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Thyrion FZ, Farneti P, Pasquini E. Sialendoscopy in Pediatric Sialolithiasis: Two Cases of Salivary Stones in the Parotid Gland and Review of the Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:857-863. [PMID: 37274989 PMCID: PMC10235292 DOI: 10.1007/s12070-023-03508-8] [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: 12/06/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023] Open
Abstract
Sialolithiasis is one of the most common diseases of the salivary glands and the most common cause of chronic obstructive sialadenitis. Whereas salivary stones are responsible for most of the cases of obstructive sialadenitis in the adult population, sialolithiasis in children is considered relatively rare. We describe two cases of a 9 and a 4-year-old male respectively, with parotid sialolithiasis treated with sialendoscopy. A systematic review of the current literature was also completed in order to evaluate all described cases of parotid sialolithiasis in the pediatric population. We found 25 articles eligible for a total of 42 cases of pediatric parotid sialolithiasis. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03508-8.
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Affiliation(s)
| | - Paolo Farneti
- ENT Department Bologna, Azienda USL di Bologna, Via Altura 3, 40139, Bologna, Italy
| | - Ernesto Pasquini
- ENT Department Bologna, Azienda USL di Bologna, Via Altura 3, 40139, Bologna, Italy
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Pediatric Sialendoscopy. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00415-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Abstract
Purpose of Review
To describe the pathophysiology, evaluation, and management of sialadenitis as well as the indications for and outcomes of sialendoscopy in the pediatric population.
Recent Findings
Pediatric sialadenitis makes up a small proportion of all salivary gland disease. Acute viral sialadenitis and juvenile recurrent parotitis are the most common forms of the condition. Juvenile recurrent parotitis is thought to be multifactorial in etiology with infectious, behavioral, autoimmune, and structural contributions. Review of the current literature supports a potential benefit from sialendoscopy for children with recurrent acute or chronic sialadenitis. Sialendoscopy can provide both diagnostic and therapeutic benefits with very low associated risks. The most common sialendoscopy findings include intraductal sludge or debris, sialoliths, and ductal strictures.
Summary
In the select pediatric population, sialendoscopy is a safe and effective procedure with associated decreased rates of recurrent acute sialadenitis including juvenile recurrent parotitis.
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Chen T, Szwimer R, Daniel SJ. The changing landscape of pediatric salivary gland stones: A half-century systematic review. Int J Pediatr Otorhinolaryngol 2022; 159:111216. [PMID: 35777140 DOI: 10.1016/j.ijporl.2022.111216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/06/2022] [Accepted: 06/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the evidence for pediatric sialolithiasis, including its demographic characteristics, diagnosis, and demonstrate the shift in its treatment paradigm. DESIGN A systematic review of sources from the Medline and Embase databases was conducted from inception to Dec 4, 2020. Two researchers independently extracted data and assessed quality. PATIENTS Patients under the age of 18 with sialolithiasis were included. MAIN OUTCOME MEASURES Study design, cohort size, age, sex, symptoms, stone characteristics, diagnostic modality and intervention were collected data points. RESULTS Forty-one studies with 243 patients were included in the review, of which 40 were case reports or series. Most stones were found in the submandibular gland (n = 210, 85.4%) and were single stones (n = 101, 71.1%). Average stone size was 7.7 mm. The most common diagnostic imaging modality used was ultrasound (n = 73, 47.4%), shifting from plain radiograph which was favoured in earlier years. Similarly, open gland excision was historically preferred, but since 2000, sialoendoscopy comprised 40.5% of all treatment modalities and continues to increase in prevalence, up to 52.1% by 2020. Extracorporeal shock wave lithotripsy was associated with the highest complication rate of 54.2%. CONCLUSIONS The pediatric sialolithiasis diagnostic and therapeutic landscape has changed with ultrasound replacing plain radiographs, and sialoendoscopy replacing submandibular gland excision. Further high-level quality evidence research is required to refine the indications, effectiveness, and safety of sialoendoscopy in pediatric sialolithiasis.
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Affiliation(s)
- Tanya Chen
- Department of Otolaryngology Head & Neck Surgery, University of Toronto, Toronto, Canada
| | - Rachel Szwimer
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Sam J Daniel
- Department of Otolaryngology Head & Neck Surgery, Montreal Children's Hospital, Montreal, Canada.
