119 Surgery vs botulinum for the impact of drooling on daily life in children with neurodevelopmental disabilities: a randomized controlled trial 5 Table 2: Social consequences of drooling BoNT-A (n= 26), n (%) 2-DL (n= 27), n (%) Baseline 8 weeks 32 weeks Baseline 8 weeks 32 weeks Avoided by other children Yes 14 (54·8) 11 (41·9) 10 (36·3) 15 (56·9) 8 (29·8) 11 (42·0) Yes, main reason drooling 12 (82·5) 6 (58·7) 7 (76·2) 11 (72·0) 1 (14·9) 8 (66·5) Avoided by adults Yes 8 (31·2) 5 (20·8) 8 (32·1) 10 (38·5) 6 (21·7) 9 (32·4) Yes, main reason drooling 6 (71·6) 5 (100) 6 (76·0) 8 (73·1) 2 (40·2) 5 (52·6) Underestimation of mental ability Yes 13 (50·6) 13 (51·5) 13 (48·1) 12 (45·7) 12 (43·1) 11 (40·2) Yes, main reason drooling 5 (37·3) 6 (43·7) 6 (50·4) 7 (58·7) 3 (26·6) 5 (43·3) Self-esteem To obtain an impression of the occurrence and change in emotional reactions, caregivers were asked whether their child overtly expressed any positive and/or negative feelings on his/her physical appearance and social acceptance by peers and adults. Eleven children treated with BoNT-A and 12 children in the 2-DL group had an estimated developmental age >4 years and were analyzed. Overtly negative reactions about the physical appearance because of drooling were expressed by 27% (3 of 11) of the children and adolescents prior to BoNT-A and by 8% (1 of 12) before 2-DL. Both BoNT-A and 2-DL reduced this to 0% at 32 weeks follow-up. Similar results were achieved regarding acceptance by adults; 26% and 10% of patients expressed negative reactions because of drooling at baseline for BoNT-A and 2-DL, respectively. At 32 weeks follow-up, patients expressed no negative reactions because of drooling in both treatment arms. Negative reactions (caused by drooling) by peers were present for 16% of the children before BoNT-A and in 18% of the children prior to 2-DL. After 32 weeks this was 30% in the patients treated with BoNT-A and 0% after 2-DL. Statistical analyses regarding emotional reactions were not performed due to the relatively limited numbers. Adverse events and post-operative complaints There were more adverse events after 2-DL compared to BoNT-A (40.7% vs. 19.2%). The total number of days with post-operative complaints was significantly greater after 2-DL compared to BoNT-A (9.6 vs. 3.9 days).5
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