Combined sialendoscopic/mini-preauricular microscopic approach for large proximal parotid sialolithiasis

Evaluation of patients' quality of life using novel "Multidisciplinary Salivary Gland Society" questionnaire in minimally invasive management of obstructive sialadenitis

OBJECTIVE

The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal. This study aimed to assess these procedures in relieving patients' complaints and their impact on quality of life using the newly introduced Multidisciplinary Salivary Gland Society questionnaire.

STUDY DESIGN

Between January 2021 and October 2021, a case series was treated with minimally invasive surgical procedures. Data such as stone size, number and location, surgical approach, symptoms relief, and improvement of quality of life were collected and analyzed. Thirty-six patients were included (22 males and 14 females); 28 had stones in the submandibular gland and 8 in the parotid gland with largest stone diameter ranging from 0.2 to 2.8 cm. The approach was selected according to stone size and location, so 17 patients were treated with sialendoscopy (alone or using a combined approach), and 19 patients were treated without sialendoscopy using a transoral approach.

RESULTS

After a 6-month follow-up, the questionnaire scores showed a statistically significant difference in comparison to preoperative ones.

CONCLUSIONS

Minimally invasive surgical procedures present an excellent option for sialolithotomy, after which the relief of symptoms, restoration of gland function, and a significant improvement in quality of life are achieved.

Sialendoscopy-assisted combined approach for parotid sialolithotomy: Our long-term experience

OBJECTIVES

To assess the long-term outcome of sialendoscopy-assisted combined approach for parotid sialolithotomy with gland preservation.

PATIENTS AND METHODS

A retrospective study of patients treated with a combined sialendoscopic and open approach was conducted between 2011 and 2020. Demographic data of patients such as operative technique, stone size, stone location, complications, and symptom relief were collected. Patients were followed up via clinical examination and questionnaires.

RESULTS

Seventy-four patients were included and underwent endoscopy-assisted combined operations for the removal of 98 parotid stones. Of the 98 stones, 92(94%) stones were completely removed and 6(6%) were partially removed. At a mean follow-up of 47.1 ± 35 months, 65 of 74 patients (88%) achieved long-term success. Patients with stone incomplete removal were significantly more often to develop the recurrence of obstructive symptoms (p = 0.000) There were no cases of facial nerve injury or fistula formation. Gland function was preserved in 73 of 74 patients (99%).

CONCLUSIONS

The combined approach for parotid stones is a safe and gland-preserving alternative to parotidectomy. The techniques described here show high success rates and good long-term results, and they avoided the need for gland resection in >95% of cases.