CPT® Code 42665

The procedure described by CPT® Code 42665 involves the ligation of a salivary duct within the oral cavity. This surgical intervention is primarily indicated for the management of excessive salivation, clinically known as sialorrhea, which can lead to uncontrolled drooling. Sialorrhea is often associated with neurological conditions, such as cerebral palsy or traumatic brain injuries, which can disrupt the normal regulation of saliva production. The salivary glands responsible for saliva secretion include the parotid, submandibular, and sublingual glands. The parotid glands, which are the largest, have ducts known as Stensen's ducts that open into the buccal cavity near the upper second molar. The submandibular glands, also referred to as submaxillary glands, have ducts called Wharton's ducts that open on the floor of the mouth adjacent to the frenulum of the tongue. The sublingual glands possess multiple ducts that also drain into the floor of the mouth, with some potentially merging with Wharton's duct. During the ligation procedure, the duct is identified, cannulated for a short distance, and an incision is made to expose the duct. The duct is then ligated in two locations to reduce saliva flow, and the incision may be sutured closed or allowed to heal naturally. This procedure aims to alleviate the symptoms of sialorrhea and improve the quality of life for affected individuals.