinum neurotoxin; drooling; lingual nerve; neurectomy; ptyalism; sialorrhea; submandibular ganglion

Abstract

© 2014 The Author(s). Background: The management of sialorrhea can be difficult for both the patient and the clinician. Current management includes behavioral modification, anticholinergics, botulinum injections, and a variety of surgical options, which all have demonstrated some efficacy. As minimally invasive procedures flourish, we explore the feasibility of highly selective transoral submandibular neurectomy (TOSN) for the management of sialorrhea. Methods: Ten human cadaver dissections of the floor of mouth were performed bilaterally, for a total of 20 separate cases. An intraoral technique for highly selective, submandibular ganglion neurectomy is demonstrated. Results: A transoral submandibular ganglion neurectomy was performed in 10 cadavers (20 neurectomies) easily and reliably, without injury to the submandibular duct or the main trunk of the lingual nerve. Conclusion: Transoral submandibular neurectomy is an attractive addition to the armamentarium of surgical options for the treatment of medically intractable sialorrhea. Further study in selected patients would need to be performed to demonstrate clinical feasibility.

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