Hamdy El-Hakim1, Susan Richards, Mahilravi Samuel Thevasagayam. 1. Pediatric Otolaryngology, Department of Pediatrics, The Stollery Children's Hospital, 2C3.57 Walter C. MacKenzie Center, Edmonton, AB T6G 2R7, Canada. haelhakim@cha.ab.ca
Abstract
OBJECTIVES: To introduce a technical modification for interruption of the parotid and submandibular salivary ducts and to demonstrate the technique's effectiveness and effect on quality of life. DESIGN: Retrospective, uncontrolled, consecutive case series. SETTING: A tertiary care pediatric otolaryngology practice. PATIENTS: Eighteen drooling and aspirating children. INTERVENTION: Transoral interruption of parotid and submandibular ducts using vascular clips. MAIN OUTCOME MEASURES: Manifestations of poor saliva control (visible drooling, number of shirts and bibs used, choking episodes, embarrassment, and incidence of salivary aspiration), Glasgow Children's Benefit Inventory scores (possible score range, - 100 to + 100), and complications. RESULTS: Eighteen patients (10 boys and 8 girls) were treated in 14 months. Patient age ranged from 2 to 14 years. Follow-up ranged from 3 to 18 months. No complications occurred. Nine patients had no drooling at all after surgery. There was a significant reduction in the number of bibs and shirts used (P < .001). Regarding measures indicating circumoral skin problems, embarrassment, choking episodes, and aspiration pneumonia, all the patients had significant improvements after surgery. The mean Glasgow Children's Benefit Inventory score was 33.2. CONCLUSIONS: Salivary duct clipping is an efficient and safe method of controlling saliva in neurologically challenged children. The operation positively affects the children's quality of life.
OBJECTIVES: To introduce a technical modification for interruption of the parotid and submandibular salivary ducts and to demonstrate the technique's effectiveness and effect on quality of life. DESIGN: Retrospective, uncontrolled, consecutive case series. SETTING: A tertiary care pediatric otolaryngology practice. PATIENTS: Eighteen drooling and aspirating children. INTERVENTION: Transoral interruption of parotid and submandibular ducts using vascular clips. MAIN OUTCOME MEASURES: Manifestations of poor saliva control (visible drooling, number of shirts and bibs used, choking episodes, embarrassment, and incidence of salivary aspiration), Glasgow Children's Benefit Inventory scores (possible score range, - 100 to + 100), and complications. RESULTS: Eighteen patients (10 boys and 8 girls) were treated in 14 months. Patient age ranged from 2 to 14 years. Follow-up ranged from 3 to 18 months. No complications occurred. Nine patients had no drooling at all after surgery. There was a significant reduction in the number of bibs and shirts used (P < .001). Regarding measures indicating circumoral skin problems, embarrassment, choking episodes, and aspiration pneumonia, all the patients had significant improvements after surgery. The mean Glasgow Children's Benefit Inventory score was 33.2. CONCLUSIONS: Salivary duct clipping is an efficient and safe method of controlling saliva in neurologically challenged children. The operation positively affects the children's quality of life.
Authors: Stijn Bekkers; Kim J van Ulsen; Eddy M M Adang; Arthur R T Scheffer; Frank J A van den Hoogen Journal: Dev Med Child Neurol Date: 2020-07-24 Impact factor: 5.449
Authors: Stijn Bekkers; Ineke M J Pruijn; Jan J W van der Burg; Karen van Hulst; Saskia E Kok; Corinne P Delsing; Arthur R T Scheffer; Frank J A van den Hoogen Journal: Dev Med Child Neurol Date: 2021-05-16 Impact factor: 5.449