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Hughes E, Velazquez-Castro OS, Cates D, Squires L. Introducing Sialendoscopy in a Veteran Population: Effect on Benign Salivary Disease Treatment. Am J Otolaryngol 2024; 45:104189. [PMID: 38142609 DOI: 10.1016/j.amjoto.2023.104189] [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: 11/02/2023] [Accepted: 12/09/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE To compare rates of sialadenectomy in a veteran population before and after introduction of sialendoscopy. MATERIALS AND METHODS All Veterans Affair (VA) Northern California Healthcare System (NCHS) encounters from 2006 to 2021 for benign obstructive salivary etiologies were identified using International Classification of Disease 9/10 codes. This cohort was then cross referenced with Current Procedural Terminology codes to identify patients who underwent a procedure for their salivary pathologies. The rates of sialadenectomy and minimally invasive procedures were measured before and after sialendoscopy was introduced to the VA NCHCS in 2016. Data was obtained via chart review and demographic information, diagnosis, and procedure type were extracted. Rates of sialadenectomy, minimally invasive procedures, and other patient and procedural characteristics were compared between the Pre-Sialendoscopy Era (PSE) and Sialendoscopy Era (SE). Statistical analysis was performed using Microsoft Excel (Microsoft, version 16.66). RESULTS An increasing number of patients per year sought care for benign obstructive salivary pathology in the SE when compared to the PSE cohort and a higher rate of female patients were treated in the SE cohort. A simultaneous reduction in sialadenectomy rates and increase in minimally invasive procedure rates was observed in the SE. Sialendoscopy represented most of the increase in minimally invasive techniques, but there was a slight increase in other procedure types. Submandibular gland obstructive pathologies required the most procedures and resulted in the most gland excisions. CONCLUSION This retrospective review strongly suggests introducing sialendoscopy reduced the incidence of sialadenectomy for benign non-tumor obstructive pathology in this VA NCHS population. Further prospective studies are needed to evaluate this in a more generalized setting.
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Affiliation(s)
- Emelia Hughes
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, United States of America.
| | - Oscar Santiago Velazquez-Castro
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, United States of America
| | - Daniel Cates
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, United States of America; Veterans Affairs Northern California Healthcare System, Sacramento, CA 95655, United States of America
| | - Lane Squires
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, United States of America; Veterans Affairs Northern California Healthcare System, Sacramento, CA 95655, United States of America
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Finegersh A, Chang J, Lee YJ, Sirjani D. Suture Stenting After Sialendoscopy: A Novel Technique That Reduces Risk of Recurrent Parotitis. Laryngoscope 2024; 134:614-621. [PMID: 37338090 DOI: 10.1002/lary.30828] [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: 11/23/2022] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Chronic sialadenitis is associated with decreased quality of life and recurrent infections. While sialendoscopy with stenting is effective in relieving symptoms of sialadenitis, currently available stents are rigid and poorly tolerated by patients, leading to early removal and potential for adverse scarring. This study examines whether sutures can be used as a stenting material to improve patient comfort and reduce recurrence risk. METHODS This is a retrospective cohort study of a consecutive series of adult patients with chronic sialadenitis undergoing sialendoscopy with or without suture stenting. Data were collected between 2014 and 2018 with a 3-year follow-up period ending in 2021. The primary outcome measure was recurrence of sialadenitis within 3 years of surgery. Secondary outcomes were stent dislodgement and patient-reported discomfort. RESULTS We included 63 patients with parotid sialadenitis of whom 28 underwent suture stenting and 35 did not receive stenting after sialendoscopy. Stents were well tolerated, with a mean duration of 34.5 days, and only 2 of 28 stents (7.1%) accidentally dislodged within the first week. Suture stenting significantly reduced symptom recurrence after sialendoscopy (OR = 0.09, 95% CI 0.02-0.45, p = 0.003; 3-year sialadenitis recurrence rate: 7.1% vs. 45.7%, p = 0.005). Cox multivariate regression for clinicodemographic variables showed an HR of 0.04 (95% CI 0.01-0.19, p < 0.001) for the risk of symptom recurrence. CONCLUSIONS AND RELEVANCE Suture stenting after sialendoscopy is low cost, available across all institutions, well-tolerated by patients, and highly efficacious in reducing risk of recurrent sialadenitis after sialendoscopy. LEVEL OF EVIDENCE 3 Laryngoscope, 134:614-621, 2024.
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Affiliation(s)
- Andrey Finegersh
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Julia Chang
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Loma Linda University, Loma Linda, California, USA
| | - Yu-Jin Lee
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
| | - Davud Sirjani
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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Mao JS, Lee YC, Chi JCY, Yi WL, Tsou YA, Lin CD, Tai CJ, Shih LC. Long-term rare giant sialolithiasis for 30 years: A case report and review of literature. World J Clin Cases 2023; 11:5376-5384. [DOI: 10.12998/wjcc.v11.i22.5376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/01/2023] [Accepted: 07/06/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Sialolithiasis is one of the most common salivary gland disorders, most commonly affecting the submandibular gland. Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments. Treatment selection was based on the ductal system anatomy and the size and location of the stones. This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables.
CASE SUMMARY This report presents a case of a long-term, rare, and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult. Our patient presented with painless right submandibular swelling. Computed tomography revealed a calcified mass measuring 35 mm × 20 mm within the right submandibular gland. In this case, the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland. Thus, right submandibular sialoadenectomy was performed via the transcervical approach. After the surgery, the patient recovered without any complaints, side effects, or complications.
CONCLUSION Tailored management is important for preserving gland function, maintaining low risk, and reducing patient discomfort.
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Affiliation(s)
- Jit-Swen Mao
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
| | - Yu-Chien Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
| | - Jessie Chao-Yun Chi
- Department of Otorhinolaryngology, Head and Neck Surgery, Taichung Hospital, Ministry of Health and Welfare, Taichung 404, Taiwan
| | - Wan-Ling Yi
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
| | - Yung-An Tsou
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chia-Der Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chih-Jaan Tai
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Liang-Chun Shih
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
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Mao JS, Lee YC, Chi JCY, Yi WL, Tsou YA, Lin CD, Tai CJ, Shih LC. Long-term rare giant sialolithiasis for 30 years: A case report and review of literature. World J Clin Cases 2023; 11:5382-5390. [PMID: 37621584 PMCID: PMC10445064 DOI: 10.12998/wjcc.v11.i22.5382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/01/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Sialolithiasis is one of the most common salivary gland disorders, most commonly affecting the submandibular gland. Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments. Treatment selection was based on the ductal system anatomy and the size and location of the stones. This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables. CASE SUMMARY This report presents a case of a long-term, rare, and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult. Our patient presented with painless right submandibular swelling. Computed tomography revealed a calcified mass measuring 35 mm × 20 mm within the right submandibular gland. In this case, the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland. Thus, right submandibular sialoadenectomy was performed via the transcervical approach. After the surgery, the patient recovered without any complaints, side effects, or complications. CONCLUSION Tailored management is important for preserving gland function, maintaining low risk, and reducing patient discomfort.