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Multiple Faces of Cervical Lesions in Children. Diagnostics (Basel) 2022; 12:diagnostics12040792. [PMID: 35453840 PMCID: PMC9024894 DOI: 10.3390/diagnostics12040792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/25/2023] Open
Abstract
Pediatric sialolithiasis is a rare condition causing tumefaction, induration, redness, and pain of the affected gland. When the submandibular gland is involved, the lesion can be mistaken for an adenopathy. As there are few studies to elucidate this condition in children, we present a rare case of a 16-year-old female with suggestive symptoms, in which initial clinical examination and two ultrasound examinations mistook the lesion for an adenopathy. A computed tomography examination was performed and the correct diagnosis was established. The patient was sent for oro-maxilo-facial examination and sialolithotomy was performed. A 10-mm yellow calculus was extracted and postoperative case evolution was favorable under wide spectrum antibiotherapy, oral nonsteroidal anti-inflammatory therapy and silagog alimentation. Although submandibular adenopathies are much more frequent in the pediatric age group, when faced with a firm, immobile submandibular lesion, the pediatrician should consider the sialolithiasis diagnosis.
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Baldovsky MD. Mass on the Floor of the Mouth in a Teenager. Pediatr Rev 2022; 43:e9-e11. [PMID: 35229115 DOI: 10.1542/pir.2020-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Velasquez N, Gardiner L, Ramprasad V, Shaffer A, Jabbour N, Stapleton A. Cost analysis of sialendoscopy for the treatment of salivary gland disorders in children. Int J Pediatr Otorhinolaryngol 2022; 153:111020. [PMID: 34973523 DOI: 10.1016/j.ijporl.2021.111020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/07/2021] [Accepted: 12/25/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Recent advances in Otolaryngology have changed the diagnosis and therapy for salivary gland disorders. Sialendoscopy-assisted surgery is a minimally invasive, conservative procedure for functional preservation of the affected gland. The goals of this study are to assess the indications, use, and outcomes of pediatric sialendoscopy at a tertiary pediatric institution as well as to analyze the direct cost related to the diagnosis and treatment of patients with sialolithiasis and Juvenile Recurrent Parotitis managed with sialendoscopy. METHODS Retrospective cohort study of pediatric patients undergoing diagnostic and/or therapeutic sialendoscopy at a tertiary level children's hospital between 2012 and 2020. Demographic, clinical, surgical variables and direct hospital costs 1 year before and after the sialendoscopy procedure were collected and analyzed. RESULTS Twenty-two pediatric patients were included. There was male predominance (59.3%). The most common indication for sialendoscopy was Juvenile Recurrent Parotitis. Average age of onset was 6.5 years for patients with JPR and 14.2 years for patients with sialolithiasis. All patients had an average of 4.5 episodes before the first procedure. 8 patients required repeat sialendoscopy for recurrent symptoms. Mean total hospital costs were significantly higher in patients with JRP 1 year before and after the sialendoscopy ($4308.8 vs. $3330) compared to patients with sialolithiasis. Costs of the sialendoscopy and related expenses including anesthesia and PACU cost were similar in both studied groups ($13,506 vs. $13,022.9). Complete resolution of symptoms was achieved in 14 patients with JRP and all patients with sialolithiasis. CONCLUSION Sialendoscopy is a low-risk procedure that aids in the treatment for pediatric salivary gland disorders. The costs related to sialendoscopy are substantial and patients with JRP incur higher hospital preoperative and postoperative costs compared to patients with sialolithiasis.
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Affiliation(s)
- Nathalia Velasquez
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
| | - Lauren Gardiner
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Vaibhav Ramprasad
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Amber Shaffer
- Department of Otolaryngology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Noel Jabbour
- Department of Otolaryngology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Amanda Stapleton
- Department of Otolaryngology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Kumar S, Kumar S, Arya V, Bootwala F, Ranganathan V, Thakker R, Hameed A, Saxena S. Bilateral hilar sialoliths in a child: A rare occurrence. J Oral Maxillofac Pathol 2022; 26:S143-S145. [PMID: 35450231 PMCID: PMC9017825 DOI: 10.4103/jomfp.jomfp_444_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/13/2021] [Indexed: 11/17/2022] Open
Abstract
Salivary sialolithiasis is a well-known cause for obstructive disease of the submandibular and parotid glands. However, the condition frequently occurs unilaterally, and it is uncommon to find a patient reporting with stones in both submandibular or parotid glands. Children below the age of 16 years rarely suffer from salivary stones. Thus, bilateral sialoliths in a child are extremely rare, with only four previous cases been reported in the literature. This is an additional case report of bilateral submandibular sialolithiasis occurring in the hilar area in a 13-year-old boy.
