title: Major salivary duct clipping for control problems in developmentally challenged children.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective, uncontrolled, consecutive case series.
  
  
  METHODS
  A tertiary care pediatric otolaryngology practice.
  
  
  METHODS
  Eighteen drooling and aspirating children.
  
  
  METHODS
  Transoral interruption of parotid and submandibular ducts using vascular clips.
  
  
  METHODS
  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.affiliation: 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
authors.forename: Hamdy
authors.initials: H
authors.lastname: El-Hakim
authors.forename: Susan
authors.initials: S
authors.lastname: Richards
authors.forename: Mahilravi Samuel
authors.initials: MS
authors.lastname: Thevasagayam
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities; D005260:Female; D006801:Humans; D008297:Male; D010306:Parotid Gland; D011788:Quality of Life; D012189:Retrospective Studies; D018987:Salivary Ducts / Q000601:surgery*; D012798:Sialorrhea / Q000601:surgery*; D013363:Submandibular Gland; D016896:Treatment Outcome