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Affiliation(s)
- Jit-Swen Mao
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
| | - Yu-Chien Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
| | - Jessie Chao-Yun Chi
- Department of Otorhinolaryngology, Head and Neck Surgery, Taichung Hospital, Ministry of Health and Welfare, Taichung 404, Taiwan
| | - Wan-Ling Yi
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
| | - Yung-An Tsou
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chia-Der Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chih-Jaan Tai
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Liang-Chun Shih
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 400, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
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Epidemiologic, radiologic, and sialendoscopic aspects in chronic obstructive sialadenitis. Eur Arch Otorhinolaryngol 2022; 279:5813-5820. [PMID: 35680655 DOI: 10.1007/s00405-022-07473-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/27/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE Chronic obstructive sialadenitis (COS) is a recurring inflammation of the salivary gland. To date, there are no known predisposing factors for COS. Given the advances seen in radiology and sialendoscopy, we must update our knowledge of COS, analyzing factors that can favor its development. METHODS We prospectively analyzed 333 patients who underwent sialendoscopy between 2012 and 2021. Epidemiologic, radiologic, and sialendoscopy-related factors were correlated. Suspected diagnosis was established based on the clinical and radiologic data. The final diagnosis was determined on the basis of sialendoscopic findings. RESULTS The most common etiology of COS was stricture (40.8%). Lack of papilla distensibility (LPD) was also described as an etiology. COS was related to patient gender and age. Submandibular gland involvement was significantly more associated with lithiasis and LPD, while COS of the parotid gland was most frequently caused by stricture. Radioiodine sialadenitis and Sjögren's syndrome were significantly associated with stricture. MR sialography (MR-Si) showed the best overall sensitivity and specificity. CONCLUSION In our series, stricture was the most common cause of COS. We describe LPD as a frequent cause of COS in this series; ours is the first study to report this finding. There was a significant association between the salivary gland involved, patient sex and age, and the cause of COS. MR-Si showed the greatest diagnostic yield.
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Goyal M, Singh PP, Batra A. Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population. J Maxillofac Oral Surg 2022; 21:715-724. [DOI: 10.1007/s12663-020-01472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022] Open
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Kataoka Y, Kojima Y, Ishibashi R, Nakao Y, Yamamura K, Takahashi S, Hashiba T, Matsue T. Transoral removal of a hilo-parenchymal submandibular sialolith. Clin Case Rep 2022; 10:e05903. [PMID: 35664512 PMCID: PMC9137105 DOI: 10.1002/ccr3.5903] [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: 12/06/2021] [Revised: 03/15/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
In sialolithiasis, the lithiasis is often large and located at the junction of the middle and posterior third of the duct, in the hilum region. In such cases, transoral approach for submandibular lithiases (TASL) is a useful treatment of choice in patients with large submandibular stones that can be palpated bimanually.
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Affiliation(s)
| | | | | | - Yuji Nakao
- Self‐Defence Forces Central HospitalSetagaya‐kuJapan
| | - Koji Yamamura
- Self‐Defence Forces Central HospitalSetagaya‐kuJapan
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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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Treatment of Sialolithiasis: What Has Changed? An Update of the Treatment Algorithms and a Review of the Literature. J Clin Med 2021; 11:jcm11010231. [PMID: 35011971 PMCID: PMC8746135 DOI: 10.3390/jcm11010231] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 12/04/2022] Open
Abstract
Treatment for sialolithiasis has undergone significant changes since the 1990s. Following the development of new minimally invasive and gland-preserving treatment modalities, a 40–50% rate of gland resection was reduced to less than 5%. Extracorporeal shock-wave lithotripsy (ESWL), refinement and extension of methods of transoral duct surgery (TDS), and in particular diagnostic and interventional sialendoscopy (intSE) are substantial parts of the new treatment regimen. It has also become evident that combining the different treatment modalities further increases the effectiveness of therapy, as has been especially evident with the combined endoscopic–transcutaneous approach. In the wake of these remarkable developments, a treatment algorithm was published in 2009 including all the known relevant therapeutic tools. However, new developments have also taken place during the last 10 years. Intraductal shock-wave lithotripsy (ISWL) has led to remarkable improvements thanks to the introduction of new devices, instruments, materials, and techniques, after earlier applications had not been sufficiently effective. Techniques involving combined approaches have been refined and modified. TDS methods have been modified through the introduction of sialendoscopy-assisted TDS in submandibular stones and a retropapillary approach for distal parotid sialolithiasis. Recent trends have revealed a potential for significant changes in therapeutic strategies for both major salivary glands. For the submandibular gland, ISWL has replaced ESWL and TDS to some extent. For parotid stones, ISWL and modifications of TDS have led to reduced use of ESWL and the combined transcutaneous–sialendoscopic approach. To illustrate these changes, we are here providing an updated treatment algorithm, including tried and tested techniques as well as promising new treatment modalities. Prognostic factors (e.g., the size or location of the stones), which are well recognized as having a strong impact on the prognosis, are taken into account and supplemented by additional factors associated with the new applications (e.g., the visibility or accessibility of the stones relative to the anatomy of the duct system).
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Management of obstructive pathology of the salivary glands in elderly patients: a preliminary study. The Journal of Laryngology & Otology 2021; 136:60-63. [PMID: 34839847 DOI: 10.1017/s0022215121003881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Obstructive pathology is a benign condition of the salivary glands that can affect elderly and co-morbid people. Sialoendoscopy is a minimally invasive surgical procedure with a success rate comparable to standard sialoadenectomy and has the advantage that it can be performed under local anaesthesia. METHODS This study aimed to assess sialoendoscopy benefits in elderly patients unfit for general anaesthesia. A group of elderly patients (aged 65 years or more) undergoing sialoendoscopy under local anaesthesia were evaluated. Age, co-morbidities, surgical time, hospital stay, and complication and recurrence rates were assessed. RESULTS Nineteen sialoendoscopies were performed in 18 elderly patients with a mean age of 69.7 ± 5.6 years, with some of them suffering from multiple co-morbidities. Surgery was successful in 16 patients, while surgery was unsuccessful in 2 patients because of intraglandular stones. The average surgical duration was 54.5 ± 30.1 minutes, and all patients were discharged 2-3 hours after surgery. No post-operative complications were found and only one patient had recurrence during follow up. CONCLUSION Sialoendoscopy under local anaesthesia is a safe and effective procedure in elderly patients who are more prone to complications.
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Zheng KT, de Paiva Leite S, Yeom BW, Hardcastle T, Ahmad Z, Morton RP. Patient Outcomes After Unsuccessful Endoscopic Sialolith Extraction. Laryngoscope 2021; 132:1029-1033. [PMID: 34797568 DOI: 10.1002/lary.29943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/12/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE/HYPOTHESIS To evaluate clinical outcomes following failed endoscopic extraction of salivary calculi and to assess any relation between clinical outcome and calculi location, number, size, and mobility. If sialendoscopy fails to extract the calculus, subsequent spontaneous passage of the calculus out of the ductoglandular system or secondary effects of sialendoscopy could mitigate the clinical impact of a residual sialolithiasis. STUDY DESIGN Prospective observational study. METHODS Prospective comparative study of endoscopic procedures for sialolithiasis performed in the Manukau Surgery Center, in Auckland, New Zealand, from 2010 to 2020. The recurrent symptoms and the variables related to the need for additional surgical intervention for salivary calculi were analyzed. RESULTS Among the 465 sialendoscopy procedures, 154 (33.1%) were for obstructive sialolithiasis. Among these, there were 30 (19.4%) with unsuccessful stone extraction with re-operation for these failures performed in 14 of the 27 failed submandibular cases (52%) and 2 of the 3 parotids (66.7%). Location of calculi was a significant factor in predicting the need of further surgery. Patients with perihilar stones were 5 times more likely to have a failed procedure (P = .001). If the stone was intraglandular, the likelihood increased to 8.5 times (P = .005). The likelihood for a revision procedure increased almost 11 times if the stone was intraglandular (P = .004). Calculi size, mobility, multiple calculi, and presence of concurrent stenosis did not correlate with need for further surgery. CONCLUSIONS A significant proportion of "failed" sialendoscopy did not require further intervention. Stone location was a significant factor in predicting a failed procedure and the need for re-intervention. Laryngoscope, 2021.
