1
|
Li X, Yang J, Qu LY, Zheng DN, Xie XY, Liu DG, Yu GY. Diagnosis and Treatment of Radioactive Iodine-Induced Sialadenitis: A 10-Year Endoscopic Experience. Laryngoscope 2024. [PMID: 38761158 DOI: 10.1002/lary.31514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/02/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVES The aim of this study was to explore the endoscopic characteristics of radioactive iodine-induced sialadenitis (RAIS), and to evaluate the treatment outcomes of endoscopic intervention for RAIS. STUDY DESIGN Retrospective case series. METHODS Eighty-two consecutive patients (11 males and 71 females) diagnosed as RAIS from Nov. 2012 to Sep. 2023 were retrospectively included. All patients underwent endoscopic exploration and intervention of the affected glands. The endoscopic features were collected, and treatment outcomes were followed-up and evaluated through post to pre-operative comparisons of gland status. RESULTS Overall, endoscopic procedures were undertaken for 162 parotid glands (PGs) and 62 submandibular glands (SMGs). Endoscopy showed severe lumen stricture (49.3%) and ductal atresia (23.5%) in PGs, as well as severe stenosis of the anterior duct and ectasia of the proximal duct (59.7%) in SMGs. During a median six months' follow-up, the treatment outcomes of PGs were evaluated as "improvement" in 23.4%,"lesion maintenance" in 45.1% and "lesion aggravation" in 31.5% of the glands. As for SMGs, the treatment outcomes were scored as "improvement"in 29.0%,"lesion maintenance"in 54.8%, and"lesion aggravation"in 16.1% of the glands. No significant differences of treatment outcomes were found relative to RAI treatment sessions and cumulative dosage. CONCLUSION RAIS is characteristic of severe lumen stricture and ductal atresia in PGs, and stenosis of the distal duct and ectasia of the proximal duct in SMGs. Endoscopy can alleviate clinical symptoms of RAIS and help to preserve the gland function. LEVEL OF EVIDENCE 4 Laryngoscope, 2024.
Collapse
Affiliation(s)
- Xiao Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jing Yang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Liu-Yang Qu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Dan-Ni Zheng
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xiao-Yan Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Deng-Gao Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| |
Collapse
|
2
|
Bhat A, Gulati A, Ryan WR, Chang JL. Comparison of Chronic Sialadenitis Symptom Burden in Patients With Sialolithiasis Versus Stenosis Before and After Sialendoscopy. Otolaryngol Head Neck Surg 2024. [PMID: 38639292 DOI: 10.1002/ohn.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/01/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE To define symptomatology and responses to treatment in chronic sialadenitis from sialolithiasis versus duct stenosis and establish a minimal clinically significant difference (MCID) in the validated Obstructive Salivary Problem Impact Test (SPIT). STUDY DESIGN Prospective, cohort. SETTING Tertiary-care center. METHODS Patients completed the SPIT questionnaire at presentation and 3 to 6 months after surgery. SPIT scores and domains were compared between patients with symptomatic sialolithiasis and those with stenosis of a major salivary gland. RESULTS Seventy-nine patients completed the SPIT, including 43 (54%) with sialolithiasis and 36 (46%) with stenosis. Stenosis patients displayed greater baseline scores compared to sialolithiasis patients (45.4 ± 19.9 vs 33.3 ± 18.5, P < .013). Frequency and severity of gland swelling and pain (21.9 ± 8.9 vs 17.1 ± 9.6, P = .02) and functional/psychosocial impact subscores were greater in the stenosis versus sialolithiasis groups (18.0 ± 10.9 vs 11.3 ± 9.4, P < .01). For 43 patients who underwent surgical intervention, SPIT scores improved at 3 to 6 months postoperatively in all domains (-18.6 ± 19.4, P < .01). Degree of improvement did not differ between sialolithiasis versus stenosis groups (-22.0 ± 20.9 vs -13.3 ± 15.8, P = .13). The MCID in SPIT score was found to be -13 points. A postoperative SPIT score of less than 10 suggested symptom resolution. CONCLUSION When compared to sialolithiasis, chronic salivary obstruction from stenosis is associated with greater baseline SPIT scores, indicating poorer sialadenitis-related quality of life due to greater symptom frequency and functional impact. Based on SPIT survey outcomes, a score decrease of 13 points or SPIT score <10 represent significant symptom improvement.
Collapse
Affiliation(s)
- Amrita Bhat
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Arushi Gulati
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - William R Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
- Surgery Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA
| |
Collapse
|
3
|
Beumer LJ, Vissink A, Gareb B, Spijkervet FKL, Delli K, van der Meij EH. Success rate of sialendoscopy. A systematic review and meta-analysis. Oral Dis 2023. [PMID: 37486613 DOI: 10.1111/odi.14662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/31/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis on the efficacy and safety of sialendoscopy in the treatment of obstructive diseases of the major salivary glands. MATERIALS AND METHODS We searched four databases for literature. The primary outcome assessed was the success rate. Secondary outcomes included the use of supportive devices, number of sialadenectomies and complications. Risk of bias was assessed. Meta-analyses with subgroup analysis were performed. RESULTS In total, 91 studies were included, comprising 8218 patients undergoing 9043 sialendoscopic procedures. The majority of studies had a medium or high risk of bias. The incidence of sialadenectomy varied from 0% to 14%. No major complications were reported. Meta-analysis revealed a weighted pooled success rate of 80.9%. Subgroup analyses showed the weighted pooled success rate in patients with sialoliths (89.6%), stenoses (56.3%), submandibular glands (88.3%), parotid glands (81.2%), patients treated by an endoscopic-assisted transoral removal of a sialolith (86.3%), patients treated by a combined approach of the parotid gland (78.2%), patients with JRP (67.0%) and with RAIS (45.8%). CONCLUSION The success rate of sialendoscopy did not considerably change in the last 9 years. Sialendoscopy is an efficient and safe procedure for the treatment of major salivary gland obstructive disease.
