172 CHAPTER 8 is a validated, semi-quantitative observational method to assess drooling intensity, and served as the objective primary outcome. The DQ is expressed as a percentage estimated from the ratio of observed drooling episode and the total number of observations (DQ [%] = 100 x number of drooling episode/20).27 Response to treatment was defined as a 50% reduction on DQ or VAS at 32 weeks compared to baseline. Examinations were performed at baseline and 8 and 32 weeks after intervention. Statistical Analysis Data were analyzed statistically using SPSS version 20.0. (SPSS Inc., Chicago, IL, USA). Descriptive statistics were used. To analyze the overall DQ and VAS scores after re-intervention we conducted paired t-test to assess differences in paired observations and conducted MANOVA with repeated measures analyses, using a within participants set-up with the measurement points as within-subject variables. Chi-squared statistics were used to compare the demographics and clinical variables to the reference cohort. A P-value of 0.05 was considered statistically significant. RESULTS Between 2003 and 2018 a total of 229 patient underwent surgical intervention for drooling. Re-intervention for anterior drooling was performed in 10 patients (6 males, 4 females) agedbetween8 and23 years. In these patients the primary surgical therapy comprised of bilateral submandibular DL (n=7), bilateral submandibular DL combined with unilateral PDL (n=1) or SMDR (n=2). In seven cases surgical failure was suspected to be the cause of relapse, which led to bilateral SMGE as a reintervention. Four times the parotid glands were judged the most likely cause for relapse. In these patients unilateral (n=3) or bilateral (n=1) PDL was performed as a re-intervention. In case of bilateral PDL, this was a tertiary intervention because the patient, not only experienced relapse of anterior drooling, but also suffered from severe aspiration of saliva (posterior drooling).
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