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Park J, Jung SY, Kim HY, Lee KE, Go YJ, Kim HS, Yoon SY, Kwon CO, Park YS. Microbiomic association between the saliva and salivary stone in patients with sialolithiasis. Sci Rep 2024; 14:9184. [PMID: 38649387 PMCID: PMC11035639 DOI: 10.1038/s41598-024-59546-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
Salivary stones, known as sialoliths, form within the salivary ducts due to abnormal salivary composition and cause painful symptoms, for which surgical removal is the primary treatment. This study explored the role of the salivary microbial communities in the formation of sialoliths. We conducted a comparative analysis of microbial communities present in the saliva and salivary stones, and sequenced the 16S rRNA gene in samples obtained from patients with sialoliths and from healthy individuals. Although the diversity in the saliva was high, the essential features of the microbial environment in sialoliths were low diversity and evenness. The association of microbial abundance between stones and saliva revealed a positive correlation between Peptostreptococcus and Porphyromonas, and a negative correlation for Pseudomonas in saliva. The functional potential differences between saliva and stones Bacterial chemotaxis and the citrate cycle were negatively correlated with most genera found in salivary stone samples. However, the functions required for organic compound degradation did not differ between the saliva samples. Although some microbes were shared between the sialoliths and saliva, their compositions differed significantly. Our study presents a novel comparison between salivary stones and salivary microbiomes, suggesting potential preventive strategies against sialolithiasis.
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Affiliation(s)
- Jiwon Park
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Soo Yeon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, 07865, Republic of Korea.
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea.
| | - Ha Yeong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, 07865, Republic of Korea
| | - Kyeong Eun Lee
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Yu Jin Go
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, 07865, Republic of Korea
| | - Han Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, 07865, Republic of Korea
| | | | - Cheol-O Kwon
- MD Healthcare Inc., Seoul, 03923, Republic of Korea
| | - Yoon Shin Park
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea.
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Takahara M, Sabusawa T, Ohara K, Katada A, Hayashi T, Harabuchi Y. Treatment outcomes of sialendoscopy for submandibular gland sialolithiasis. Auris Nasus Larynx 2023:S0385-8146(23)00024-X. [PMID: 36775770 DOI: 10.1016/j.anl.2023.01.006] [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: 08/20/2022] [Revised: 11/10/2022] [Accepted: 01/24/2023] [Indexed: 02/13/2023]
Abstract
OBJECTIVE Sialendoscopy is a procedure used to remove salivary stones intraorally using a sialendoscope. In this study, we identified treatment outcomes of sialendoscopic surgery and identified predictive factors for successful stone removal by sialendoscopy alone. METHODS We assembled the medical records of 144 patients who underwent sialendoscopic surgery for submandibular gland sialolithiasis at the Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, from October 2010 to November 2021, and collected patient backgrounds, medical condition, perioperative factors including operation method and complications, postoperative course, and stone constituents from a clinical laboratory testing company. RESULTS Submandibular gland stones were successfully removed using sialendoscopy in 58 patients (40%). In multivariate analysis, location, major axis, and mobility of the stones were independent factors for successful removal. In receiver operating characteristic analysis, <7.5 mm of a major axis may be used as a measuring standard for successful removal. Removal of parenchymal stones is prone to involve prolonged operation times, increased postoperative complications, and development of retained stones. The stones mainly consisted of calcium phosphate and protein, with content percentages ranging from 0 to 98% (median 37%) and from 0 to 100% (median 63%), respectively. The percentage of calcium phosphate was negatively correlated with the number of floating stones and successful stone removal. CONCLUSION Sialendoscopy is an aesthetically attractive treatment for sialolithiasis that avoids cervical incisions. The present results showed not only known but also new predictive factors for the successful removal of stones (<7.5 mm) and percentage of calcium phosphate. Moreover, our results suggest that careful consideration is required regarding the indication of sialendoscopic surgery in patients with parenchymal stones.
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Affiliation(s)
- Miki Takahara
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Hokkaido, Japan.
| | - Tomoaki Sabusawa
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Hokkaido, Japan
| | - Kenzo Ohara
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Hokkaido, Japan
| | - Akihiro Katada
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Hokkaido, Japan
| | - Tatsuya Hayashi
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Hokkaido, Japan
| | - Yasuaki Harabuchi
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
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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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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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Acevedo JR, Hsu AC, Yu JC, Rice DH, Kwon DI, Kung RW, Kokot NC. Cost-effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis. Otolaryngol Head Neck Surg 2021; 166:662-668. [PMID: 34253114 DOI: 10.1177/01945998211026847] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. STUDY DESIGN Cost-effectiveness analysis. SETTING Outpatient surgery centers. METHODS A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer's perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. RESULTS Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. CONCLUSION Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.