Collapse
Affiliation(s)
- L J Beumer
- Department of Oral and Maxillofacial Surgery, Medical Centre Leeuwarden, Leeuwarden, Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - B Gareb
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - F K L Spijkervet
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - K Delli
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - E H van der Meij
- Department of Oral and Maxillofacial Surgery, Medical Centre Leeuwarden, Leeuwarden, Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| |
Collapse
|
4
|
Callander JK, Plonowska-Hirschfeld K, Gulati A, Chang JL, Ryan WR. Symptom Outcomes After Sialendoscopy-Assisted Salivary Duct Surgery: A Prospective 6-Year Study. Laryngoscope 2023; 133:792-800. [PMID: 35848880 DOI: 10.1002/lary.30294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/01/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective is to evaluate the long-term impact of sialendoscopic-assisted salivary duct surgery (SASDS) on sialadenitis symptoms using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. METHODS The COSS questionnaire, which scores symptoms on a 0-100 scale, was administered prospectively to adult patients pre-operatively, 1-year, and 6-years post-operatively. We examined COSS scores and categories representing complete (<10), partial (10-25), and no (>25) resolution of symptoms with attention to factors significantly associated with incomplete resolution (≥10). RESULTS Approximately 6-years after SASDS, 111 patients reported scores for 128 symptomatic glands (72 with sialolithiasis, 56 without sialolithiasis). For glands with sialolithiasis, the median COSS score pre-SASDS was 27.5 (interquartile range [IQR]: 13.5-43), which was significantly reduced to 1.0 (IQR: 0-5.5) at 1-year and 1.5 (IQR 0-5) at 6-years postoperatively. Glands without sialolithiasis had a median COSS score of 40.5 (IQR: 23-52.5) preoperatively, that significantly reduced to 13.5 (IQR 5-21) at 1-year and 14 (IQR 6.5-25.5) at 6-years post-operatively. There was no significant difference in scores from 1- to 6-years. Intraoperative presence of sialolith, absence of stenosis, stenosis in the distal duct, and submandibular gland involvement were significant predictors of complete resolution of symptoms at 6-years. CONCLUSION Approximately 6-years after SASDS for sialadenitis, the majority of patients have durable symptom improvement. The sialolithiasis group had higher rates of complete resolution compared to the non-sialolithiasis group. Presence of ductal stenosis on sialendoscopy, non-distal stenoses, and parotid gland involvement were risk factors for persistent long-term sialadenitis symptoms. Laryngoscope, 133:792-800, 2023.
Collapse
Affiliation(s)
- Jacquelyn K Callander
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Karolina Plonowska-Hirschfeld
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Arushi Gulati
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Jolie L Chang
- Division of General Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Center, University of California San Francisco, San Francisco, California, U.S.A
- Surgery Service, Department of Veterans Affairs Medical Center, San Francisco, California, U.S.A
| | - William R Ryan
- Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Center, University of California San Francisco, San Francisco, California, U.S.A
| |
Collapse
|
5
|
Liu J, Liu P, Wei L, Li W, Li B, Cheng Y. Oxidative-antioxidant imbalance in chronic sialadenitis of submandibular gland in human and rat. Oral Dis 2023; 29:1005-1016. [PMID: 34826194 DOI: 10.1111/odi.14087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to evaluate the level of oxidative stress (OS) in human and rat chronic sialadenitis (CS) of the submandibular gland (SMG). METHOD We collected human SMG tissues and established a rat CS model using Wharton's duct partial ligation (PL). Morphological changes in the SMG were evaluated by HE, Sirius Red, AB/PAS, TUNEL and immunohistochemical (IHC) staining. Oxidative damage and antioxidant capacity were detected by ELISA, commercial assay kits and IHC staining to evaluate their expression levels and locations in the SMG. RESULTS Histopathological damage were observed in the human and rat CS. In rat PL group, the oxidative damage products (8-OHdG, AOPP, 8-iso-PGF2α and H2 O2 ) were significantly increased. For antioxidants, the PL group had markedly decreased T-AOC and CAT activity, but markedly increased SOD activity. 3-NT, 4-HNE and MDA expression changed during the process of CS, and antioxidant enzymes (CAT, SOD1, SOD2, GPX1 and GPX4) were mainly expressed in ducts. CONCLUSIONS The oxidative-antioxidant imbalance of CS in human and rats was revealed, the different expression of oxidative damage during the process of CS was detected, and the different antioxidant reaction in acinar and ductal cells was demonstrated.
Collapse
Affiliation(s)
- Jingyang Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Pei Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lili Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bo Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yong Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| |
Collapse
|
6
|
Lakshmi Nair S, Faizal B, Hari H. A Prospective Study of Recovery of Salivary Gland Function After Calculus Removal by Sialendoscopy. Indian J Otolaryngol Head Neck Surg 2023; 75:88-93. [PMID: 37007899 PMCID: PMC10050491 DOI: 10.1007/s12070-023-03526-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/21/2023] [Indexed: 02/12/2023] Open
Abstract
Sialendoscopy is gaining popularity in treating obstructive sialolithiasis as a gland preserving procedure. The study aimed to determine if the salivary glands recovered apart from symptomatic improvement after interventional sialendoscopy for calculus removal. A prospective comparative study was conducted in a tertiary care center on 24 patients diagnosed with sialolithiasis. The eligibility criterion was patients who underwent calculus removal through interventional sialendoscopy. All patients underwent objective and subjective methods of assessments of function of the salivary glands with the help of salivary Technetium (Tc) 99 Scintigraphy, measurement of salivary flow rate, Chronic obstructive sialadenitis symptoms (COSS), and xerostomia index (XI) questionnaires. Assessments were done before the procedure and repeated after 3 months. Categorical variables were expressed using frequency and percentage. Numerical variables were represented using mean and standard deviation. To test the statistical significance of the difference in the mean of the four parameters Wilcoxen sign ranked test was used. According to our study improvement in functionality was noted in all of the subjective and objective parameters assessed namely Tc scintigraphy, salivary flow rate, COSS questionnaire, and XI questionnaire, with a statistically significant p value (< 0.001). Functionality of salivary gland showed improvement within 3 months of calculus removal through sialendoscopy. There was a marked improvement in the symptoms after sialendoscopy. This study demonstrates that removal of obstructing calculus results in rapid recovery of glandular function thereby emphasizing the need for salivary gland preservation. Level of evidence: Level III.
