Thesis

198 FUTURE RESEARCH ABSTRACT Rationale: drooling is associated with physical, psychosocial, and emotional distress. Previous studies revealed that submandibular duct ligation (2-DL) is an effective and safe treatment for drooling in neurodisabilities. However, a quarter of patients recurred in the period between week 8 and 32 weeks after 2-DL. Alternative salivary pathways were proposed as leading reason for recurrence and treatment failure of 2-DL. Recent literature illustrated that intraductal ethanol infusion in the salivary gland is safe and effective for the treatment of drooling. Objective: theprimary aimof this study is toevaluate the feasibility of submandibular duct ligation right after intraductal ethanol infusion into the submandibular salivary gland (Ethanol two-duct ligation [E-2DL] in order to improve treatment effect, and prevent recurrence and alternative salivary pathways after 2-DL. The secondary aims of the study are to evaluate effect, and to evaluate whether an out-patient setting is suitable for the procedure. Study design: Prospective pilot study Study population: This pilot study aims to enrol 5 children or adolescents with a non-progressive neurodevelopmental disability that suffer from ‘severe’ anterior drooling (Drooling Frequency ([DF] Score ≥ 3 or Drooling Severity [DS] Score ≥ 2), aged ≥ 10 years. Intervention: submandibular duct ligation right after intraductal ethanol infusion into the submandibular salivary gland. Main study parameters/endpoints: The primary aim of this study is to evaluate the feasibility of the procedure which is defined by adverse events and postoperative complaints (i.e. safety). Secondary outcomes include surgical time, and the suitability for an out-patient setting. Although not an aim of this study, we will obtain treatment success, defined as a ≥ 50% reduction in a visual analog scale for severity of drooling (VAS) and/or Drooling Quotient (DQ) from baseline, VAS, DQ,

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