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Affiliation(s)
- Kevin Tiankai Zheng
- Department of Otolaryngology-Head and Neck Surgery, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand
| | - Sandro de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Brian William Yeom
- Department of Otolaryngology-Head and Neck Surgery, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand
| | - Tim Hardcastle
- Department of Otolaryngology-Head and Neck Surgery, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand
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Donaldson G, de Paiva Leite S, Hardcastle T, Ahmad Z, Morton RP. The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review. Ann Otol Rhinol Laryngol 2021; 131:805-811. [PMID: 34493105 DOI: 10.1177/00034894211045262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis. DESIGN Qualitative systematic review. METHODS A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced peer-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility. RESULTS About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management of ductal stenoses. CONCLUSION This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up.
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Affiliation(s)
| | - Sandro de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Tim Hardcastle
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Zahoor Ahmad
- University of Auckland, Auckland, New Zealand.,Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Randall P Morton
- University of Auckland, Auckland, New Zealand.,Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
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Sialendoscopy and CT navigation assistance in the surgery of sialolithiasis. Radiol Oncol 2021; 55:284-291. [PMID: 33768767 PMCID: PMC8366728 DOI: 10.2478/raon-2021-0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A sialendoscopy-assisted combined approach is well established in the surgery of sialolithiasis. In cases of proximal salivary stones, transcutaneous sialendoscopy-assisted extractions with parotid and submandibular gland preservation is the primary intention of treatment. We recently added computer tomography (CT) navigation to improve the results of this challenging surgery equally in both localizations. PATIENTS AND METHODS Al l the patients who submitted to sialendoscopy and sialendoscopy-assisted procedures at the tertiary institution between January 2012 and October 2020 were included in the present study. From November 2019, CT navigation was added in cases with sialolithiasis and a presumably poor sialendoscopic visibility. We evaluated the parameters of the disease, diagnostic procedures, sialendoscopic findings and outcomes, with or without optical surgical navigation. RESULTS We performed 178 successful salivary stone removals in 372 patients, of which 118 were combined sialendos-copy-assisted approaches, including 16 transcutaneous proximal, 10 submandibular and 6 parotid stone operations. Surgical navigation was used in six patients, four times for submandibular and twice for parotid sialolithiasis. These were all non-palpable, sialendoscopically invisible or partially visible stones, and we managed to preserve five of the six salivary glands. CONCLUSIONS The addition of CT navigation to sialendoscopy-assisted procedures for non-palpable, sialendoscopically invisible and fixed stones is a significant advantage in managing sialolithiasis. By consistently performing sialendoscopy and related preservation procedures, we significantly reduced the need for sialoadenectomies in patients with obstructive salivary gland disease.
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14
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Hardcastle T, Rasul U, de Paiva Leite S, Zheng K, Donaldson G, Ahmad Z, Morton RP. The Manukau Salivary Symptoms Score for Assessing the Impact of Sialendoscopy in Recurrent Obstructive Sialadenitis. Otolaryngol Head Neck Surg 2021; 166:461-467. [PMID: 34253080 DOI: 10.1177/01945998211017444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the Manukau Salivary Symptom Score (MSSS) questionnaire as a validated tool to assess obstructive sialadenitis-specific symptoms to both indicate disease severity and assess the outcome after sialendoscopic procedures. STUDY DESIGN A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic chronic obstructive salivary gland disease (COSGD). SETTING Department of Otolaryngology-Head and Neck Surgery at the Manukau Surgical Centre, Auckland, New Zealand, between June 2010 and September 2019. METHODS A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic COSGD. Patients completed the MSSS preoperatively and at postoperative follow-up. Statistical tests were used to compare pre- and postoperative answers. Cronbach's α was used to measure internal consistency. Finally, construct validity was determined by comparing the 5-question MSSS questionnaire to the preexisting 20-question Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. RESULTS Postoperatively, patients had significant improvements in pain, eating, talking, swelling, and quality of life (P < .001). The MSSS questionnaire was found to have high internal consistency (α = 0.938). Questions in the MSSS had a very strong positive correlation with 3 COSS questions, a strong positive correlation with 8, a moderate positive correlation with 4, and a weak positive correlation with 1. Four COSS questions were not considered relevant and were not included in the MSSS questionnaire. CONCLUSION The MSSS questionnaire is a simple, validated questionnaire that is useful for assessing the impact of sialendoscopy in patients with COSGD.
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Affiliation(s)
- Tim Hardcastle
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Usman Rasul
- University Hospital Hairmyres, National Health Service Lanarkshire, Scotland, UK
| | - Sandro de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Kevin Zheng
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, 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
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
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15
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Abstract
Simple sialendoscopy procedures may be performed in the outpatient clinic with few complications. This process spares patients the risks, increased cost, and time burdens of sialendoscopy under general anesthesia. Sialendoscopy procedures may be incorporated into the outpatient practice after gaining experience with these procedures in the operating room. Diagnostic sialendoscopy, dilation of stenosis, and endoscopic sialolithotomies of small, freely mobile stones are appropriate for in-office sialendoscopy in many instances.
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16
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Şengör GA, Bilgili AM. A Novel Approach for the Treatment of Sialolithiasis that Preserves Salivary Duct Anatomy. Ann Otol Rhinol Laryngol 2021; 131:268-276. [PMID: 34049458 DOI: 10.1177/00034894211018926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The sialendoscopy era in the treatment of salivary gland stones has reduced the use of classical surgical methods. However, the miniature ducts and tools may cause difficulties in removing large sialoliths. Therefore, invasive combined oral surgeries or gland resection may be considered. We searched for the most suitable method in order to stay in line with the minimally invasive approach that preserves the ductus anatomy, and that can reduce the surgical fears of patients. MATERIALS AND METHODS The study included 84 cases (23 parotid and 61 submandibular) in whom stones were fragmented by pneumatic lithotripsy and removed between January 2015 and January 2020. The parotid cases comprised 7 females and 16 males, and the submandibular cases comprised 25 females and 36 males. Intraductal lithotripsy was performed using pneumatic lithotripter. This study has fourth level of evidence. RESULTS Based on total number of cases (n = 84), success rate was 67/84 (79.7%) immediately after sialendoscopy, and overall success rate was 77/84 (91.6%). Based on number of stones treated (n = 111), our immediate success rate was 94/111 (84.6%), and overall success rate was 104/111 (93.7%). The success criteria were complete removal of the stone and fragments in a single sialendoscopy procedure and resolution of symptoms. CONCLUSIONS We successfully treated salivary gland stones, including L3b stones, in our patient cohort with sialendoscopy combined with pneumatic lithotripsy. The lithotripsy method that we have adapted seems to be more useful and cost-effective compared to its alternatives. We were also able to preserve the ductus anatomy and relieve patients' concerns.Level of Evidence: Level IV.