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Affiliation(s)
- Sanjeev Kumar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Sunil Kumar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Varun Arya
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Fatema Bootwala
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Vatsala Ranganathan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Rishabh Thakker
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Aasimah Hameed
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Susmita Saxena
- Department of Oral and Maxillofacial Pathology, ESIC Dental College and Hospital, New Delhi, India
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Yuhan BT, Svider PF, Mutchnick S, Sheyn A. Benign and Malignant Oral Lesions in Children and Adolescents: An Organized Approach to Diagnosis and Management. Pediatr Clin North Am 2018; 65:1033-1050. [PMID: 30213347 DOI: 10.1016/j.pcl.2018.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Oral lesions in children encompass a wide range of etiologies, including idiopathic entities as well as those related to an underlying systemic illness. In addition, oral masses include benign entities harboring locally destructive behavior and even malignancies in rare cases. Thorough patient history and detailed and efficient physical examination are critical for determining which lesions can be closely observed versus those require further diagnostic work-up. Understanding normal oral cavity anatomy is crucial for performing appropriate evaluation. This review describes the appropriate diagnostic and therapeutic strategies for oral cavity lesions and reviews the broad differential diagnosis of oral cavity masses.
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Affiliation(s)
- Brian T Yuhan
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, 4201 Street Antoine, Detroit, MI 48201, USA
| | - Peter F Svider
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, 4201 Street Antoine, Detroit, MI 48201, USA.
| | - Sean Mutchnick
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, 4201 Street Antoine, Detroit, MI 48201, USA
| | - Anthony Sheyn
- Department of Otolaryngology, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 420, Memphis, TN 38163, USA; Department of Pediatric Otolaryngology, LeBonheur Children's Hospital, 848 Adams Avenue, Memphis, TN 38103, USA; Department of Otolaryngology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
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Jouan R, Picot E, Hermann R, Faure F, Marchal F. Sialendoscopy for sialolithiasis in children: 4-8 years follow up. Br J Oral Maxillofac Surg 2018; 56:120-123. [PMID: 29373144 DOI: 10.1016/j.bjoms.2017.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/08/2017] [Indexed: 01/22/2023]
Abstract
Sialolithiasis is rare in children, there are no guidelines for its treatment, and there are few, if any, long term follow-up studies. We report a retrospective review of medical records of children who were treated for sialolithiasis by sialendoscopy between 1 January 2007 and 31 December 2011, and who have been followed up for 4-8 years. Personal and clinical details, including age, sex, symptoms, whether the lithiasis was parotid or submandibular, the technique of sialendoscopy and complications, were recorded. Twenty-six children (30 sides) were successfully treated by sialendoscopy between 2007 and 2011 (mean (range) age 12 (3-17) years). Stones were removed from the parotid gland in four patients and the submandibular gland in 22. The main indication for sialendoscopy was swelling of the salivary gland during meals. Twenty-six procedures were done endoscopically. Twelve were treated with a wire basket alone, 10 by the combined approach, and laser was used in eight. Four patients developed complications, but without long-term effects. During follow-up of 4-8 years there were no recurrent swellings. We conclude that endoscopic treatment of stones in childhood is an efficient and conservative option for salivary glands, has few complications and no clinical recurrence at medium to long-term follow-up.
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Affiliation(s)
- R Jouan
- Oral and Maxillofacial Surgery Department, Hospices Civils de Lyon, France.
| | - E Picot
- Oral and Maxillofacial Surgery Department, Hospices Civils de Lyon, France
| | - R Hermann
- Otorhinolaryngology, Head and Neck Surgery Department, Hospices Civils de Lyon, France
| | - F Faure
- Otorhinolaryngology, Head and Neck Surgery Department, Hospices Civils de Lyon, France; ENT Department, Infirmerie Protestante, Caluire, France
| | - F Marchal
- Department of Otolaryngology, Head and Neck Surgery, University Hospital, Geneva, Switzerland
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Schwarz Y, Bezdjian A, Daniel SJ. Sialendoscopy in treating pediatric salivary gland disorders: a systematic review. Eur Arch Otorhinolaryngol 2017; 275:347-356. [DOI: 10.1007/s00405-017-4830-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/28/2017] [Indexed: 11/24/2022]
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McCoy JM, Oreadi D. Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2017; 75:e224-e263. [DOI: 10.1016/j.joms.2017.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Won SJ, Lee E, Kim HJ, Oh HK, Jeong HS. Pediatric sialolithiasis is not related to oral or oropharyngeal infection: A population-based case control study using the Korean National Health Insurance Database. Int J Pediatr Otorhinolaryngol 2017; 97:150-153. [PMID: 28483226 DOI: 10.1016/j.ijporl.2017.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Poor oral hygiene is one of the risk factors for sialolithiasis particularly in adults; however the etiology of sialolithiasis in pediatric patients remains largely unknown. The purpose of this study is to identify the association between sialolithiasis and the oral/oropharyngeal infections in the pediatric population, as surrogate indicators for oral hygiene and retrograde infections to the affected salivary gland. METHODS This was a population based case-control study using the Korean National Health Insurance Database. We identified 10,095 pediatric patients, diagnosed with sialolithiasis, as cases (study period 2011-2015) and 50,475 age/gender/residence matched subjects without sialolithiasis, but with unrelated diseases (e.g., simple trauma in extremities) were set as controls. Logistic regression analyses were conducted to evaluate the association of sialolithiasis with oral or oropharyngeal infections. RESULTS The morbidity rate of sialadenitis was much higher in the cases than the controls (32.92% vs 0.72%, p < 0.0001). By contrast, the prevalence of oral or oropharyngeal infections (stomatitis, gingivitis, periodontitis, and pharyngo-tonsillitis) was significantly lower in pediatric sialolithiasis patients in all age (0-18) groups. The adjusted odds ratios of the multivariate analyses also confirmed significantly less prevalence of the oral and oropharyngeal infections in pediatric sialolithiasis patients. CONCLUSION Oral or oropharyngeal infections were inversely associated with pediatric sialolithiasis, suggesting that pediatric sialolithiasis may result from the intrinsic factors of the salivary gland itself, not from oral or oropharyngeal infections.
