Treatment of Gleeking

Gleeking is when an individual is able to squirt spit out of the mouth causing amazement if not disgust from surrounding people. This salivary spray comes out from Wharton's duct which is an opening located under the tongue tip that drains the submandibular glands located under the jawline (black arrows in pic).

This duct opening normally is about 0.5mm in diameter... very small! The channel that carries saliva to this opening is about 4mm in size.

However, in individuals who have a tendency to gleek unintentionally, the duct opening diameter is even smaller! So what happens with a gleek is when saliva accumulates behind this unusually tight opening (aka, stenotic papilla). Once enough saliva builds up creating enough pressure to overcome this small stenotic opening, it all gets ejected out all at once.

A gleek is analogous to a "cough" where air pressure is built up in the lungs behind a closed voicebox which is than released all at once.

Treatment

Treatment is essentially to "stretch" the opening of Wharton's duct to a more normal+ size. Otherwise known as dilation, this can be accomplished through sialendoscopy.

Sialendoscopy is when tiny cameras and instruments are threaded into the duct. Such instrumentation includes dilation of the duct opening which would resolve gleeking.