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Affiliation(s)
| | - Ahmet Mert Bilgili
- Medical Faculty Department of Otolaryngology, Cyprus International University, Nicosia, Cyprus
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17
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Erdoğan O, Özcan C, İsmi O, Gür H, Vayısoğlu Y, Görür K. Effectiveness of sialendoscopy on the symptoms of chronic obstructive sialadenitis and patient satisfaction degree. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:314-319. [PMID: 34033943 DOI: 10.1016/j.jormas.2021.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the effectiveness of sialendoscopy (SE) on the symptom severity of chronic obstructive sialadenitis (COS) and patient satisfaction by using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire and the Patient Satisfaction Scores (PSS). PATIENT AND METHODS COSS questionnaire was employed to 51 Turkish patients with COS before and three months after SE. Patients' satisfaction with SE was evaluated by analyzing the PSS. RESULTS Gland preservation rate of the SE operation was 96.2%. The sialolith extraction rate was 74.2%. A significant decrease in the COSS scores of all of the patients in the study sub-groups was observed (p < 0.05). The effectiveness of SE was more pronounced for patients with sialolithiasis and submandibular gland (SG) involvement (p < 0.001, p = 0.03, respectively). Totally extracted stone and symptom duration were the only independent factors that significantly affected the COSS score gain values in patients with and without sialolithiasis, respectively (p < 0.001). There was a statistically significant correlation between COSS score gain values and PSS values. (r = 0.786) CONCLUSION: The benefit of SE was more pronounced in patients with sialolithiasis and SG involvement. Successful stone extraction and symptom duration were two independent factors that influenced both clinical improvement and patient satisfaction for patients with and without sialolithiasis, respectively. COSS questionnaire results correlated with the PSS values; thus, this questionnaire can also be used to evaluate the patients' satisfaction with SE.
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Affiliation(s)
- Osman Erdoğan
- Department of Otorhinolaryngology, Şanlıurfa Training and Research Hospital, Yenice street, Şanlıurfa 63300, Turkey.
| | - Cengiz Özcan
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Onur İsmi
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Harun Gür
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Yusuf Vayısoğlu
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Kemal Görür
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey
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18
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Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
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Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
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19
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Colella G, Lo Giudice G, De Luca R, Troiano A, Lo Faro C, Santillo V, Tartaro G. Interventional sialendoscopy in parotidomegaly related to eating disorders. J Eat Disord 2021; 9:25. [PMID: 33597023 PMCID: PMC7890799 DOI: 10.1186/s40337-021-00378-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the viability and efficacy of sialendoscopy for the management of parotidomegaly related to eating disorders, 6 patients suffering from eating disorders and recurring symptoms of glandular swelling were followed up at the Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli". After the detection of the impaired gland through clinical and radiographical analysis, the diagnostic unit was introduced into the duct and was advanced in, reaching the ductal system. Plaques were washed out, any strictures were dilated both by hydrostatic pressure application and steroid solution injection directly in the fibrotic area. RESULTS Both glands resulted affected in 83% of patients. 11 parotid glands were explored and treated. Strictures were found in 2 glands (33%), sialectasis in 3 glands (50%), strictures and sialectasis together in 1 glands (17%). In 3 parotid glands (50%) Stenon's duct was affected, in two (33%) only secondary ducts, in 1 (17%) both. We reached symptomatic improvement in 5 patients (83%), reporting the spherical volume of the parotid region and pain reduction. CONCLUSIONS Our results demonstrate that sialendoscopy is a safe and effective therapeutic method to treat EDs salivary symptoms. Treating the underlining psychiatric pathology should be the primary goal in patient care to lower the possible recurrence rate and increase the successful outcome of this technique.
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Affiliation(s)
- Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy.
| | - Roberto De Luca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy
| | - Antonio Troiano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy
| | - Carmelo Lo Faro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy
| | - Vincenzo Santillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
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20
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Brooks JK, Macauley MR, Price JB. Concurrent giant sialoliths within the submandibular gland parenchyma and distal segment of Wharton's duct: Novel case report. Gerodontology 2021; 38:437-440. [PMID: 33586807 DOI: 10.1111/ger.12544] [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: 12/09/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This article discusses the clinical significance of an unusual case of the simultaneous occurrence of 2 giant sialoliths within the ipsilateral submandibular gland and distal aspect of Wharton's duct in a 63-year-old patient. BACKGROUND The majority of submandibular gland sialoliths are found in Wharton's duct, with fewer within the gland parenchyma. Giant sialoliths (exceeding 15 mm in size) are rare. MATERIALS AND METHODS An asymptomatic, otherwise healthy older patient sought dental care and underwent a comprehensive oral and radiographic examination. RESULTS A panoramic radiograph revealed 2 incidental radiopaque structures, representing giant sialoliths within the submandibular gland and along the distal segment of Wharton's duct. This synchronous finding apparently represents the first case reported in the geriatric literature. CONCLUSIONS The detection of 1 salivary stone should heighten the scrutiny for additional stones. Practitioners should carefully weigh the risk of sialolith removal versus deferment of treatment in older medically compromised patients.
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Affiliation(s)
- John K Brooks
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
| | | | - Jeffery B Price
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
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21
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Kim EM, Lee SH, Oh SH, Kim GT, Choi YS, Hwang EH. Ultrasound-guided sialo-irrigation for the treatment of chronic sialodochitis with sialolithiasis. Oral Radiol 2021; 37:345-351. [PMID: 33394278 DOI: 10.1007/s11282-020-00495-2] [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: 09/21/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
Sialolithiasis is one of the most common causes of salivary duct obstruction. In the last 20 years, minimally invasive procedures like sialendoscopy, extracorporeal lithotripsy, and basket snaring are increasingly being used for the treatment of salivary gland duct stones. Sialo-irrigation of the salivary gland is an effective procedure for treating inflammation and providing symptomatic relief. This procedure can be employed for the treatment of sialolithiasis using the back pressure of instilled saline. Sialo-irrigation under ultrasound (US) guidance allows for dynamic studies showing real-time images during diagnostic or surgical procedure and can be used for the removal of sialoliths. In addition, it can also be used to remove primitive sialoliths and microliths by washing out the ductal system, which prevents the recurrence of sialoliths. The aim of this study was to propose a minimally invasive technique for sialolithiasis using US-guided sialo-irrigation.
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Affiliation(s)
- Eun Mi Kim
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Sung Hyun Lee
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Gyu-Tae Kim
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Yong-Suk Choi
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Eui-Hwan Hwang
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea
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22
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Bento RF. Sialendoscopy for Improvement of Salivary Flow in Patients with Sjögren Syndrome - Comparative Analysis of Intraglandular Washing Solutions. Int Arch Otorhinolaryngol 2021; 25:e1-e7. [PMID: 33391395 PMCID: PMC7850891 DOI: 10.1055/s-0040-1716574] [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: 04/29/2020] [Accepted: 07/29/2020] [Indexed: 10/31/2022] Open
Abstract
Introduction Among the potential diseases that present altered salivary flow and activity is Sjögren syndrome. Sialendoscopy seems to be an important therapeutic option. Objective To compare the results obtained with sialendoscopy for improving salivary flow measured by scintigraphy in patients with primary Sjögren syndrome to those obtained with other intraglandular washing solutions. Methods Patients from our institution's rheumatology clinic diagnosed with primary Sjögren syndrome underwent parotid scintigraphy prior to the sialendoscopy procedure. During the sialendoscopy procedure, one of the parotid glands was randomized to receive a wash with saline while the other was washed with a corticosteroid solution. After 1 month, a new scintigraphy examination of the parotid glands was performed to observe the salivary flow for comparison. Results A total of 13 female patients with mean age of 53.38 years (range, 27-76 years) were included in this study. After sialendoscopy, 10 patients (76.92%) were observed to have improvement in salivary excretion with radiopharmaceutical during scintigraphy. When analyzing each gland that was treated separately (26 glands), after sialendoscopy, improvement was observed in 18 glands (69.23%), 8 treated with dexamethasone and 10 with saline solution in the wash. There was no improvement in 8 glands (30.77%). Conclusion This study demonstrates that sialendoscopy is as an important tool to improve salivary flow measured by scintigraphy in patients with primary Sjogren syndrome, increasing salivary excretion through dilation and consequent unblocking of the ducts. These data suggest that there is no statistically significant difference between intraductal washing solutions using saline or dexamethasone solution.