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Affiliation(s)
- Seong Jun Won
- Department of Otorhinolaryngology-Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Eunkyu Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Hee Jung Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Hyun-Kyung Oh
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea.
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Bannister M, Chowdhury MM, Sharma A. Radiologically-guided balloon sialoplasty for treatment of salivary duct stricture: A novel technique in young children. Int J Pediatr Otorhinolaryngol 2016; 88:22-4. [PMID: 27497380 DOI: 10.1016/j.ijporl.2016.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/03/2016] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To describe our experience using radiologically-guided balloon sialoplasty to successfully treat sialadenitis in two children as a single modality intervention. METHODS A retrospective case series. RESULTS Both children were successfully treated using balloon sialoplasty with complete and lasting resolution of their symptoms. CONCLUSION Paediatric sialadenitis secondary to salivary strictures are traditionally managed surgically. We believe that this is the first article to describe this intervention in such a series of children and that balloon sialoplasty is a safe technique and can be repeated as necessary, which should be considered as a management option in such paediatric cases.
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Affiliation(s)
- Miles Bannister
- Department of Paediatric Otolaryngology, Royal Hospital for Sick Children Edinburgh, 9 Sciennes, Edinburgh, EH9 1LF, United Kingdom.
| | - Moti M Chowdhury
- Department of Radiology, Royal Hospital for Sick Children Edinburgh, 9 Sciennes, Edinburgh, EH9 1LF, United Kingdom
| | - Alok Sharma
- Department of Paediatric Otolaryngology, Royal Hospital for Sick Children Edinburgh, 9 Sciennes, Edinburgh, EH9 1LF, United Kingdom
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Togan B, Gander T, Lanzer M, Martin R, Lübbers HT. Incidence and frequency of nondental incidental findings on cone-beam computed tomography. J Craniomaxillofac Surg 2016; 44:1373-80. [DOI: 10.1016/j.jcms.2016.06.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/18/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022] Open
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Surgical removal of submandibular gland sialolithiasis in a 9-year-old girl: A case report. PEDIATRIC DENTAL JOURNAL 2014. [DOI: 10.1016/j.pdj.2014.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kim DH, Song WS, Kim YJ, Kim WD. Parotid sialolithiasis in a two-year-old boy. KOREAN JOURNAL OF PEDIATRICS 2013; 56:451-5. [PMID: 24244214 PMCID: PMC3827494 DOI: 10.3345/kjp.2013.56.10.451] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 02/14/2013] [Accepted: 02/26/2013] [Indexed: 11/27/2022]
Abstract
Sialolithiasis is caused by the obstruction of a salivary gland or its excretory duct by the formation of calcareous concretions or sialoliths; this results in salivary ectasia and provokes subsequent dilation of the salivary gland. Sialolithiasis is relatively common, accounting for 30% of salivary diseases; however, it is rarely observed in childhood. This case report describes a 2-year-old male patient who complained of a painful swelling over the right cheek, and presented with palpable stones and pus discharge from the orifice of the right Stensen's duct. Computerized tomography of the neck confirmed the diagnosis, and the patient received intravenous empiric antibiotics combined with intraoral sialolithotomy. We also provide a review of the spectrum of concepts regarding the pathogenesis, diagnosis, and treatment of sialolithiasis.