Collapse
Affiliation(s)
- S. Lakshmi Nair
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham University, Kochi, India
| | - Bini Faizal
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham University, Kochi, India
| | - Harsha Hari
- Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham University, Kochi, India
| |
Collapse
|
7
|
Santillán Coello JM, Sánchez Barrueco Á, González Galán F, Díaz Tapia G, Mahillo Fernández I, Villacampa Aubá JM, Cenjor Español C. Validación de un cuestionario específico de calidad de vida en sialoadenitis obstructiva crónica (CSOC). ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023. [DOI: 10.1016/j.otorri.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
|
8
|
Santillán Coello JM, Sánchez Barrueco Á, González Galán F, Díaz Tapia G, Mahillo Fernández I, Villacampa Aubá JM, Cenjor Español C. Validation of a Spanish chronic obstructive sialadenitis quality of life questionnaire (CSOC). ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022; 74:116-123. [PMID: 36272442 DOI: 10.1016/j.otoeng.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Interest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility. MATERIAL AND METHODS A prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. RESULTS All the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94 respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31. CONCLUSIONS The CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis.
Collapse
Affiliation(s)
- Jessica Mireya Santillán Coello
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain; ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain
| | - Álvaro Sánchez Barrueco
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain; ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain.
| | - Fernando González Galán
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain; ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain
| | - Gonzalo Díaz Tapia
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain; ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain
| | - Ignacio Mahillo Fernández
- Institute for Health Research, Research Unit, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - José Miguel Villacampa Aubá
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain; ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain
| | - Carlos Cenjor Español
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain; ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain
| |
Collapse
|
9
|
de Paiva Leite S, de Oliveira MMR, Ahmad Z, Morton RP. Impact on quality of life in obstructive sialadenitis predicting outcomes after sialendoscopy. Am J Otolaryngol 2022; 43:103431. [PMID: 35460971 DOI: 10.1016/j.amjoto.2022.103431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/02/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Sialendoscopy is a minimally invasive procedure considered a paradigm shift in the treatment of obstructive sialadenitis. However, it shows an average need for revision procedure in up to 24% of operated cases. This study analyzed whether patient-related variables could predict the need for a revision during postoperative follow-up. METHODS From 2012 to 2020, this prospective comparative study analyzed demographic data as well as preoperative responses to the "Manukau Salivary Symptoms Score" (MSSS) questionnaire as predictors of the need for a revision procedure due to symptoms recurrence. RESULTS 188 sialendoscopies (39.4% for stones/60.6% for stenoses) in 112 parotid (59.6%) and 76 submandibular glands (40.4%) were included in this study. Forty patients (21.3%) required a revision procedure. The variable "Impact on quality of life" in the preoperative period of patients with sialoliths showed that the likelihood of a revision procedure increases by 33.6% with each increase in the 10-point Likert scale presented in the MSSS (p = 0.010, OR = 1336, CI = 1.071 to 1.667). This finding was not influenced by the location of the sialolith in the duct (p = 0.415), size (p = 0.058) or number of stones (P = 0.476). Other demographic variables related to the patient showed no association with the need of a revision procedure. CONCLUSION Further studies should be performed to exclude the influence of other variables on the results; however, special attention should be given to patients who report a greater pre-operative impact on quality of life due to sialolithiasis. LEVEL OF EVIDENCE II.
Collapse
Affiliation(s)
- Sandro de Paiva Leite
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand; University of Auckland, New Zealand.
| | | | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand; University of Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand; University of Auckland, New Zealand
| |
Collapse
|
10
|
Melo GM, Neves MC, Rosano M, Vanni CMRS, Abrahao M, Cervantes O. Quality of life after sialendoscopy: prospective non-randomized study. BMC Surg 2022; 22:11. [PMID: 34998366 PMCID: PMC8742341 DOI: 10.1186/s12893-021-01462-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The symptomatic (swelling and pain) salivary gland obstructions are caused by sialolithiasis and salivary duct stenosis, negatively affecting quality of life (QOL), with almost all candidates for clinical measures and minimally invasive sialendoscopy. The impact of sialendoscopy treatment on the QOL has been little addressed nowadays. The objective is to prospectively evaluate the impact of sialendoscopy on the quality of life of patients undergoing sialendoscopy due to benign salivary obstructive diseases, measured through QOL questionnaires of xerostomia degree, the oral health impact profile and post sialendoscopy satisfaction questionnaires. RESULT 37 sialendoscopies were included, most young female; there were 64.5% sialolithiasis and 35.4% post-radioiodine; with 4.5 times/week painful swelling symptoms and 23.5 months symptom duration. The pre- and post-sialendoscopy VAS values were: 7.42 to 1.29 (p < 0.001); 86.5% and 89.2% were subjected to sialendoscopy alone and endoscopic dilatation respectively; 80.6% reported improved symptoms after sialendoscopy in the sialolithiasis clinic (p < 0.001). The physical pain and psychological discomfort domain scores were mostly impacted where sialendoscopy provided relief and improvement (p < 0.001). We found a positive correlation between sialendoscopy and obstructive stone disease (p < 0.001) and no correlation in sialendoscopy satisfaction in xerostomia patients (p = 0.009). CONCLUSIONS We found improved symptoms with overall good satisfaction after sialendoscopy correlated with stones; and a negative correlation between xerostomia. Our findings support the evident indication of sialendoscopy for obstructive sialolithiasis with a positive impact on QOL and probably a relative time-dependent indication for stenosis/other xerostomia causes that little improved QOL satisfaction. LEVEL OF EVIDENCE 2b-Prospective non-randomized study. TRIAL REGISTRATION WHO Universal Trial Number (UTN): U1111-1247-7028; Brazilian Clinical Trials Registry (ReBeC): RBR-6p8zfs.