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Affiliation(s)
- Ricardo Ferreira Bento
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
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23
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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.
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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
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24
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Koch M, Schapher M, Mantsopoulos K, Iro H. Intraductal Lithotripsy in Sialolithiasis Using the Calculase III™ Ho:YAG Laser: First Experiences. Lasers Surg Med 2020; 53:488-498. [PMID: 32997838 DOI: 10.1002/lsm.23325] [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: 07/02/2020] [Revised: 08/24/2020] [Accepted: 09/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES To report the first experiences with a newly available Ho:YAG laser system for the treatment of salivary stones. STUDY DESIGN/MATERIALS AND METHODS A retrospective study in a tertiary referral center was conducted. Patients diagnosed with sialolithiasis were treated in Erlangen using the Calculase III™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany). Preset parameters had a frequency of 4 Hz and energy of 0.8-1.2 J, resulting in 3.2-4.8 W. Following total fragmentation, one to two serial sialendoscopies were performed to achieve complete fragment clearance. RESULTS A total of 55 stones in 49 patients were treated; 17 stones in 15 submandibular glands and 38 in 34 parotids. In total, 61 laser lithotripsies (range 1-3 per stone) were performed using various modes (long, short, and burst) and with preset parameters of 4 Hz and energy of 0.8-1.2 J, resulting in effective power of 3.2-4.8 W. Complete fragmentation was achieved in all the accessible stones. Sialendoscopes, fibers, or the mode used had no significant influence on success rates. A multimodal therapy concept was employed to treat stones in 12.24% of the cases; 95.92% of the patients were ultimately stone-free, and all became symptom-free. All glands were preserved. CONCLUSIONS The new Calculase III™ Ho:YAG laser was effective in the treatment of sialolithiasis with no increased risk of complications in the patients or damage to the sialendoscopes. Clinical factors such as the type of gland involved, or the location and size of stones had a greater impact on success rates than the technical or preset parameters. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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25
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Faklaris I, Bouropoulos N, Vainos NA. Sialolithiasis: Application parameters for an optimal laser therapy. JOURNAL OF BIOPHOTONICS 2020; 13:e202000044. [PMID: 32277604 DOI: 10.1002/jbio.202000044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
In-vitro experimental parametric studies of laser ablation using natural sialoliths and artificial stones have been performed toward an efficient laser treatment of sialolithiasis. Surface microstructure and water adsorption become critical for coupling high power pulsed Ho:YAG laser radiation (λ = 2080 nm, τ ∼250 μsec), inducing ablative interactions and stone fragmentation. Results reveal a generic trend, with single pulse laser energy density threshold for sialolith ablative erosion at ∼200 J cm-2 (corresponding to intensity ∼800 kW cm-2 ) and fragmentation rates reaching ∼1 mm/pulse at ∼2400 J cm-2 . This process shows no saturation, suggesting that very high energy density irradiation at low pulse repetition rate is an efficient approach. Such operation facilitates rapid cooling and minimal thermal loading of the oral and maxillofacial area, thus causing negligible adverse effects. The method is expected to contribute to the establishment of an easy and optimal therapeutic protocol for sialolithiasis pathology.
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Affiliation(s)
- Ioannis Faklaris
- Department of Materials Science, University of Patras, Patras, Greece
- Dentomaxillofacial Radiology Department, 251 Hellenic Air Force and VA General Hospital, Athens, Greece
| | - Nikolaos Bouropoulos
- Department of Materials Science, University of Patras, Patras, Greece
- Foundation for Research & Technology-Hellas/ICE-HT (FORTH/ICE-HT), Patras, Greece
| | - Nikolaos A Vainos
- Department of Materials Science, University of Patras, Patras, Greece
- National Hellenic Research Foundation - TPCI, (NHRF/TPCI), Athens, Greece
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26
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Badger CD, Patel S, Romero NJ, Fuson A, Joshi AS. In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi. Otolaryngol Head Neck Surg 2020; 164:124-130. [PMID: 32600219 DOI: 10.1177/0194599820937676] [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: 11/16/2022]
Abstract
OBJECTIVES The present study was developed to evaluate the accuracy of in vivo ultrasound sizing for parotid and submandibular salivary gland calculi, as compared with ex vivo pathology sizing with a standard plastic ruler after extraction. STUDY DESIGN Retrospective chart review. SETTING Ultrasound is frequently used to size salivary calculi and make treatment decisions, but the accuracy of measurements from this modality has not been validated. SUBJECTS AND METHODS We evaluated and reviewed the charts and ultrasound examinations of 167 patients who underwent procedures for the treatment of sialolithiasis involving the parotid and submandibular glands. US examinations were performed between 2009 and 2016 in a tertiary-level hospital setting by the senior author. Measurements were collected from ultrasound evaluation before sialolithotomy, and pathology measurements were taken after removal. Ultrasound measurements in millimeters were compared with the measurements collected with a ruler. The differences were calculated and compared. RESULTS A total of 167 calculi measurements were compared. Good concurrent validity between pathology and ultrasound measurements was suggested by a Pearson correlation of 0.92 (95% CI, 0.887-0.937). On Bland-Altman plot, correlation of the difference between US and pathology measurements showed a mean difference of 0.095 mm (95% CI, -0.19 to 0.38 mm) with a limit of agreement ranging from -3.59 mm (95% CI, -3.84 to -3.34 mm) to +3.78 mm (95% CI, +3.53 to +4.03 mm). CONCLUSIONS Ultrasound is an accurate, relatively precise, and minimally invasive imaging tool for salivary gland sialolithiasis. Preoperative size of calculi can be used to guide management and clinical decision making. LEVEL OF EVIDENCE 2C.
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Affiliation(s)
- Christopher D Badger
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Sahil Patel
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Nahir J Romero
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Andrew Fuson
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Arjun S Joshi
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
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Kanerva M, Tapiovaara L, Aro K, Saarinen R. Pediatric sialendoscopy: An 11-year study from a single tertiary care center. Int J Pediatr Otorhinolaryngol 2020; 131:109869. [PMID: 31972384 DOI: 10.1016/j.ijporl.2020.109869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate the suitability, benefits, and limitations of sialendoscopy for pediatric patients. METHODS We performed a retrospective analysis of all pediatric sialendoscopy patients (aged 16 years or younger) in our tertiary care institution between September 2007 and October 2018. We characterized patient data, procedure-related factors, complications, and outcomes. RESULTS In total, 55 sialendoscopies were performed on 42 patients. Among these, 36 were diagnostic endoscopies and 19 were interventional. Five endoscopies were performed under local anesthesia. We identified 16 sialolithiasis patients, where removal of a sialolith was possible in 11 (69%) cases; one case required a second endoscopy. We removed two sialoliths under local anesthesia. Among recurrent juvenile parotitis (RJP) patients, 18/20 (90%) were symptom-free after a single sialendoscopy, and all after a second endoscopy. The median follow-up time was 70 months. We achieved a 95% success rate in sialendoscopies, with a failure-to-treat rate of 15%. The complication rate for the study cohort was 2%, with prolonged parotid swelling the only complication encountered. CONCLUSIONS Sialendoscopy represented a safe and effective method to treat pediatric patients. Local anesthesia was successful in selected cases, even for sialolith removal. Sialendoscopy had a soothing effect on RJP and the majority of sialoliths were suitable for endoscopic removal.