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Affiliation(s)
- Do Hoon Kim
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
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Carlson ER, Ghali GE, Herb-Brower KE. Diagnosis and management of pathological conditions. J Oral Maxillofac Surg 2012; 70:e232-71. [PMID: 23128003 DOI: 10.1016/j.joms.2012.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Konstantinidis I, Chatziavramidis A, Tsakiropoulou E, Malliari H, Constantinidis J. Pediatric sialendoscopy under local anesthesia: limitations and potentials. Int J Pediatr Otorhinolaryngol 2011; 75:245-9. [PMID: 21131065 DOI: 10.1016/j.ijporl.2010.11.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/02/2010] [Accepted: 11/03/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Sialendoscopy in children is a recently described procedure. The small amount of existed literature presents the procedure under general anesthesia. We report our experience on pediatric sialendoscopy under local anesthesia at an outpatient setting. METHODS In a period of 1.5 years 9 children with age >8 years suffering from recurrent parotid swellings were assessed with sialendoscopy. In 8 out of 9 cases the parents accepted a procedure under local anesthesia. In 7 cases the procedure was completed uneventfully however in one case was discontinued and repeated under general anesthesia. The endoscope used was a 1.1mm Marchal type. Prior to endoscopy xylocaine solution 4% was applied on the papilla area for 15min. Intraductal injection of xylocaine 2% (5ml) was performed prior the insertion of the endoscope. During the procedure parents evaluated pain by means of a 6-point smiley scale. Social life and school activity were also evaluated by means of an 11-point scale pre- and 1 year post-sialendoscopy. RESULTS Seven out of eight children (8 sialendoscopies) tolerated and completed the sialendoscopy assessment. The mean duration of the procedure was 39.2min. No major complications were reported at the early post-endoscopy period. Four children presented no further swellings, two experienced one recurrence and one needed a repeat sialendoscopy (3 recurrent episodes). Sialendoscopy findings showed fibrinous debris in 4 children, mucous plugs in 2, evidence of sialodochitis with purulent debris in one child and stenosis in 3 children. The diagnosis in our cases was Juvenile Recurrent Parotitis in 6 children and chronic microbial parotitis in one case. Social life and school activity were improved in 6 children 1-year post-sialendoscopy according to parent's ratings. CONCLUSIONS Sialendoscopy under local anesthesia can be an alternative option in children of age >8 years and satisfactory cooperative skills, avoiding unnecessary general anesthesias and hospital stay.
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Affiliation(s)
- I Konstantinidis
- Sialendoscopy Clinic, 2nd ORL Department, Aristotle University, Papageorgiou Hospital, Ring Road, Efkarpia, Thessaloniki 56403, Greece.
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Abstract
Salivary gland abnormalities and salivary dysfunction are important orofacial disorders. Patients with such problems are usually seen in the dental office for evaluation and therapy, and the dental practitioner is required to make a diagnosis and institute care. Therefore, it is necessary for the dentist to be knowledgeable regarding the more common pathologic entities that involve the salivary apparatus, and also be familiar with the diagnostic and therapeutic tools that are available. Successful diagnosis is dependent on the organized integration of the information derived from past history, clinical examination, salivary volume study, imaging, serology, and histopathologic examination. This article discusses the most common disorders seen in the Salivary Gland Center and indicates the current approaches to diagnosis. Improvement in diagnostic skills will avoid serious complications and lead to specific and effective therapy.
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Affiliation(s)
- Louis Mandel
- College of Dental Medicine, 630 West 168th Street, New York, NY 10032, USA.
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Salivary calculus diagnosis with 3-dimensional cone-beam computed tomography. ACTA ACUST UNITED AC 2010; 110:94-100. [PMID: 20610300 DOI: 10.1016/j.tripleo.2010.03.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 02/28/2010] [Accepted: 03/09/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate cone-beam CT (CBCT) diagnoses of sialoliths in the major salivary glands. STUDY DESIGN Twenty-nine CBCT images containing salivary calculi were retrospectively evaluated for image quality and artifact influence. Additionally, the reproducibility of calculus measurement and the differences between CBCT measurements and ultrasonography (US) and histomorphometry (HM) measurements were determined. Diagnostic sensitivity and specificity calculations were based on the observations of 3 masked clinicians, who reviewed a total of 58 CBCT volumes. RESULTS Salivary calculi were sufficiently visualized in all patients. Metal artifacts were detected in images of 7 patients, and movement artifacts in 2. CBCT calculi measurements were highly reproducible, with mean differences of less than 350 microm. Mean CBCT measurements of calculi diameters differed from mean US measurements by approximately 500 microm and differed from mean HM measurements by approximately 1 mm. For calculus diagnoses, the mean sensitivity and specificity were both 98.85%. CONCLUSION Although poor image qualities and artifacts can reduce diagnostic information, salivary calculi can be evaluated adequately with CBCT. CBCT measurements of calculi are highly reproducible and differ little from measurements made with US and HM. Diagnostic sensitivity and specificity levels with CBCT are as high as or higher than those obtained with other diagnostic methods. Because of its high diagnostic-information-to-radiation-dose ratio, CBCT is the preferable imaging modality for salivary calculus diagnosis.
