Siyaloreli hastaya yaklaşım ve tedavi yönetimi
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Drooling of saliva or sialorrhea is a clinical expression of a dysfunction in the coordination of the oral phase of swallowing mechanism. It is caused by an inability to swallow saliva frequently, rather than by an excessive production of saliva in neurologically impaired patients. Physical and psychosocial complications of sialorrhea can cause significant negative effects on physical health and quality of life. Current treatment options of sialorrhea are oral motor therapy, behavioral therapies, orthodontic therapy, medical treatments such as anticholinergics, radiotherapy, injection of botulinum toxin, and surgical treatments. Status of the quality of patient’s life determines necessity of treatment. Treatments are administered gradually from minimally invasive to most invasive. Treatment of sialorrhea is best implemented by team work. Surgical treatments are ductus rerouting that diverts salivary flow or ductus ligation, submandibular and/or sublingual gland excision, and tympanic neurectomy with or without chorda tympani section, which decrease salivary secretion. Parotid ductus ligation, submandibular ductus rerouting, and excision of sublingual glands are the most effective and minimally invasive methods.
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