Collapse
Affiliation(s)
- Giulianno Molina Melo
- Department of Otorhinolaryngology and Surgery of Head and Neck, Federal University of São Paulo/Paulista School of Medicine (UNIFESP/EPM), R. Maestro Cardim, 560 cj 24 Bela Vista, São Paulo, SP, CEP 01323000, Brazil. .,Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, Sao Paulo, SP, Brazil.
| | - Murilo Catafesta Neves
- Department of Otorhinolaryngology and Surgery of Head and Neck, Federal University of São Paulo/Paulista School of Medicine (UNIFESP/EPM), R. Maestro Cardim, 560 cj 24 Bela Vista, São Paulo, SP, CEP 01323000, Brazil.,Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, Sao Paulo, SP, Brazil
| | - Marcello Rosano
- Department of Otorhinolaryngology and Surgery of Head and Neck, Federal University of São Paulo/Paulista School of Medicine (UNIFESP/EPM), R. Maestro Cardim, 560 cj 24 Bela Vista, São Paulo, SP, CEP 01323000, Brazil.,Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, Sao Paulo, SP, Brazil
| | | | - Marcio Abrahao
- Department of Otorhinolaryngology and Surgery of Head and Neck, Federal University of São Paulo/Paulista School of Medicine (UNIFESP/EPM), R. Maestro Cardim, 560 cj 24 Bela Vista, São Paulo, SP, CEP 01323000, Brazil
| | - Onivaldo Cervantes
- Department of Otorhinolaryngology and Surgery of Head and Neck, Federal University of São Paulo/Paulista School of Medicine (UNIFESP/EPM), R. Maestro Cardim, 560 cj 24 Bela Vista, São Paulo, SP, CEP 01323000, Brazil
| |
Collapse
|
11
|
Buchholzer S, Faure F, Tcheremissinoff L, Herrmann FR, Lombardi T, Ng SK, Lopez JM, Borner U, Witt RL, Irvine R, Abboud O, Cernea CR, Ghan S, Matsunobu T, Ahmad Z, Morton R, Anicin A, Magdy EA, Al Abri R, Konstantinidis I, Capaccio P, Klein H, Poorten VV, Lombardi D, Lyons B, Al Rand H, Liao G, Kim JK, Subha S, Su RYX, Su CH, Boselie F, Andre R, Seebach JD, Marchal F. Novel Multidisciplinary Salivary Gland Society (MSGS) Questionnaire: An International Consensus. Laryngoscope 2021; 132:322-331. [PMID: 34236085 PMCID: PMC9291943 DOI: 10.1002/lary.29731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/26/2021] [Accepted: 06/21/2021] [Indexed: 01/01/2023]
Abstract
Objectives First, establishment and validation of a novel questionnaire documenting the burden of xerostomia and sialadenitis symptoms, including quality of life. Second, to compare two versions regarding the answering scale (proposed developed answers Q3 vs. 0–10 visual analogue scale Q10) of our newly developed questionnaire, in order to evaluate their comprehension by patients and their reproducibility in time. Study Design The study is a systematic review regarding the evaluation of the existing questionnaire and a cohort study regarding the validation of our new MSGS questionnaire. Materials and Methods A Multidisciplinary Salivary Gland Society (MSGS) questionnaire consisting of 20 questions and two scoring systems was developed to quantify symptoms of dry mouth and sialadenitis. Validation of the questionnaire was carried out on 199 patients with salivary pathologies (digestive, nasal, or age‐related xerostomia, post radiation therapy, post radioiodine therapy, Sjögren's syndrome, IgG4 disease, recurrent juvenile parotitis, stones, and strictures) and a control group of 66 healthy volunteers. The coherence of the questionnaire's items, its reliability to distinguish patients from healthy volunteers, its comparison with unstimulated sialometry, and the time to fill both versions were assessed. Results The novel MSGS questionnaire showed good internal coherence of the items, indicating its pertinence: the scale reliability coefficients amounted to a Cronbach's alpha of 0.92 for Q10 and 0.90 for Q3. The time to complete Q3 and Q10 amounted, respectively, to 5.23 min (±2.3 min) and 5.65 min (±2.64 min) for patients and to 3.94 min (±3.94 min) and 3.75 min (±2.11 min) for healthy volunteers. The difference between Q3 and Q10 was not significant. Conclusion We present a novel self‐administered questionnaire quantifying xerostomia and non‐tumoral salivary gland pathologies. We recommend the use of the Q10 version, as its scale type is well known in the literature and it translation for international use will be more accurate. Laryngoscope, 132:322–331, 2022
Collapse
Affiliation(s)
- Samanta Buchholzer
- Department of Maxillofacial Surgery and Oral Medicine and Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Frédéric Faure
- Otorhinolaryngology, Head and Neck Surgery Department, Hospices Civils de Lyon, Lyon, France.,ENT Department, Infirmerie Protestante, Caluire, France
| | | | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Tommaso Lombardi
- Oral Medicine and Oral and Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Siu-Kwan Ng
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jean-Michel Lopez
- Department of Otorhinolaryngology-Head and Neck Surgery, Centre Hospitalier de Perpignan, Perpignan, France
| | - Urs Borner
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Robert L Witt
- Christiana Care, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - Robert Irvine
- Division of Otolaryngology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Olivier Abboud
- Division of Otolaryngology-Head and Neck Surgery, University of Montreal, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - Claudio R Cernea
- Department of Surgery, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Shirish Ghan
- Department of Otolaryngology, Deenanath Mangeshkar Hospital and Research Center, Pune, India
| | - Takeshi Matsunobu
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Nipppon Medical School, Tokyo, Japan
| | - Zahoor Ahmad
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Nipppon Medical School, Tokyo, Japan
| | - Randall Morton
- Department of Otolaryngology Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Aleksandar Anicin
- Department of Otorhinolaryngology and Cervicofacial Surgery University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Emad A Magdy
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rashid Al Abri
- Department of Surgery, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Pasquale Capaccio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, ENT Clinic Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Hila Klein
- Faculty of Medicine, Sialendoscopy and Minimal Invasive Surgery Service, Rambam Health Care Campus, Haifa, Israel
| | - Vincent Vander Poorten
- Head and Neck Surgery, University Hospitals Leuven-Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Davide Lombardi
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Bernard Lyons
- Director ENT Head and Neck Surgery and Skull Base Surgery, St. Vincent's Hospital, Melbourne, Australia
| | - Hussain Al Rand
- Department of Otorhinolaryngology, Dr. Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | - George Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Jeong K Kim
- Department of Otolaryngology-Head and Neck Surgery, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Sethu Subha
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine & Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Richard Y-X Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Chin-Hui Su
- Department of Otolaryngology Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.,School of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Franciscus Boselie
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Raphaël Andre