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Jadu F, Yaffe MJ, Lam EWN. A comparative study of the effective radiation doses from cone beam computed tomography and plain radiography for sialography. Dentomaxillofac Radiol 2010; 39:257-63. [PMID: 20587648 DOI: 10.1259/dmfr/62878962] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES As a first step in developing a protocol for multidimensional sialography using cone beam CT (CBCT), the objective of this study was to compare the effective radiation doses from sialography of the parotid and submandibular glands using plain radiography and CBCT. METHODS The effective doses were calculated from dose measurements made at 25 selected locations in the head and neck of a radiation analogue dosimeter (RANDO) phantom, using International Commission on Radiological Protection 2007 tissue weighting factors. RESULTS The effective dose (E) changed in relationship to changes in CBCT field of view (FOV), peak kilovoltage (kVp) and milliamperage (mA). Specifically, E decreased from a maximum of 932 microSv (30 cm FOV, 120 kVp, 15 mA) to 60 microSv (15 cm FOV, 80 kVp, 10 mA) for a parotid gland study and to 148 microSv (15 cm FOV, 80 kVp, 10 mA) for a submandibular study. The collective series of plain radiographs made during sialography of the parotid and submandibular glands yielded effective doses of 65 microSv and 156 microSv, respectively. The plain parotid gland series included one panoramic, two anterior-posterior skull and four lateral skull radiographs, whereas the submandibular gland series included one panoramic, one standard mandibular occlusal and four lateral skull radiographs. CONCLUSION The effective doses from CBCT examinations centred on the parotid and submandibular glands were similar to those calculated for plain radiograph sialography when a 15 cm FOV was chosen in combination with exposure conditions of 80 kVp and 10 mA.
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Affiliation(s)
- F Jadu
- Discipline of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario M5G 1G6, Canada
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Pathogenesis and Diverse Histologic Findings of Sialolithiasis in Minor Salivary Glands. J Oral Maxillofac Surg 2010; 68:465-70. [DOI: 10.1016/j.joms.2009.03.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Accepted: 03/23/2009] [Indexed: 11/17/2022]
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24
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Woo SH, Jang JY, Park GY, Jeong HS. Long-term outcomes of intraoral submandibular stone removal in children as compared with adults. Laryngoscope 2009; 119:116-20. [DOI: 10.1002/lary.20039] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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25
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Faure F, Querin S, Dulguerov P, Froehlich P, Disant F, Marchal F. Pediatric Salivary Gland Obstructive Swelling: Sialendoscopic Approach. Laryngoscope 2007; 117:1364-7. [PMID: 17762270 DOI: 10.1097/mlg.0b013e318068657c] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the efficacy of sialendoscopy as a diagnostic and interventional procedure for salivary ductal pathologies of children. DESIGN Prospective case series study. SETTING Tertiary care teaching hospitals. PATIENTS Eight children were investigated under general anesthesia by sialendoscopy for recurring salivary gland swellings between 2003 to 2004 in two university centers. INTERVENTION Diagnostic sialendoscopy was used for classifying ductal lesions as sialolithiasis or stenosis. Interventional sialendoscopy was used to treat these disorders. Different variables were analyzed: type of endoscope used, intraoperative findings, type of device used for sialoliths fragmentation or extraction, total number of procedures, and size and number of sialoliths removed. RESULTS Five cases of parotid and three cases of submandibular gland recurring swellings were included in the present study. Diagnostic sialendoscopy was possible in all cases. Salivary stones were found in six patients and parotid ductal stenosis in the remaining two. Multiple stones were seen in two cases. Interventional sialendoscopy was also possible in all cases, allowing an intraductal retrieval of the stones in three cases, and a marsupialization of the duct in two cases. Two cases required laser fragmentation of the stone. No major complications occurred intraoperatively or during follow-up (mean 18 months). CONCLUSION Diagnostic sialendoscopy is a new technique allowing a reliable evaluation of salivary ductal disorders in children, with low morbidity. Interventional sialendoscopy allows early treatment of pediatric sialoliths and stenosis in most cases, avoiding classical open surgery.
