CPT® Code 42508

Deleted

A bilateral parotid duct diversion, commonly known as a Wilke procedure, is a surgical intervention aimed at addressing excessive salivation, medically referred to as sialorrhea. This condition often leads to uncontrolled drooling, which can significantly impact a patient's quality of life. Sialorrhea is frequently associated with neurological disorders, such as cerebral palsy or traumatic brain injuries, which can disrupt the normal regulation of saliva production. The primary salivary glands involved in this process are the parotid, submandibular, and sublingual glands. During the procedure, the parotid ducts are meticulously dissected from the surrounding tissues, preserving a cuff of mucosa. This allows for the transposition of the ducts to the tonsillar fossae, where they are secured with sutures to redirect saliva away from the oral cavity. In the case of CPT® Code 42508, the procedure includes the excision of one submandibular gland, which further aids in reducing saliva production. The surgical approach involves making an incision in the upper neck, just below the mandible, to access and remove the submandibular gland while carefully protecting the marginal mandibular branch of the facial nerve. This comprehensive approach not only alleviates the symptoms of sialorrhea but also addresses the underlying anatomical factors contributing to the condition.