- Department of Dermatology, Geneva University Hospitals, Geneva, Switzerland.,Department of Allergology and Clinical Immunology, Geneva University Hospitals, Geneva, Switzerland
| | - Jörg D Seebach
- Division of Clinical Immunology and Allergy, Department of Medical Specialties, University Hospitals and Medical Faculty, Geneva, Switzerland
| | - Francis Marchal
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
12
|
Strohl MP, Chang C, Ryan WR, Chang JL. Botulinum toxin for chronic parotid sialadenitis: A case series and systematic review. Laryngoscope Investig Otolaryngol 2021; 6:404-413. [PMID: 34195360 PMCID: PMC8223475 DOI: 10.1002/lio2.558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To evaluate salivary gland chemodenervation with botulinum toxin in chronic parotid sialadenitis. METHODS Patients who underwent parotid gland chemodenervation for chronic sialadenitis due to duct stenosis refractory to siaendoscopy were reviewed (case series). Additionally, a systematic review of the literature on botulinum toxin injection for chronic parotid sialadenitis was performed. Inclusion criteria included studies containing original data on botulinum toxin injections in patients with chronic sialadenitis symptoms. RESULTS Sialadenitis symptoms from 10 patients with 13 affected parotid glands were examined. All had duct stenosis diagnosed on sialendoscopy, refractory sialadenitis symptoms, and received parotid onabotulinum toxin injection(s) (median dose 65U). Of patients with 3-month follow-up, 78% reported significant improvement in symptoms. Mean Chronic Obstructive Sialadenitis Symptoms (COSS) Score improved at 3 months post-injection (47-25.9, P = .039) with significant reduction in gland pain frequency and gland swelling severity. No patients had a facial nerve paralysis or increased xerostomia. With the systematic review, 518 abstracts were reviewed and 11 studies met inclusion criteria and included case series or case reports with a total of 40 patients treated with botulinum toxin for chronic parotitis. Thirty-four out of a total of 35 patients in the studies (97%) reported complete (9, 26%) or partial (25, 71%) improvement in sialadenitis symptoms with minimal complications. CONCLUSION Parotid gland chemodenervation with botulinum toxin is a minimally invasive treatment option for symptomatic chronic sialadenitis refractory to medical treatment or sialendoscopy. Botulinum toxin injections alleviate gland pain and swelling associated with salivary obstruction and provide an alternative to parotidectomy for recurrent sialadenitis.Level of evidence: 4.
Collapse
Affiliation(s)
- Madeleine P. Strohl
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Chia‐Fan Chang
- Department of Otorhinolaryngology‐Head and Neck SurgeryTaipei Veterans General Hospital and Faculty of Medicine, School of Medicine, National Yang‐Ming UniversityTaipeiTaiwan
| | - William R. Ryan
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Jolie L. Chang
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| |
Collapse
|
13
|
Zhao YN, Zhang LQ, Zhang YQ, Chen Y, Liu DG, Yu GY. Allergy-Related Sialodochitis: A Preliminary Cohort Study. Laryngoscope 2021; 131:2030-2035. [PMID: 33710620 DOI: 10.1002/lary.29508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/23/2021] [Accepted: 03/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To explore the clinically feasible diagnosis criteria and treatment outcomes of allergy-related sialodochitis (ARS). STUDY DESIGN Prospective Cohort Study. METHODS Ninety-six consecutive patients were enrolled by the following criteria: 1) recurrent swelling of ≥2 large salivary glands that lasted for ≥3 months; 2) with mucus plug exudations; 3) with atopic diseases; 4) ductal stenosis and/or ectasia. Sixty-four patients with elevation of peripheral blood eosinophil (PBE) and/or serum IgE level comprised group A (highly-suspected ARS group), while the remaining 32 comprised group B (patients without confirmed evidence of ARS). These patients were treated with interventional endoscopy. A chronic obstructive sialadenitis symptom (COSS) questionnaire was used to quantify the treatment outcomes. RESULTS In group A, Serum IgE was elevated in 84.4% of patients and PBE was elevated in 34.4% of patients. Percentage of submandibular gland involvement was higher in group A than group B (48.4% vs. 18.8%). On sialograms, the snowflake changes of branch ducts were seen in higher percentage of group A compared with group B (59% vs. 35% for parotid glands, 27% vs. 8% for submandibular glands, respectively). Mucus plug smears showed abundant eosinophils in 14 group A patients. Biopsy of five group A patients revealed significant eosinophil infiltration around the main and interlobular ducts. During follow-up, the COSS scores were significantly decreased in both groups, and group B was improved better than group A. CONCLUSION PBE and serum IgE are important diagnostic indexes of ARS. Mucus plug smear or histopathology verifies the diagnosis. Interventional endoscopy is helpful for ARS cases. LEVEL OF EVIDENCE 3 Laryngoscope, 131:2030-2035, 2021.
Collapse
Affiliation(s)
- Ya-Ning Zhao
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Li-Qi Zhang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Ya-Qiong Zhang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Yan Chen
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Deng-Gao Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| |
Collapse
|
14
|
Plonowska KA, Ochoa E, Ryan WR, Chang JL. Sialendoscopy in Chronic Obstructive Sialadenitis Without Sialolithiasis: A Prospective Cohort Study. Otolaryngol Head Neck Surg 2020; 164:595-601. [PMID: 32988282 DOI: 10.1177/0194599820957256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To evaluate long-term chronic sialadenitis symptoms in patients without sialolithiasis following sialendoscopy-assisted salivary duct surgery (SASDS) compared to a control group managed conservatively. STUDY DESIGN Prospective cohort study. SETTING Tertiary care center. METHODS Thirty-six patients (52 glands) with chronic sialadenitis without sialolithiasis completed the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire at presentation and at 3-month time intervals thereafter for 1 year. Lower COSS scores represent lower symptom severity. We compared 27 patients who underwent SASDS to 9 control patients who elected conservative management. RESULTS COSS gland-specific scores from 38 SASDS-treated glands (cases) and 14 control glands were similar at baseline. At 6 to 12 months (mean, 8.4 months), the surgically treated group had significantly lower scores and a greater score reduction from baseline compared to controls (mean score change [95% confidence interval] cases: 20.7 points [15.7-25.8]; controls: 11.7 points [4.9-18.4]; P = .04). There was a significant difference in scores between the 2 groups over time (P < .001). A greater proportion (72%) of cases reported partial or complete resolution of overall sialadenitis symptoms at 6 to 12 months compared to the controls (22%, P < .05). CONCLUSION Compared to patients electing for conservative management, patients with sialadenitis without sialolithasis treated with SASDS had improved symptom scores and a greater reduction of symptom severity after 6 months. With SASDS, patients had higher rates of significant overall symptom improvement. In evaluating chronic sialadenitis, assessment at multiple time points is necessary to capture the intermittent and cyclical pattern of obstructive symptoms.