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Chung MK, Jeong HS, Ko MH, Cho HJ, Ryu NG, Cho DY, Son YI, Baek CH. Pediatric sialolithiasis: what is different from adult sialolithiasis? Int J Pediatr Otorhinolaryngol 2007; 71:787-91. [PMID: 17336398 DOI: 10.1016/j.ijporl.2007.01.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 01/26/2007] [Accepted: 01/30/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the clinical characteristics of pediatric sialolithiasis, which are distinct from those of adult sialolithiasis. METHODS A total of 210 patients with sialolithiasis confirmed by surgical treatment were enrolled in the study from Samsung Medical Registry (1995-2005). Twenty-nine were pediatric patients (age < or =18 years) and 181 adult patients (age >19 years). Comparison of pediatric and adult sialolithiasis was performed in terms of subject characteristics, clinical manifestations, salivary calculi characteristics, treatment modalities and outcomes. RESULTS Postprandial recurrent swelling was the most frequent complaint in pediatric sialolithiasis patients, as similar as in adult patients. However, duration of symptoms was shorter in pediatric patients (mean 14.1 months versus 30.7 months, P=0.003). Most calculi were less than 1cm in pediatric patients (93.1%), compared to 56.3% of the adult patients (P=0.001). The calculi were located more in the distal duct (62.0%) than in proximal duct and gland in the pediatric patients, whereas 44.7% in the adult patients (P=0.038). CONCLUSION Because of large proportion of relatively small and distal sialolithiasis in pediatric patients, bimanual careful palpation of the oral cavity is mandatory to diagnostic approach for children suspicious of sialolithiasis. These findings also suggest that intra-oral approach is effective treatment procedure for most of sialolithiasis in children.
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Affiliation(s)
- Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea
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Waseem Z, Waseem BAZ, Forte V. An unusual case of bilateral submandibular sialolithiasis in a young female patient. Int J Pediatr Otorhinolaryngol 2005; 69:691-4. [PMID: 15850690 DOI: 10.1016/j.ijporl.2004.11.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2004] [Revised: 10/18/2004] [Accepted: 11/08/2004] [Indexed: 11/16/2022]
Abstract
Salivary calculi in the pediatric population comprise only 3% of all cases of sialolithiasis. In addition, the presentation of bilateral calculi in children is rare. The formation of stones in the salivary glands has been attributed to slow salivary flow, salivary stagnation and unknown metabolic events. There is no report in the literature of an association between dietary calcium intake and calculi formation. We describe the clinical findings and management in a patient with bilateral sialolithiasis thought to be linked to high dietary calcium intake and review the literature.
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Affiliation(s)
- Zeeshan Waseem
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ont., Canada
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Lindman JP, Woolley AL. Multiple Intraparenchymal Parotid Calculi: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2003. [DOI: 10.1177/014556130308200817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We describe an unusual case of bilateral intraparenchymal parotid stones with unilateral parotitis in a 17-year-old boy. The patient went on to develop multiple parotid abscesses, which we treated with a superficial parotidectomy. To our knowledge, this is only the second report of intraparenchymal parotid stones in a pediatric patient.
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Affiliation(s)
- Jonathan P. Lindman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alabama at Birmingham School of Medicine
| | - Audie L. Woolley
- Department of Pediatric Otolaryngology, Children's Hospital of Alabama, Birmingham
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Lozano Blasco J, López Segura N, Bonet Alcaina M, Herrero Pérez S, Seidel Padilla V, García-Algar O. Expulsión espontánea de un cálculo salival submandibular. An Pediatr (Barc) 2003; 59:393-5. [PMID: 14519307 DOI: 10.1016/s1695-4033(03)78200-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Sialolithiasis rarely occurs in children and usually affects the submandibular salivary gland. Because of its rarity, its clinical expression is frequently missed and diagnosis is delayed. We describe the case of a 9-year-old boy with submandibular sialolithiasis who presented spontaneous passage of a large salivary stone. We review the clinical findings and etiopathogenesis of sialolithiasis in children, as well as diagnostic imaging techniques and several therapeutic approaches to stone extraction.
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30
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Bodner L. Giant salivary gland calculi: Diagnostic imaging and surgical management. ACTA ACUST UNITED AC 2002. [DOI: 10.1067/moe.2002.123863] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ottaviani F, Marchisio P, Arisi E, Capaccio P. Extracorporeal shockwave lithotripsy for salivary calculi in pediatric patients. Acta Otolaryngol 2001; 121:873-6. [PMID: 11718255 DOI: 10.1080/00016480152602366] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Salivary gland lithiasis is uncommon in pediatric patients. Color Doppler ultrasonography (US) enables an accurate diagnosis of lithiasis to be made without exposure to the radiation of traditional imaging techniques. The development of minimally invasive techniques in the ENT field has made salivary lithotripsy a feasible alternative to traditional invasive surgery. The safety and efficacy of shock wave lithotripsy for salivary calculi were evaluated in pediatric patients. Seven children (5 males; age 4-15 years) with single calculi (mean diameter 4.4 mm) of the submandibular (n = 4) and parotid glands (n = 3) underwent extracorporeal electromagnetic shock wave lithotripsy (EESWL). In four cases the stone was intraductal (two submandibular and two parotideal) and in the remaining three cases it was intraparenchymal (two submandibular and one parotideal). In one case sedative anesthesia was performed. The mean number of therapeutic sessions was five. Patients were followed up clinically and with US for 6-72 months (mean 32 months). Complete disintegration of the calculi was achieved in five cases while in two cases a residual fragment < 2 mm in diameter was observed. None of the patients had recurrence of calculi in the treated gland. Mild self-limited adverse effects (pain, swelling of the gland, self-limiting bleeding from the duct, cutaneous petechiae) were observed in four cases. Our data suggest that EESWL is effective, safe and well tolerated; the minimal invasiveness of the technique suggests that EESWL should be used as the primary approach to salivary calculi in pediatric patients. The continuous US monitoring enables the efficacy of EESWL to be evaluated during both treatment and follow-up, with only slight discomfort for the pediatric patient.
