[Updated S2k AWMF guideline on obstructive sialadenitis]

The update of this guideline was an important step to define standards for the use of sialendoscopy and other emerging minimally invasive techniques for the therapy of sialolithiasis and other obstructive salivary gland diseases. The current actualization was necessary to adapt the diagnostic and therapeutic algorithms to the current scientific knowledge. In this article they are presented in a shortened version with a focus on conservative therapeutic measures which are especially relevant for daily practice.

Updated S2K AWMF guideline for the diagnosis and follow-up of obstructive sialadenitis--relevance for radiologic imaging

The interdisciplinarily developed German S2k AWMF guideline for the treatment of obstructive sialadenitis represents a new standard in the guideline program of the AWMF, the German Society for Consultants and the clinical disciplines working in the field of diseases of the head and neck region. In the last few years new diagnostic and therapeutic possibilities have been established in obstructive chronic Sialadenitis offering individually optimized therapeutic strategies. Only a few years ago extirpation of the whole affected gland was the only relevant therapy option. Nowadays therapeutic options such as interventional sialendoscopy and extracorporeal shock-wave lithotripsy (ESWL) are available in combination with marsupialization or incision of the duct. If possible the focus is on preserving the main glandular duct. In the following article the relevant aspects for the diagnostic radiologic procedures are presented.

[The new S2k AWMF guideline for the treatment of obstructive sialadenitis in commented short form]

A new and interdisciplinary S2k AWMF guideline for the treatment of obstructive sialadenitis has been published. There have been several technical achievements, for instance in the field of ultrasonography, via sialendoscopy, or by MR-sialography, that have increased the possibilities for diagnosis and treatment of patients with obstructive sialadenitis. In the past, the treatment of choice in case of unsuccessful medical treatment was a complete extirpation of the affected salivary gland. Nowadays, using a variety of modern treatment options (like sialendoscopy, or extracorporeal shock-waves lithotripsy sometimes combined with salivary duct incision), it is possible in most patients, especially in cases of sialolithiasis, to preserve the affected gland. A functional recovery after gland-sparing surgery is described but more data is needed to finally evaluate the long-time results. The new guideline describes all relevant steps to diagnose an obstructive sialadenitis and values all diagnostic tools critically. Finally, all recommendable therapy options are described and valued, too.