Collapse
Affiliation(s)
- Karolina A Plonowska
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| | - Edgar Ochoa
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| | - William R Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| |
Collapse
|
15
|
de Paiva Leite SH, Morton RP, Ahmad Z, Marchal F. Do Postoperative Oral Corticosteroids Improve Results After Sialendoscopy for Ductal Stenosis? Laryngoscope 2020; 131:E1503-E1509. [PMID: 32990331 DOI: 10.1002/lary.29111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/26/2020] [Accepted: 09/11/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study aims to review the effects of short- and long-term oral administration of postoperative corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis due to ductal stenosis. STUDY DESIGN Prospective comparative study. METHODS A prospective observational study was conducted at Manukau Surgical Center in Auckland, New Zealand, where patients undergoing sialendoscopic surgery for recurrent obstructive sialadenitis due to ductal stenoses were reviewed. Univariable and multivariable analysis, and also logistic regression were performed to identify variables correlated with the likelihood of the need for revision surgery for persistent or recurrent symptoms. RESULTS In this study, sialendoscopy was performed in 142 patients: 162 parotid glands (86.6%) and 25 submandibular glands (13.4%). Postoperative oral steroids were prescribed for 48 patients (34%); 19 (13%) were prescribed for less than 7 days and 29 (20%) for more than 7 days. In total, 33 patients (23.2%) required a revision sialendoscopy during follow-up due to recurrence of symptoms. Oral steroids prescribed for more than 7 days after a sialendoscopy reduced the likelihood of a revision procedure by 93% when compared with patients who did not receive this medication, and by 96% when compared with patients who received steroids for less than 7 days. CONCLUSION The results showed that in our population oral administration of corticosteroids for more than 7 days after sialendoscopy for the treatment of recurrent obstructive sialadenitis due to ductal stenosis markedly reduced the need for later revision surgery. Routine use of corticosteroids for more than 7 days is recommended after sialendoscopy in patients with ductal stenosis. LEVEL OF EVIDENCE II Laryngoscope, 131:E1503-E1509, 2021.
Collapse
Affiliation(s)
- Sandro Henrique de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
| | | |
Collapse
|
16
|
Singer MC, Marchal F, Angelos P, Bernet V, Boucai L, Buchholzer S, Burkey B, Eisele D, Erkul E, Faure F, Freitag SK, Gillespie MB, Harrell RM, Hartl D, Haymart M, Leffert J, Mandel S, Miller BS, Morris J, Pearce EN, Rahmati R, Ryan WR, Schaitkin B, Schlumberger M, Stack BC, Van Nostrand D, Wong KK, Randolph G. Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology. Head Neck 2020; 42:3446-3459. [PMID: 32812307 DOI: 10.1002/hed.26417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/03/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Postoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement. METHODS A multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations. RESULTS Consensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management. CONCLUSION Salivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.
Collapse
Affiliation(s)
- Michael C Singer
- Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Francis Marchal
- Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Peter Angelos
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Vic Bernet
- Department of Endocrinology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA
| | - Laura Boucai
- Department of Endocrinology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Samanta Buchholzer
- Maxillofacial Surgery and Oral Medicine and Pathology, Geneva University Hospital, Geneva, Switzerland
| | - Brian Burkey
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - David Eisele
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Medical School, University of Health Sciences, Istanbul, Turkey
| | - Frederic Faure
- Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Suzanne K Freitag
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Marion Boyd Gillespie
- Department of Otolaryngology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Richard Mack Harrell
- Memorial Center for Integrative Endocrine Surgery, Memorial Healthcare System, Hollywood, Florida, USA
| | - Dana Hartl
- Department of Head and Neck Oncology, Institut de Cancerologie Gustave Roussy, Villejuif, France
| | - Megan Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Susan Mandel
- Department of Endocrinology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbra S Miller
- Division of Endocrine Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - John Morris
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth N Pearce
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition & Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Rahmatullah Rahmati
- Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA
| | - William R Ryan
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Barry Schaitkin
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Saclay, Villejuif, France
| | - Brendan C Stack
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Doug Van Nostrand
- Division of Nuclear Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Ka Kit Wong
- Department of Radiology, Division of Nuclear Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory Randolph
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
17
|
Zhu WX, Chen Y, Liu DG, Yu GY. Eosinophilic Sialodochitis: A Type of Chronic Obstructive Sialadenitis Related to Allergy. Laryngoscope 2020; 131:E800-E806. [PMID: 32621541 DOI: 10.1002/lary.28772] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/10/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the clinical, laboratory, radiological, histopathological, and immunohistochemical features, and the expression of allergy-related cytokines in eosinophilic sialodochitis (ES). METHODS Thirty-eight patients diagnosed with chronic obstructive sialadenitis (COS) who had undergone glandular excision or incisional biopsy were enrolled. Seventeen patients with comorbid atopic disease and increased ductal tissue eosinophils comprised the ES group, while 21 patients comprised the COS group. The clinicopathological features and allergy-related cytokine expression were compared between groups. RESULTS The ES group frequently involved multiple, bilateral major salivary glands, and the number of glands was significantly greater than the COS group (2.8 ± 1.1 vs. 1.2 ± 0.4, P < .001). Serum immunoglobulin (Ig) E was elevated in 91% of patients in ES group (419 ± 357 kU/L) and peripheral blood eosinophil was significantly greater compared with the COS group (7.6% ± 4.6% vs. 2.5% ± 1.4%, P < .001). Histologically, eosinophil infiltration in ES group was observed around the main and interlobular ducts (50 ± 39/high power field [HPF]). Follicular hyperplasia (76%), epithelial mucous metaplasia (82%), and mucus plugs with eosinophils (41%) were observed. IgE-positive cell count was 20.7 ± 18.3/HPF and tryptase-positive mast cell count was 23.5 ± 15.1/HPF, which was significantly greater than the respective cell counts in COS group, which mainly infiltrated around the ducts. The levels of interleukin-4, interleukin-13, and eotaxin in tissue were significantly greater in ES than the COS group. CONCLUSIONS The clinicopathological characteristics of ES are significantly different from COS and ES might have an allergy-related pathogenesis. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E800-E806, 2021.
