Causes and treatment of drooling in children with cerebral palsy

  The main reason is that the brain tissue of the child is damaged in the immature stage of development, resulting in a non-progressive and irreversible lesion, which causes neuromuscular atrophy in the corresponding functional area and oral muscle motor coordination dysfunction, resulting in abnormal swallowing function and inability to clear the oral cavity. This is caused by abnormal swallowing function and inability to clear saliva.  As a reminder, do not be afraid or avoid a child with cerebral palsy because of drooling, as this disease is not contagious and will never be transmitted to another child through contact. Therefore, children with cerebral palsy should never be isolated from normal children. Instead, they should be exposed to each other and encouraged to be together with social groups to do activities, study and work together to promote the normal development of children with cerebral palsy. Children with cerebral palsy should be allowed to rejoin society through a comprehensive scientific treatment that combines rehabilitation and surgery.  For children with cerebral palsy who often drool, parents can press the area between the child’s nose and lips with their fingers and give the command “swallow”, so that over time, the child will learn to shut up and swallow, and swallow the saliva by himself. If this does not work, surgery will be necessary to solve the problem of drooling in children with cerebral palsy.  Currently, we are using FreeandexcisionofsympatheticplexusOfcommoncaroticartery (FES-CCA) to treat drooling in children with cerebral palsy, and we have achieved remarkable results. The principle of this surgery for treating drooling symptoms in children with cerebral palsy is based on the following two aspects: 1. After stripping the sympathetic nerve network of the external membrane of the common carotid artery, the blood vessels in the brain can be dilated, the blood supply to the brain can be increased, the symptoms of ischemia and hypoxia in the brain tissue can be improved, the lateral branch circulation can be established, the function of some neuronal cells in the critical state can be restored, and the compensatory function of the brain tissue can be improved, so that the swallowing movement and the oral sphincter can be improved through central regulation and the salivation can be reduced. This can reduce salivation by improving the coordination function of swallowing movement and oral sphincter through central regulation.  2. The salivary glands are innervated by sympathetic nerves and linguopharyngeal nerves. The sympathetic nerves innervating the salivary glands originate from the lateral horn of the gray matter in the thoracic segment of the spinal cord, and send out postganglionic fibers after the exchange of nerves in the superior cervical ganglion, which climb on the common carotid artery epicardium and distribute upward to the salivary glands. The surgical stripping of the common carotid artery epicardium blocks sympathetic nerve conduction and reduces the direct innervation effect of sympathetic nerves and the secretion of saliva.  The FES-CCA procedure can also be referred to as common carotid artery episiotomy, in which an incision is made at the anterior medial border of the sternocleidomastoid muscle in children with cerebral palsy, the skin is incised for 3 cm, and the superficial fascia and the broad cervical muscle are cut with an electric knife. The common carotid artery, vein and vagus nerve were bluntly separated and exposed, and the common carotid artery and vagus nerve were investigated for adhesions with the surrounding tissues and for embedded compression of the vagus nerve; if so, they were freed and released respectively to relieve the compression; then the outer membrane of the common carotid artery was cut, peeled off for 2 cm and excised, and an anti-adhesive membrane was placed around the artery. At the same time, the surgery also improved the patient’s symptoms such as speech and language disorders, strabismus, difficulty in swallowing and eating, ataxia, and tardive dyskinesia to varying degrees.