CPT® Code 42509

A bilateral parotid duct diversion, commonly known as a Wilke procedure, is a surgical intervention aimed at addressing excessive salivation, medically termed 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. In the context of CPT® Code 42509, the procedure involves not only the diversion of the parotid ducts but also the excision of both submandibular glands. The surgical approach includes making bilateral incisions in the upper neck, allowing for the careful dissection and removal of the submandibular glands while preserving critical anatomical structures, such as the marginal mandibular branch of the facial nerve. This comprehensive approach aims to alleviate the symptoms of sialorrhea by reducing saliva production and improving the patient's overall comfort and social interactions.