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Affiliation(s)
- F Ottaviani
- Institute of Otorhinolaryngology IV, Hospital L. Sacco, Milan, Italy.
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Nahlieli O, Eliav E, Hasson O, Zagury A, Baruchin AM. Pediatric sialolithiasis. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 90:709-12. [PMID: 11113815 DOI: 10.1067/moe.2000.109075a] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pediatric sialolithiasis is a rare condition. This article characterizes 15 cases in children between 5 and 14 years of age. The diagnoses of this condition were made with routine radiograph and ultrasound, as well as with sialography whenever possible. Sialoendoscopy was performed as a diagnostic and treatment modality. Thirteen of the 15 affected children were boys, and 12 of 15 cases occurred in the submandibular gland. We were able to diagnose 67% by our imaging methods; the remainder were diagnosed by clinical examination.
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Affiliation(s)
- O Nahlieli
- Oral and Maxillofacial Surgery Department, Barzilai Medical Center, Ashkelon, Israel.
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33
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Mandel L, Hatzis G. The role of computerized tomography in the diagnosis and therapy of parotid stones: a case report. J Am Dent Assoc 2000; 131:479-82. [PMID: 10770010 DOI: 10.14219/jada.archive.2000.0204] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Small, semi-calcified parotid stones are difficult to diagnose as imaging can be extremely difficult. Understanding how to diagnose parotid stones is important to dentists, however, because people with this condition develop parotid swellings and may seek routine dental care. CASE DESCRIPTION The authors describe a classic case of parotid sialadenitis secondary to a small lucent stone in Stensen's duct. They discovered the stone only because of the keen sensitivity of computerized tomography, or CT, to minimal amounts of calcific salts. The CT scan's ability to accurately locate the stone and its position within 1 centimeter of the orifice facilitated a successful intraoral surgical approach. CLINICAL IMPLICATIONS CT can be a significant aid in early diagnosis and therapy of patients with parotid stones, who eventually develop sialadenitis. With early intervention, further gland degeneration and parotidectomy will be prevented.
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Affiliation(s)
- L Mandel
- Columbia University School of Dental and Oral Surgery, New York, N.Y. 10032, USA
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Escudier MP, Drage NA. The management of sialolithiasis in 2 children through use of extracorporeal shock wave lithotripsy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1999; 88:44-9. [PMID: 10442944 DOI: 10.1016/s1079-2104(99)70192-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The management of salivary calculi in children may prove difficult for a number of reasons. Traditional investigations require ionizing radiation and in cases of sialography may be poorly tolerated. Similarly, any surgical treatment is likely to require general anesthesia and, in a number of cases, removal of the affected gland, which is associated with attendant risks. As an alternative, ultrasound and extracorporeal shock wave lithotripsy therapy offers low morbidity and outpatient procedures that are well tolerated, as illustrated by these 2 cases.
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Affiliation(s)
- M P Escudier
- Guy's and St Thomas' NHS Trust, London, United Kingdom
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Abstract
This report documents an unusual case of buccal mucosa swelling due to a giant (25 x 13 mm), parotid duct sialolith. Review of the literature disclosed that this is the largest parotid sialolith ever reported. Diagnostic imaging and treatment are described.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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36
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Abstract
PURPOSE To evaluate the images obtained by CT in diagnosis and treatment plan of teeth in the maxillary sinus. METHODS Twelve patients with teeth in the maxillary sinus were studied by plain film radiography (PFR) and by CT with a dental software programme, which displays multiple panoramic and cross-sectional views of the mandible and maxilla. The three-dimensional morphology of the tooth, its inclination, proximity to the sinus wall, surgical planning and prediction of prognosis and complications were estimated on both PFR and on CT scans and scored. RESULTS The radiographical features interpreted from PFR were fair or poorly diagnosed whereas CT provided excellent features. The surgical approach of choice was based on CT interpretation. CONCLUSION CT is useful for diagnosis and treatment planning of teeth in the maxillary antrum.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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