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Affiliation(s)
- Mervi Kanerva
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Laura Tapiovaara
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katri Aro
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Riitta Saarinen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Erkul E, Çekin E, Güngör A. Long-Term Outcomes of Sialendoscopy in the Management of Sialolithiasis and Idiopathic Chronic Sialadenitis with Ductal Scars. Turk Arch Otorhinolaryngol 2019; 57:75-80. [PMID: 31360924 DOI: 10.5152/tao.2019.4290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/28/2019] [Indexed: 12/15/2022] Open
Abstract
Objective We aimed to present the long-term outcomes and sialendoscopic findings in only patients with sialolithiasis and ductal scars in idiopathic chronic recurrent sialadenitis who experienced unsuccessful results with conservative treatment and were treated with sialendoscopy. Methods We retrospectively analyzed the patients with a diagnosis of only sialolithiasis and ductal scars in chronic recurrent sialadenitis who underwent sialendoscopy between January 2011 and June 2016. We collected clinical and intraoperative data including patient age, sex, date of the procedure, the involved gland, operative findings and complications. Follow-up data included whether the symptoms were resolved or recurred and whether any further procedures were performed. Results Of a total of 38 patients, 16 were excluded from the study due to missing clinical or follow-up data, and analysis was conducted on 22 patients. Twelve were diagnosed with sialolithiasis, while the remaining 10 were diagnosed with idiopathic chronic sialadenitis and had ductal scars. Stone sizes ranged from 2 mm to 10 mm. Mean follow-up time was 39.5 months. The final success rate was 100%. Of the 10 patients with ductal scarring, five had scar in the parotid gland duct, and five in the submandibular gland duct. The mean follow-up time of all ductal scar patients was 47.1 months. The final success rate was 70%. Conclusion Sialendoscopy is a minimally invasive method for the diagnosis and treatment of sialolithiasis and ductal scars of the salivary glands after failure of conservative treatments in adults.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, University of Health Sciences, Gülhane Medical School, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Engin Çekin
- Department of Otorhinolaryngology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Atila Güngör
- Department of Otorhinolaryngology, Medical Park Hospital Göztepe, İstanbul, Turkey
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Pachisia S, Mandal G, Sahu S, Ghosh S. Submandibular sialolithiasis: A series of three case reports with review of literature. Clin Pract 2019; 9:1119. [PMID: 30996853 PMCID: PMC6444375 DOI: 10.4081/cp.2019.1119] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/20/2019] [Indexed: 11/22/2022] Open
Abstract
One of the most common disorders of the salivary glands is sialolithiasis. A history of pain or/and swelling in the salivary glands, especially during meal suggests this diagnosis. For small and accessible stones conservative therapies like milking of ducts with palliative therapy can produce satisfactory results. Surgical management should be considered when the stone/stones are inaccessible or large in size as conservative therapies turned out to be unsatisfactory. In this paper, we present three cases of sialolithiasis in the submandibular gland along with a review of existing literature. The purpose of this paper is to add three more cases to the literature and review the theories of etiology, clinical features, available diagnostic and treatment procedures.
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Affiliation(s)
- Sandeep Pachisia
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
| | - Gaurav Mandal
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
| | - Sudipto Sahu
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
| | - Sucharu Ghosh
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
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Fabie JE, Kompelli AR, Naylor TM, Nguyen SA, Lentsch EJ, Gillespie MB. Gland‐preserving surgery for salivary stones and the utility of sialendoscopes. Head Neck 2018; 41:1320-1327. [DOI: 10.1002/hed.25560] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/24/2018] [Accepted: 11/15/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Joshua E. Fabie
- Department of Otolaryngology – Head and Neck SurgeryThe Medical University of South Carolina Charleston South Carolina
| | - Anvesh R. Kompelli
- Department of Otolaryngology – Head and Neck SurgeryThe Medical University of South Carolina Charleston South Carolina
| | - Tate M. Naylor
- Department of Otolaryngology – Head and Neck SurgeryThe University of Tennessee Health Science Center Memphis Tennessee
| | - Shaun A. Nguyen
- Department of Otolaryngology – Head and Neck SurgeryThe Medical University of South Carolina Charleston South Carolina
| | - Eric J. Lentsch
- Department of Otolaryngology – Head and Neck SurgeryThe Medical University of South Carolina Charleston South Carolina
| | - M. Boyd Gillespie
- Department of Otolaryngology – Head and Neck SurgeryThe University of Tennessee Health Science Center Memphis Tennessee
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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. Treatment outcomes of sialendoscopy for submandibular gland sialolithiasis: The minor axis of the sialolith is a regulative factor for the removal of sialoliths in the hilum of the submandibular gland using sialendoscopy alone. Auris Nasus Larynx 2018; 45:772-776. [DOI: 10.1016/j.anl.2017.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 08/06/2017] [Accepted: 09/05/2017] [Indexed: 11/25/2022]
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Sialolithiasis of Right Submandibular Duct of Unusual Size. Indian J Surg 2018; 80:190-191. [DOI: 10.1007/s12262-018-1723-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022] Open
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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. Int J Oral Maxillofac Surg 2018; 47:223-227. [DOI: 10.1016/j.ijom.2017.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 11/19/2022]
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Foletti JM, Graillon N, Avignon S, Guyot L, Chossegros C. Salivary Calculi Removal by Minimally Invasive Techniques: A Decision Tree Based on the Diameter of the Calculi and Their Position in the Excretory Duct. J Oral Maxillofac Surg 2018; 76:112-118. [DOI: 10.1016/j.joms.2017.06.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
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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.
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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
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Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy. Laryngoscope 2017; 128:E332-E338. [DOI: 10.1002/lary.27037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/01/2017] [Accepted: 11/08/2017] [Indexed: 12/22/2022]
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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.
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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
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Purcell YM, Kavanagh RG, Cahalane AM, Carroll AG, Khoo SG, Killeen RP. The Diagnostic Accuracy of Contrast-Enhanced CT of the Neck for the Investigation of Sialolithiasis. AJNR Am J Neuroradiol 2017; 38:2161-2166. [PMID: 28838906 DOI: 10.3174/ajnr.a5353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/16/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Sialolithiasis is a common benign pathology affecting the salivary glands but it is unclear if contrast-enhanced CT, which is commonly used for investigation of head and neck pathology, can identify calculi as accurately as noncontrast CT. The aim of this study was to assess the diagnostic accuracy of contrast-enhanced CT of the neck in the diagnosis of sialolithiasis compared with noncontrast CT of the neck used as the criterion standard. MATERIALS AND METHODS This was a retrospective, case-control study of 92 consecutive cases in 90 patients who underwent both noncontrast CT of the neck and contrast-enhanced CT of the neck in 2 tertiary referral centers from January 2011 to December 2015 for investigation of sialolithiasis. Axial 3-mm-section images were assessed by a fellowship-trained diagnostic neuroradiologist and diagnostic neuroradiology fellow in consensus. Blinded assessment of the contrast-enhanced CT of the neck was performed first, followed by noncontrast CT of the neck after a 2-week interval. The presence or absence of a stone and stone location and size were documented. Statistical analysis was undertaken to assess the agreement between CT protocols and calculate the sensitivity and specificity of contrast-enhanced CT of the neck. RESULTS Fifty calculi were identified on noncontrast CT of the neck in 31 cases; and 48 calculi, in 31 cases on contrast-enhanced CT of the neck. No calculi were identified in the remaining 61 cases. The sensitivity and specificity of contrast-enhanced CT of the neck in the detection of sialolithiasis was 96% (95% CI, 86.3%-99.5%) and 100% (95% CI, 94.1%-100%), respectively. The positive predictive value of contrast-enhanced CT of the neck was 100% (95% CI, 92.6%-100%), and the negative predictive value was 96.8% (95% CI, 89%-99.6%). The accuracy of contrast-enhanced CT of the neck in diagnosing the presence or absence of salivary calculi was 98%. CONCLUSIONS Contrast-enhanced CT of the neck is accurate in the detection of sialolithiasis, with no difference in diagnostic accuracy compared with noncontrast CT of the neck.
