First in Israel: Salivary Duct Ligation in 13-year-old

13-year-old Yonatan suffered from hypersalivation (excessive production of saliva), a condition that affected his life and quality of life. He was treated with medications but when there was no improvement, he was referred to the Hypersalivation Clinic at Schneider Children's.

Hypersalivation can cause functional, social, psychological, and surrounding mouth infection problems in children representing complex issues for treatment. It can also lead to coughing, choking and vomiting. The condition can be caused by different factors such as dysphagia (difficulty in swallowing), unstable jaw or weak muscles.

The Hypersalivation Clinic assists children and their families in the comprehensive assessment, treatment and follow-up of the condition. The multidisciplinary team comprises neurologist Dr. Eilat Halevy, pulmonologist Dr. Dario Prais, otolaryngologist Dr. Roi Hod, occupational therapist Adi Cooper, and communication technician Yifat Nitzan.

The clinic aims to raise awareness of the problem, its early identification, and provide appropriate optimal treatment among available therapies to every child according to his needs. Among these is an innovative surgical procedure called salivary duct ligation.

According to Dr. Hod, "Yonatan was referred to us following treatment with medications that did not improve his condition. We injected Botox into his salivary glands which also did not relieve the hypersalivation. Therefore, we decided to perform ligation of 4 salivary ducts to reduce the amount of saliva excreted. This is the first time that this procedure has been done in Israel in a child of his age."

The surgery was conducted by Dr. Hod and Dr. Hannah Gilat, an otolaryngologist from the Sharon Hospital, under general anesthetic. The operation - conducted through the mouth without any exterior scarring – entailed cutting and tying 4 main ducts leading from the glands to the mouth. It ensued about an hour after which Yonatan was transferred to the Pediatric Intensive Care Unit for a few days until his discharge.

Now, some two months after the surgery, Yonatan's general condition is excellent, the hypersalivation has completely stopped and his quality of life significantly improved.