Collapse
Affiliation(s)
- Wen-Xuan Zhu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yan Chen
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Deng-Gao Liu
- Department of Oral Radiology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
18
|
Costs of sialendoscopy and impact on health-related quality of life. Eur Arch Otorhinolaryngol 2018; 276:233-241. [PMID: 30430242 PMCID: PMC6338794 DOI: 10.1007/s00405-018-5196-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/02/2018] [Indexed: 12/28/2022]
Abstract
Purpose To analyse costs related to the diagnosis and treatment of patients with sialolithiasis and sialadenitis managed with sialendoscopy, and to prospectively evaluate the impact of sialendoscopy on health-related quality of life (HRQoL) in a longitudinal follow-up study. Methods All patients undergoing sialendoscopy or sialendoscopy-assisted surgery at a tertiary care university hospital between January 2014 and May 2016 were identified from a surgical database, and the direct hospital costs were retrospectively evaluated from 1 year before to 1 year after the sialendoscopy. The 15D HRQoL questionnaire and a questionnaire exploring the use of health care services during the preceding 3 months were mailed to the patients before sialendoscopy as well as at 3 and 12 months after the operation. Results A total of 260 patients were identified. Mean total hospital costs, costs related to the sialendoscopy, and complications were significantly higher in sialolithiasis patients than in patients with other diagnoses. 74 patients returned the baseline 15D questionnaire, and 51 patients all three 15D questionnaires. At baseline, the dimensions “discomfort and symptoms” and “distress” were lower in patients than in age- and gender-standardised general population, but the total 15D score did not differ significantly. The dimension “discomfort and symptoms” improved significantly at 3 and 12 months postoperatively, and the mean total HRQoL score improved in patients with sialolithiasis at 3 months postoperatively. Conclusions The costs related to sialendoscopy are substantial and the cost-effectiveness of sialendoscopy warrants further studies. However, sialendoscopy seems to reduce patients’ discomfort and ailments and to improve HRQoL at least in patients with sialolithiasis.
Collapse
|
19
|
Li W, Wei L, Wang F, Peng S, Cheng Y, Li B. An experimental chronic obstructive sialadenitis model by partial ligation of the submandibular duct characterised by sialography, histology, and transmission electron microscopy. J Oral Rehabil 2018; 45:983-989. [PMID: 30125980 DOI: 10.1111/joor.12711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 08/06/2018] [Accepted: 08/15/2018] [Indexed: 01/05/2023]
Abstract
Extensive investigation into the mechanism of chronic obstructive sialadenitis (COS) calls for a reliable model that mimics the onset and progression of the disease. Duct obstruction is closely correlated with COS, and partial duct obstruction is usually observed in COS. Partial ligation of ducts or vessels is a valid treatment to mimic pathological processes in certain animal studies. In this study, we developed a novel animal model of COS by incomplete ligation of Wharton's duct and clarified the corresponding morphological alterations in the submandibular gland. Partial ligation of Wharton's duct in Japanese white rabbits resulted in a gradually progressive COS model as demonstrated by sialographic, gross, microscopic, and ultrastructural changes in acinar and ductal degenerations over 8 weeks. The model is a feasible option for investigating the pathogenesis of COS and evaluating the efficacy and safety of novel treatments of COS.
Collapse
Affiliation(s)
- Wei Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.,Department of Oral Radiology of School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Lili Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.,Department of Oral Radiology of School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Fang Wang
- Department of Oral Radiology of School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Shangwen Peng
- Department of Oral Radiology of School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Yong Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.,Department of Oral Radiology of School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Bo Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.,Department of Oral Radiology of School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
20
|
Moe J, Helman JI. Surgical Techniques for the Management of Submandibular Salivary Duct Strictures. Atlas Oral Maxillofac Surg Clin North Am 2018; 26:99-103. [PMID: 30077328 DOI: 10.1016/j.cxom.2018.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Justine Moe
- Oral and Maxillofacial Surgery, Hospital Dentistry, University of Michigan, 1515 East Hospital Drive, Towsley Center, G1200, Ann Arbor, MI 48109, USA
| | - Joseph I Helman
- Oral and Maxillofacial Surgery, Hospital Dentistry, University of Michigan, 1515 East Hospital Drive, Towsley Center, G1200, Ann Arbor, MI 48109, USA.