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Affiliation(s)
- Joseph R Acevedo
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
| | - Ashley C Hsu
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jeffrey C Yu
- Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA.,School of Pharmacy, University of Southern California, Los Angeles, California, USA
| | - Dale H Rice
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
| | - Daniel I Kwon
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
| | - Raymond W Kung
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
| | - Niels C Kokot
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
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Giotakis AI, Fischlechner R, Dejaco D, Gottfried T, Riechelmann H. [Prognostic factors for successful outcome in sialendoscopy for sialolithiasis]. Laryngorhinootologie 2021; 101:228-237. [PMID: 34058775 PMCID: PMC8885298 DOI: 10.1055/a-1510-9548] [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] [Indexed: 11/04/2022]
Abstract
Hintergrund
Der Erfolg der Sialendoskopie hängt von mehreren Faktoren ab. Im Jahr 2008 wurde die Lithiasis-Stenosis-Dilatation (LSD) -Klassifikation zur genaueren Beschreibung des Stein-Gang-Verhältnisses eingeführt. Neben dem Nutzen der LSD-Klassifikation untersuchten wir weitere prä- und intraoperativ erhobene Einflussfaktoren auf den Erfolg der Sialendoskopie bei Sialolithiasis.
Methode
PatientInnen mit Sialolithiasis der Glandula submandibularis und Glandula parotis, die zwischen September 2018 und März 2020 eine primäre Sialendoskopie erhielten, wurden retrospektiv untersucht. Die Steingröße, Steinlokalisation und LSD-Klassifikation wurden unter anderem als prognostische Einflussfaktoren untersucht.
Ergebnisse
Insgesamt wurden 37 PatientInnen retrospektiv untersucht. Eine erfolgreiche Steinextraktion wurde bei 12/37 (32 %) PatientInnen durchgeführt. Bei Erfolg betrug die mediane Steingröße 3,7 mm, verglichen mit 10 mm bei Misserfolg (Mann-Whitney-Test; p < 0,0001). Bei Erfolg waren 11/12 Steine distal lokalisiert, verglichen mit 13/25 proximal lokalisierten Steinen bei Misserfolg (Pearson-Chi-Quadrat-Test; p = 0,010). Bei Erfolg wurden 10/12 Steine als L1S0D0 klassifiziert, während 15/25 bei Misserfolg als L3aS0D0-Steine klassifiziert wurden (Pearson-Chi-Quadrat-Test; p = 0,001). Für distal lokalisierte Steine, die kleiner als 5 mm waren, lag die Erfolgsrate bei 100 %. Für proximal lokalisierte Steine, die größer als 4 mm waren, lag die Erfolgsrate bei 0 %. Für die als L1S0D0 klassifizierten Steine betrug die Erfolgsrate 60–100 %.
Schlussfolgerung
Distal lokalisierte Steine und Steine kleiner als 5 mm in einem ansonsten unauffälligen Gangsystem können als prognostisch günstige Faktoren angesehen werden. Zukünftige Studien sollten anhand größerer Datenmengen die LSD-Klassifikation, das Volumen der Steine und deren Gangorientierung bzw. deren Abstand von der Papille untersuchen.
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Affiliation(s)
- Aris I Giotakis
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Rene Fischlechner
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Daniel Dejaco
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Timo Gottfried
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Herbert Riechelmann
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
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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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Comparison of general anesthesia and monitored anesthesia care for sialendoscopy procedures. Am J Otolaryngol 2021; 42:102809. [PMID: 33125904 DOI: 10.1016/j.amjoto.2020.102809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The literature remains scarce in terms of comparing different anesthesia modalities in sialendoscopy. Due to the lack of a standard of care or guidelines to anesthetic care, it is generally accepted that surgeons perform these surgeries under the anesthetic modality in which they are most comfortable. In this study, we evaluate time spent on the day of surgery and post-surgical outcomes for patients receiving sialendoscopy under monitored anesthesia care versus general anesthesia. MATERIALS AND METHODS We retrospectively assessed patients who underwent sialendoscopy using a solely endoscopic approach for sialadenitis or sialolithiasis from March 2017 to December 2019. Anesthesia modality (monitored anesthesia care versus general anesthesia) was compared. Main outcomes included total time in hospital, operative time, total time in operating room, anesthesia time, and recovery time. Secondary outcomes included rate of resolution of symptoms, requiring further medical management, requiring further surgical intervention, and complications. RESULTS A total of 172 procedures were included. Sialendoscopy under monitored anesthesia care center compared to general anesthesia decreased median hospital time (141 min reduction), anesthesia time (46 min reduction), operative time (24 min reduction), time in operating room (43 min reduction), and recovery time (56 min reduction). Utilizing monitored anesthesia care demonstrated similar rates of post-operative resolution of symptoms, complications, and further medical or surgical intervention compared to the general anesthesia cohort. CONCLUSION Sialendoscopy can be safely performed under monitored anesthesia care for appropriate sialadenitis or sialolithiasis cases while decreasing hospital time, operative time, time in operating room, anesthesia time, and recovery time while maintaining similar post-operative outcomes. Monitored anesthesia care should be considered for solely endoscopic cases as guided by surgeon and patient comfort.