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Affiliation(s)
- Y M Purcell
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - R G Kavanagh
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - A M Cahalane
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - A G Carroll
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - S G Khoo
- Otolaryngology (S.G.K.), St. Vincent's University Hospital, Elm Park, Dublin, Ireland
- Departments of Otolaryngology (S.G.K.)
| | - R P Killeen
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
- Radiology (R.P.K.), Royal Victoria Eye and Ear Hospital, Dublin, Ireland
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Faizal B, Gangadharan S, Thankappan K. Comparison between Sialendoscopy and Conventional Methods in the Treatment of Sialolithiasis. Malays J Med Sci 2017; 24:94-100. [PMID: 29386976 DOI: 10.21315/mjms2017.24.5.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 09/07/2017] [Indexed: 10/18/2022] Open
Abstract
Background Sialendoscopy is gaining in popularity in treating calculus disease. The delicacy of the instrument and the diameter of the salivary ducts are factors that limit the ability to achieve complete success. There is also continued speculation regarding the utility of the procedure, especially among clinicians who are masters of conventional methods like sialadenectomy and sialodochotomy. Objective To assess the efficacy of sialendoscopy over conventional methods in treating sialolithiasis. Methods A prospective case control study was conducted in a tertiary care centre; this study involved 50 patients of sialolithiasis, and it extended over a 36-month period. All had undergone treatment, either by conventional methods or interventional sialendoscopy. All patients with nonpalpable calculi smaller than 6 mm underwent interventional sialendoscopy. Failed sialendoscopies and larger nonpalpable calculi were removed through sialadenectomy. The outcome variables studied included calculus removal, postoperative symptoms, and gland preservation. Results The success rate in terms of calculus removal by sialendoscopy was 88%, versus 100% by sialadenectomy. The salivary gland was preserved in 88% of the cases in the sialendoscopy group. Only 12% of patients were symptomatic. Conclusion Sialendoscopy was effective in removing calculi of various sizes; it was definitely superior to conventional methods. Sialadenectomy should be reserved for cases either not suitable for sialendoscopy or in which there was an intervention failure.
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Affiliation(s)
- Bini Faizal
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham, Kochi, India
| | - Sangeetha Gangadharan
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham, Kochi, India
| | - Krishnakumar Thankappan
- Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham, Kochi, India
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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. The landmark for removal of sialoliths using sialendoscopy alone in parotid gland sialolithiasis. Auris Nasus Larynx 2017; 45:306-310. [PMID: 28651858 DOI: 10.1016/j.anl.2017.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/02/2017] [Accepted: 05/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the general guidelines for removal of sialoliths in parotid gland sialolithiasis using sialendoscopy alone. METHODS We analyzed 34 sialoliths treated using sialendoscopy in 26 patients with parotid gland sialolithiasis. We divided the Stensen's duct and parotid gland into for parts using computed tomography findings: (A) front of the masseter, (B) anterior and lateral to the center (anterolateral) of the masseter, (C) posterior and lateral to the center (posterolateral) of the masseter, (D) behind of the masseter. The location and size of each sialolith was assessed. RESULTS The removal rates of sialoliths in the different locations by sialendoscopy alone were as follows: front of the masseter, 68.8%; anterolateral of the masseter, 60.0%; posterolateral of the masseter, 0%; and behind of the masseter, 33.3%. The removal rate using sialendoscopy alone was significantly higher in the sections anterior to the center of the masseter than in those posterior to the center of the masseter (66.7% [14/21] vs. 20.0% [2/10]; P=0.019). The size of the sialolith was not correlated to the removal rate by sialendoscopy alone. CONCLUSION Sialoliths of the parotid gland located in positions anterior to the center of the masseter are significantly easier to remove by sialendoscopy alone. The center of the masseter is a general landmark for removal of sialoliths from the parotid gland using sialendoscopy alone. The size of the sialolith is not correlated with removal, except rare huge sialoliths.
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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
| | - 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
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Serbetci E, Sengor GA. Sialendoscopy: Experience with the First 60 Glands in Turkey and a Literature Review. Ann Otol Rhinol Laryngol 2017; 119:155-64. [DOI: 10.1177/000348941011900303] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives We performed a retrospective analysis to contribute to the increasing number of reports on sialendoscopy in the literature and give basic concepts for beginners at the same time. Methods Between 2004 and 2009, 83 patients with symptoms of ductal obstruction of the major salivary glands were admitted to our clinic. Diagnostic and/or interventional sialendoscopy was applied to 60 glands (33 submandibular and 27 parotid) of 54 patients. A holmium:yttrium-aluminum-garnet laser or a pneumatic lithotripter was used for intraductal stone fragmentation. Results Sialendoscopy revealed no disorder in 2 cases, and in 38 glands (28 submandibular and 10 parotid) sialolithiasis was the underlying disease. Fifteen glands (5 submandibular and 10 parotid) were found to have other main disorders such as stenosis, synechia, or kink formation. Other findings included sialodochitis in 6 glands (2 submandibular and 4 parotid), a polyp in 1 parotid gland, mucus plugs in 21 glands (6 submandibular and 15 parotid), ductal ectasia in 4 glands (2 submandibular and 2 parotid), and ductal collapse in 1 parotid gland. The overall interventional success rate was 83% of all cases, and no complications occurred. Conclusions The success rate of the interventional sialendoscopy performed in the current study shows consistency with the results given in the related medical literature. In the age of sialendoscopy, the adjunctive intraoral surgeries can be argued to be safer, easier, and more successful than before. Sialendoscopy may be considered to be the best practice not only in sialolithiasis, but also in other treatments of obstructive ductal disorders.
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Affiliation(s)
- Erhun Serbetci
- Otorhinolaryngology Group, Nisantasi ENT Group, Istanbul, Turkey
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Ng SK, Chan JYK, Wong EWY, Vlantis AC. Diagnostic accuracy of sialendoscopy referenced to current imaging modalities. SURGICAL PRACTICE 2017. [DOI: 10.1111/1744-1633.12239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Siu-Kwan Ng
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Jason Ying-Kuen Chan
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Eddy Wai-Yeung Wong
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Alexander Chris Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
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Capaccio P, Torretta S, Pignataro L, Koch M. Salivary lithotripsy in the era of sialendoscopy. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2017; 37:113-121. [PMID: 28516973 PMCID: PMC5463518 DOI: 10.14639/0392-100x-1600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 01/17/2023]
Abstract
The traditional management of obstructive salivary disorders has been replaced by minimally-invasive gland-preserving techniques including shock-wave lithotripsy, sialendoscopy, interventional radiology and endoscopically video-assisted trans-oral and cervical stone retrieval, of which sialendoscopy is considered to be the method of first choice. Primary endoscopically controlled stone extraction without prior fragmentation is only possible in 15-20% of cases; in more than 80%, fragmentation is necessary because of the size, impactation and location of the stone, or an alternative treatment such as transoral duct surgery or combined approaches are required. Moreover, about 10-20% of all stones cannot be adequately accessed by means of a sialendoscope or any alternative surgical method and, in such cases, extra-corporeal shock wave lithotripsy (ESWL) is the treatment of choice. However, in endoscopically accessible stones, ESWL is being gradually replaced by endoscopically assisted intra-corporeal techniques, including endoscopically guided laser and pneumatic intracorporeal lithotripsy. We describe the currently most widely used techniques for salivary lithotripsy, including ESWL, and endoscopically guided laser, electrohydraulic, electrokinetic and pneumatic intra-corporeal lithotripsy, and discuss their indications given the widespread use of advanced rehabilitative sialendoscopy and combined therapeutic approaches.