| |
Collapse
|
21
|
Ryan WR, Plonowska KA, Gurman ZR, Aubin-Pouliot A, Chang JL. One-Year symptom outcomes after sialolithiasis treatment with sialendoscopy-assisted salivary duct surgery. Laryngoscope 2018; 129:396-402. [DOI: 10.1002/lary.27398] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/10/2018] [Accepted: 05/29/2018] [Indexed: 11/08/2022]
Affiliation(s)
- William R. Ryan
- Division of Head and Neck Oncologic and Endocrine Surgery, Salivary Gland Surgery Center; Department of Otolaryngology-Head and Neck Surgery; San Francisco California
| | - Karolina A. Plonowska
- the University of California; San Francisco School of Medicine; San Francisco California
| | - Zev R. Gurman
- the Division of General Otolaryngology, Salivary Gland Surgery Center, Department of Otolaryngology-Head and Neck Surgery; University of California; San Francisco California
| | - Annick Aubin-Pouliot
- the Division of General Otolaryngology, Salivary Gland Surgery Center, Department of Otolaryngology-Head and Neck Surgery; University of California; San Francisco California
| | - Jolie L. Chang
- the Division of General Otolaryngology, Salivary Gland Surgery Center, Department of Otolaryngology-Head and Neck Surgery; University of California; San Francisco California
| |
Collapse
|
22
|
Plonowska KA, Gurman ZR, Humphrey A, Chang JL, Ryan WR. One‐year outcomes of sialendoscopic‐assisted salivary duct surgery for sialadenitis without sialolithiasis. Laryngoscope 2018; 129:890-896. [DOI: 10.1002/lary.27433] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 06/03/2018] [Accepted: 06/18/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Karolina A. Plonowska
- University of California, San Francisco School of Medicine San Francisco, San Francisco California U.S.A
| | - Zev R. Gurman
- the Division of General Otolaryngology, Salivary Gland Surgery Center, Department of Otolaryngology–Head and Neck Surgery San Francisco, San Francisco California U.S.A
| | - Amanda Humphrey
- University of California, San Francisco School of Medicine San Francisco, San Francisco California U.S.A
| | - Jolie L. Chang
- the Division of General Otolaryngology, Salivary Gland Surgery Center, Department of Otolaryngology–Head and Neck Surgery San Francisco, San Francisco California U.S.A
| | - William R. Ryan
- the Division of Head and Neck Oncologic and Endocrine Surgery, Salivary Gland Surgery Center, Department of Otolaryngology–Head and Neck SurgeryUniversity of California San Francisco, San Francisco California U.S.A
| |
Collapse
|
23
|
Jokela J, Haapaniemi A, Mäkitie A, Saarinen R. Sialendoscopy in treatment of adult chronic recurrent parotitis without sialolithiasis. Eur Arch Otorhinolaryngol 2017; 275:775-781. [PMID: 29290052 DOI: 10.1007/s00405-017-4854-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this prospective study was to evaluate the efficacy of sialendoscopy in the management of adult chronic recurrent parotitis without sialolithiasis. In addition, preliminary results of an initial randomized placebo-controlled trial of single-dose intraductal steroid injection given concurrently with sialendoscopy, are presented. METHODS Forty-nine adult patients with chronic recurrent parotitis without sialoliths were included in this study. They underwent sialendoscopy and were randomized to receive either a concurrent intraductal injection of isotonic saline solution or 125 mg of hydrocortisone. Symptom severity was evaluated with visual analogue scale (VAS) and by recording symptom frequency and course with a multiple-choice questionnaire completed preoperatively and at 3, 6, and 12 months after the procedure. RESULTS The mean VAS score was 5.6 preoperatively and dropped to 2.9 at 3 months, 3.0 at 6 months, and 2.7 at 12 months after the procedure. The VAS score and the frequency of symptoms were significantly lower at 3 (p < 0.001), 6 (p < 0.001) and 12 (p < 0.001) months after the procedure when compared with the preoperative scores indicating that sialendoscopy reduces the symptoms of recurrent parotitis. However, complete permanent resolution of symptoms was rare. Single-dose steroid injection concomitant to sialendoscopy provided no additional benefit, but the current study is not sufficiently powered to determine a clinical difference between the steroid and non-steroid groups. CONLUSION Sialendoscopy appears to reduce the symptoms of chronic recurrent parotitis. While total permanent symptom remission is rare, sialendoscopy can be considered a safe and relatively efficacious treatment method for this patient group.
Collapse
Affiliation(s)
- Johanna Jokela
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland.
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - Riitta Saarinen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland
| |
Collapse
|
24
|
Kondo N, Yoshihara T, Yamamura Y, Kusama K, Sakitani E, Seo Y, Tachikawa M, Kujirai K, Ono E, Maeda Y, Nojima T, Tamiya A, Sato E, Nonaka M. Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography. Auris Nasus Larynx 2017; 45:880-884. [PMID: 29217121 DOI: 10.1016/j.anl.2017.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 11/02/2017] [Accepted: 11/06/2017] [Indexed: 11/16/2022]
Abstract
Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjögren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen's duct stenosis and may similarly have limitation in the treatment of Sjögren's syndrome and recurrent parotitis.
Collapse
Affiliation(s)
- Norio Kondo
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
| | - Toshio Yoshihara
- Department of Otolaryngology, Tohto Bunkyo Hospital, 3-5-7, Yushima, Bunkyo-ku, Tokyo 113-0034, Japan; Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 164-0023, Japan
| | - Yukie Yamamura
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kaoru Kusama
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Eri Sakitani
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yukako Seo
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Mayako Tachikawa
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Keiko Kujirai
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Erika Ono
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yasuyo Maeda
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Tomohito Nojima
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Akiko Tamiya
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Emiri Sato
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Manabu Nonaka
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| |
Collapse
|
25
|
Delagnes EA, Zheng M, Aubin-Pouliot A, Chang JL, Ryan WR. Salivary duct stenosis: Short-term symptom outcomes after sialendoscopy-assisted salivary duct surgery. Laryngoscope 2017; 127:2770-2776. [DOI: 10.1002/lary.26665] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/02/2017] [Accepted: 04/12/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Elise A. Delagnes
- School of Medicine; University of California-San Francisco; San Francisco California U.S.A
| | - Melissa Zheng
- School of Medicine; University of California-San Francisco; San Francisco California U.S.A
| | - Annick Aubin-Pouliot
- Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Surgery Center; University of California-San Francisco; San Francisco California U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Surgery Center; University of California-San Francisco; San Francisco California U.S.A
| | - William R. Ryan
- Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Oncologic and Endocrine Surgery, Salivary Gland Surgery Center; University of California-San Francisco; San Francisco California U.S.A
| |
Collapse
|
26
|
Chronic sialadenitis with sialolithiasis associated with parapharyngeal fistula and tonsillolith. Radiol Case Rep 2017; 12:519-522. [PMID: 28828116 PMCID: PMC5552011 DOI: 10.1016/j.radcr.2017.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/01/2017] [Indexed: 11/23/2022] Open
Abstract
Sialolithiasis is a common salivary pathology, suggested to affect over 1% of the population by postmortem studies. An uncommon complication of sialadenitis and sialolithiasis is the formation of fistulous tracts to other cervicofacial compartments. Submandibular gland sialocutaneous and sialo-oral fistulae have been sparsely described, but a sialo-pharyngeal fistula manifesting as a tonsillolith has yet to be described. We present an unusual case of a 35-year-old male presenting with recalcitrant neck pain and a presumed tonsillolith in the background of chronic submandibular sialadenitis, subsequently demonstrating a salivary fistula through the parapharyngeal space. We offer a thorough review of the literature to highlight the possibility of migratory sialolithiasis and its complications.
Collapse
|