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Abstract
A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur in salivary glands. The most common problem is painful blockage of ducts by stones that prevents drainage of saliva. Sialadenitis can be due to either infectious or noninfectious factors. Bacterial or viral infections are the most common causes of acute sialadenitis. Staphylococcus is the usual bacterial cause, whereas paramyxovirus (mumps) is the common viral cause. Eighty percent of salivary tumors are benign, whereas about 20% are malignant. Most tumors occur in the parotid gland and on the hard palate. Classifications, imaging, and suggested treatment are described.
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Langbein T, Chaussé G, Baum RP. Salivary Gland Toxicity of PSMA Radioligand Therapy: Relevance and Preventive Strategies. J Nucl Med 2018; 59:1172-1173. [PMID: 29903929 DOI: 10.2967/jnumed.118.214379] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/07/2018] [Indexed: 11/16/2022] Open
Affiliation(s)
- Thomas Langbein
- Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Zentralklinik, Bad Berka, Germany; and
| | - Guillaume Chaussé
- Division of Nuclear Medicine, Department of Radiology, McGill University, Montreal, Canada
| | - Richard P Baum
- Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Zentralklinik, Bad Berka, Germany; and
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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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Larson AR, Aubin-Pouliot A, Delagnes E, Zheng M, Chang JL, Ryan WR. Surgeon-Performed Ultrasound for Chronic Obstructive Sialadenitis Helps Predict Sialendoscopic Findings and Outcomes. Otolaryngol Head Neck Surg 2017; 157:973-980. [DOI: 10.1177/0194599817728867] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To determine the accuracy of surgeon-performed ultrasound (SP-US) features for predicting intraoperative sialendoscopic findings and to correlate ultrasound features with short-term symptomatic outcomes following sialendoscopy-assisted salivary duct surgery (SASDS). Study Design Case series with chart review. Setting The practices of 2 academic sialendoscopy surgeons. Subjects and Methods Between February 2014 and September 2015, 82 patients with 105 symptomatic glands underwent SASDS, of whom 56 patients (75 glands) met inclusion criteria. SP-US and sialendoscopic findings were reviewed for patients with chronic obstructive sialadenitis who underwent SASDS and who had been prospectively evaluated with the University of California–San Francisco Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire (scored 0-100) administered preoperatively and 3 months postoperatively. Results The positive predictive value (PPV) and negative predictive value (NPV) of SP-US for identifying sialoliths intraoperatively were 94% (33/35) and 91% (39/43), respectively. Of glands with sialoliths on SP-US, 97% (34/35) had complete symptom resolution (COSS ≤10) after SASDS. The PPV and NPV of salivary duct dilation on SP-US for finding a corresponding stenosis on sialendoscopy were 93% (14/15) and 50% (14/28), respectively. Nonsialolith SP-US features with the highest PPV for complete or partial symptom resolution (COSS ≤25) following SASDS included distal duct dilation of all glands (86%; 6/7) and dilation of both distal and proximal parotid ducts (75%; 6/8). Conclusion SP-US has high accuracy for ruling in and ruling out sialoliths, as well as for ruling in but not for necessarily ruling out stenosis presence and location. Ultrasound is helpful in estimating degree of short-term symptom response following SASDS.