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Affiliation(s)
- P. Capaccio
- Department of Biomedical, Surgical and Dental Sciences
| | - S. Torretta
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - L. Pignataro
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - M. Koch
- Department of Otorhinolaryngology, Head and Neck Surgery; Friedrich Alexander University of Erlangen Nuremberg, Germany
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Modayil PC, Jacob V, Manjaly G, Watson G. Intracorporeal electrokinetic lithotripsy: an advancement in minimally invasive management of parotid duct calculus. The Journal of Laryngology & Otology 2017; 122:428-31. [PMID: 17498338 DOI: 10.1017/s0022215107008304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Symptomatic salivary stones in the middle or proximal parotid duct have previously been treated by gland excision, which is associated with a 3–7 per cent risk to the facial nerve. Minimally invasive approaches to the management of salivary duct calculi have been devised over the past decade. Fluoroscopically guided basket retrieval, lithotripsy and intra-oral stone removal under general anaesthesia have found favour with most surgeons. Endoscopically controlled intracorporeal shock wave lithotripsy using the pneumoblastic lithotripter has been replaced by electrohydraulic lithotripsy (used in sialolith treatment).Method:The electrokinetic lithotripter is normally used for the treatment of lower ureteric stones, and has the benefit of minimal concomitant tissue damage. We have extended its use to the treatment of parotid duct calculi. We present initial results for its use in the treatment of a proximal parotid duct stone.Result:Application of the shock wave to the stone under direct vision avoided injury to the duct or to any local structure. The patient made an uneventful recovery and was asymptomatic after 18 months' follow up.Conclusion:Continuous, endoscopically monitored electrokinetic lithotripsy with good irrigation gives a well illuminated field and absolute delivery of energy to the target. It avoids the side effects caused by impact of the shock wave on the parotid duct and adjacent anatomical structures, thereby making it a safer procedure.
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Affiliation(s)
- P C Modayil
- Department of Otorhinolaryngology, Eastbourne District General Hospital, East Grinstead, UK.
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Gerni M, Foletti J, Collet C, Chossegros C. Evaluation of the prevalence of residual sialolith fragments after transoral approach of Wharton’s duct. J Craniomaxillofac Surg 2017; 45:167-170. [DOI: 10.1016/j.jcms.2016.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/09/2016] [Accepted: 04/07/2016] [Indexed: 11/29/2022] Open
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Balin VN, Zolotukhin SY. [Experience of organ spare sialolitiasis treatment using sialoendoscopy]. STOMATOLOGIIA 2017; 96:46-50. [PMID: 28317830 DOI: 10.17116/stomat201796146-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of the study was to evaluate the effectiveness of organ spare sialolitiasis treatment by sialoscopy-guided techniques. The study included 317 patients with parotid and submandibular sialolitiasis. In 22 patients conventional surgical approach was used because of distal location and larger size of concrements, while in 295 miniinvasive sialoscopy-guided procedures were performed. The use of sialoscopy-guided approach drastically diminished the rate of submandibular glands extirpations (performed in 5% of patients), as well as early and long-term surgical complications.
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Affiliation(s)
- V N Balin
- National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russia
| | - S Yu Zolotukhin
- National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russia
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Pniak T, Štrympl P, Staníková L, Zeleník K, Matoušek P, Komínek P. Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods. Open Med (Wars) 2016; 11:461-464. [PMID: 28352836 PMCID: PMC5329868 DOI: 10.1515/med-2016-0081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 10/03/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the accuracy of ultrasound, sialography, and sialendoscopy for examining benign salivary gland obstructions. METHODS In this prospective study, patients with symptoms of obstruction of the major salivary gland duct system presenting at the ENT Clinic University Hospital, Ostrava, from June 2010 to December 2013 were included. All patients (n=76) underwent ultrasound, sialography, and sialoendoscopy. The signs of sialolithiasis, ductal stenosis, or normal findings were recorded after the examinations. Statistical analysis of the sensitivity and specificity of all the methods was performed, as well as a comparison of the accuracy of each method for different kinds of pathology (sialolithiasis or stenosis). RESULTS The sensitivity of ultrasound, sialography, and sialoendoscopy for sialolithiasis findings were 71.9%, 86.7 %, and 100%, respectively. The sensitivity of sialography and sialoendoscopy for stenosis of the duct was 69.0%, and 100%, respectively. The study showed impossibility of ultrasonic diagnostics of ductal stenosis. The sensitivity of sialoendoscopy for both pathologies was significantly higher than that from ultrasound or sialography (p<0.05). The specificity of sialoendoscopy was significantly higher than that from by ultrasound or sialography (p<0.05). CONCLUSION Sialoendoscopy was the most accurate method for examination ductal pathology, with significantly higher sensitivity and specificity than by ultrasound or sialography.
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Affiliation(s)
- Tomáš Pniak
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Pavel Štrympl
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Lucia Staníková
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Karol Zeleník
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Petr Matoušek
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otolaryngology, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic, Tel. 00420597375801
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Delagnes EA, Aubin‐Pouliot A, Zheng M, Chang JL, Ryan WR. Sialadenitis without sialolithiasis: Prospective outcomes after sialendoscopy‐assisted salivary duct surgery. Laryngoscope 2016; 127:1073-1079. [DOI: 10.1002/lary.26308] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/25/2016] [Accepted: 08/04/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Elise A. Delagnes
- School of MedicineUniversity of California–San FranciscoSan Francisco California U.S.A
| | - Annick Aubin‐Pouliot
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California–San FranciscoSan Francisco California U.S.A
| | - Melissa Zheng
- School of MedicineUniversity of California–San FranciscoSan Francisco California U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California–San FranciscoSan Francisco California U.S.A
| | - William R. Ryan
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncologic and Endocrine SurgeryUniversity of California–San FranciscoSan Francisco California U.S.A
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Kopeć T, Wierzbicka M, Kałużny J, Młodkowska A, Szyfter W. Sialendoscopy and sialendoscopically-assisted operations in the treatment of lithiasis of the submandibular and parotid glands: our experience of 239 cases. Br J Oral Maxillofac Surg 2016; 54:767-71. [DOI: 10.1016/j.bjoms.2016.04.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
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Capaccio P, Paglia M, Minorati D, Manzo R, Ottaviani F. Diagnosis and Therapeutic Management of Iatrogenic Parotid Sialocele. Ann Otol Rhinol Laryngol 2016; 113:562-4. [PMID: 15274417 DOI: 10.1177/000348940411300709] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Salivary gland sialoceles are relatively common and may be a complication of trauma with a penetrating salivary gland injury or may be a complication of salivary gland surgery. The development of new diagnostic tools such as magnetic resonance sialography and endoscopic techniques has led to further improvements in the clinical and diagnostic assessment of this condition, and botulinum toxin therapy has recently been described in the management of parotid sialoceles. We here report the case of a 41-year-old patient with an unusually complicated parotid sialocele following an unsuccessful attempt to remove a stone located in the distal third of Stensen's duct. Magnetic resonance sialography and sialoendoscopy were used in order to obtain an adequate diagnostic assessment. The patient underwent extracorporeal lithotripsy that led to partial symptom regression. After the development of a parotid abscess, he received antibiotics and a botulinum toxin type A injection that induced spontaneous drainage and disappearance of the symptoms. Magnetic resonance sialography and sialoendoscopy are promising new diagnostic techniques for better noninvasive management of iatrogenic sialoceles.
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