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Affiliation(s)
- Andrew R. Larson
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Annick Aubin-Pouliot
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Elise Delagnes
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Melissa Zheng
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Jolie L. Chang
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - William R. Ryan
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
- Salivary Gland Center, Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
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Bignet C, Carvalho J, Lemaire E, Charpiot A. Acute submaxillitis: Etiological data and etiological management. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:315-319. [PMID: 28359731 DOI: 10.1016/j.anorl.2017.02.015] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objective of the present study was to test the hypothesis that acute submaxillitis involves salivary duct obstruction. Obstacle characteristics and treatment were analyzed. MATERIAL AND METHODS Patients presenting with an episode of acute submaxillitis between 2009 and 2015 were retrospectively included. All underwent salivary duct imaging and/or sialendoscopy, with pathologic examination if the salivary gland was removed for etiologic diagnosis. For etiological treatment, if the causal lesion could not be treated by isolated sialendoscopy, surgery used a direct approach assisted by sialendoscope. In case of failure of these procedures, submaxillectomy was indicated. RESULTS Twenty-nine patients were included, 28 of whom showed salivary duct abnormality. At least 1 calculus was found in 27 patients; calculi were usually single (n=20), situated in the mid-third (n=21), and large (mean 7.7mm). Ten patients showed stenosis, associated with salivary calculus in 9 cases. Twenty-five patients with salivary duct obstruction underwent sialendoscopy. Isolated sialendoscopy was used in 5 cases, and a combined approach in 13 cases. CONCLUSION An episode of submaxillitis requires salivary duct exploration by sialendoscopy, to enable early treatment given the prevalence of associated calculi and high success rate of conservative management by sialendoscopy.
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Affiliation(s)
- C Bignet
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - J Carvalho
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - E Lemaire
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Charpiot
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
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14
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Device failure in sialoendoscopy: Intraoperative practical decision-making. Int J Pediatr Otorhinolaryngol 2016; 90:193-195. [PMID: 27729130 DOI: 10.1016/j.ijporl.2016.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 11/23/2022]
Abstract
Sialoendoscopy has recently emerged as an alternative to gland excision in management of recurrent sialoadenitis and sialolithiasis. This technique has both diagnostic and therapeutic purposes. We report a case of unusual device failure during removal of a submandibular stone from Wharton's duct, which ultimately led to ductal avulsion. Sialoendoscopy is safe and effective in management of non-neoplastic major salivary gland disorders. Ductal avulsion can happen during mechanical procedures like stone removal or dilation of strictures. Failing to release the stone from the basket is very rare but can be problematic and lead to major complications.
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15
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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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16
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Stelmach R, Pawłowski M, Klimek L, Janas A. Biochemical structure, symptoms, location and treatment of sialoliths. J Dent Sci 2016; 11:299-303. [PMID: 30894988 PMCID: PMC6395265 DOI: 10.1016/j.jds.2016.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 02/16/2016] [Indexed: 11/06/2022] Open
Abstract
Background/purpose Sialolithiasis is the most common disease of the salivary glands, which can cause acute and chronic infections. More than 80% of sialoliths occur in the submandibular gland or its duct, 6% in the parotid gland, and 2% in the sublingual gland or minor salivary glands. Typical symptoms are recurrent swelling and pain in the involved gland, often associated with eating, due to obstructions of the draining duct. The aim of the study was to analyze biochemical structure, symptoms, size, and location of salivary stones as well as concomitance with nephrolithiasis. Materials and methods This study was conducted targeting 46 patients with sialolithiasis who visited the Department of Oral Surgery, Medical University of Lodz, Poland in 2009–2015. Medical records containing patients' age, sex, position of the salivary stone, and symptoms were collected and analyzed. Stones were examined ultrastructurally with a scanning electron microscope and X-ray diffractometer. Results Multiple stones were found in 1% of patients. We observed that men had sialolithiasis about twice as often as women. The chemical structure of the stones varied but they mainly contained different traces of carbon, calcium, oxygen, phosphorus, and sulfur. Longitudinal sections of the stones revealed elongated, round, and irregular shapes. We noticed that nephrolithiasis was present in 11 (24%) patients. We observed the unilateral location of sialoliths with multilayer structures, mainly composed of inorganic material, such as hydroxyapatite. Conclusion We found that the location of the stones influenced the symptoms, and concomitance of sialoliths and nephroliths was common.
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Affiliation(s)
- Rafał Stelmach
- Department of Oral Surgery, Medical University of Lodz, Lodz, Poland
| | - Maciej Pawłowski
- Department of Pediatrics and Allergy, Medical University of Lodz, Nicolaus Copernicus Hospital, Lodz, Poland
| | - Leszek Klimek
- Institute of Material Science and Engineering, Lodz University of Technology, Lodz, Poland
| | - Anna Janas
- Department of Oral Surgery, Medical University of Lodz, Lodz, Poland
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Steck JH, Stabenow E, Volpi EM, Vasconcelos ECG. The learning progression of diagnostic sialendoscopy. Braz J Otorhinolaryngol 2016; 82:170-6. [PMID: 26671021 PMCID: PMC9449080 DOI: 10.1016/j.bjorl.2015.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/21/2015] [Indexed: 11/25/2022] Open
Abstract
Introduction Sialendoscopy is becoming the gold standard procedure for diagnosis and treatment of Salivary Gland Inflammatory Diseases. Objective To evaluate the learning progression of a single surgeon to implement and perform diagnostic sialendoscopy: to estimate how many procedures were necessary to achieve better results; if it was higher rate of complications in the beginning. Methods Retrospective analysis involving 113 consecutive sialendoscopies performed from 2010 to 2013. According to a descriptive analysis of the factors related to surgeon's experience, the casuistic was divided into two groups: group (A) comprising the first 50 exams, and group (B) the last 63. Groups were then compared concerning demographic and peri-operative aspects. Results In Group A, failure to catheterize papilla were 22% versus 3% in B (p = 0.001). Failure to complete examination was 30% in group A versus 6% in B (p = 0.001), and necessity to repeat exams was 22% in group A versus 10% in B (p = 0.058). The complication rates were 18% in group A, and 10% in B (p = 0.149). Operative time was slightly shorter in group B (56 versus 41 min, p = 0.045). Conclusion We found better outcomes after the first 50 diagnostic sialendoscopies. Complication rates were statistically the same between early and late groups of experience with sialendoscopy.
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Galinat L, Curry J, Luginbuhl A, Rosen D, Cognetti DM. Nonvisualization of Sialoliths during Sialendoscopy. Otolaryngol Head Neck Surg 2016; 154:1019-22. [DOI: 10.1177/0194599816632165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/22/2016] [Indexed: 11/16/2022]
Abstract
Objectives Analyze the characteristics of patients undergoing interventional sialendoscopy for sialolithiasis whose stones were not visualized intraoperatively. Study Design Case series with chart review. Setting Tertiary care hospital. Subjects and Methods Patients (n = 276) undergoing sialendoscopy between June 2008 and December 2014 were reviewed for patient characteristics, imaging characteristics, and outcomes. Nonvisualization was defined as a sialolith that was documented on imaging preoperatively but not visualized intraoperatively during sialendoscopy, despite successful ductal cannulation and evaluation. Results A total of 337 sialendoscopy procedures were preformed. Preoperative imaging documented a sialolith in 203 (60%) cases. Nonvisualization occurred in 31 (15%) cases with sialolith. The parotid gland was involved in 58% (18 of 31) of nonvisualization cases, as opposed to 21% (43 of 203) of all sialolith cases. The submandibular gland was involved in 42% (13 of 31) of nonvisualization cases, as compared with 79% (160 of 203) of all sialolith cases. Nonvisualization occurred in 42% (18 of 43) of parotid cases versus 8% (13 of 160) of submandibular cases, a statistically significant difference ( P < .001). Parotid stones located posterior to the plane of insertion of the posterolateral edge of the masseter were significantly more likely to experience nonvisualization (73%) than those along and anterior to the masseter (25% and 0%, respectively; P = .009). Conclusions Intraoperative nonvisualization of a sialolith is more likely to occur in the parotid gland. Proximal stone location may predict nonvisualization. These factors should be considered during treatment planning and counseling for patients with sialolithiasis.
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Affiliation(s)
- Lauren Galinat
- Department of Otolaryngology, Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joseph Curry
- Department of Otolaryngology, Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adam Luginbuhl
- Department of Otolaryngology, Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - David Rosen
- Department of Otolaryngology, Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - David M. Cognetti
- Department of Otolaryngology, Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Jokela J, Haapaniemi A, Ojala J, Mäkitie A, Saarinen R. Sialendoscopy in sialadenitis: an unselected cohort of 228 patients. Clin Otolaryngol 2016; 41:416-20. [PMID: 26333199 DOI: 10.1111/coa.12531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J Jokela
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Haapaniemi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J Ojala
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - R Saarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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20
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Sialoendoscopy as a diagnostic and therapeutic option for obstructive diseases of the large salivary glands—a retrospective analysis. Clin Oral Investig 2015; 20:1065-70. [DOI: 10.1007/s00784-015-1588-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
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21
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Mikolajczak S, Bremke M, Beutner D, Luers JC. Combined endoscopic and transcutaneous approach for immobile parotid stones. Acta Otolaryngol 2015; 135:85-9. [PMID: 25496180 DOI: 10.3109/00016489.2014.953204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Salivary stones in the parotid gland that are not amenable to endoscopic extraction can safely be removed by a combined, endoscopic-external approach. OBJECTIVE Limitations for endoscopic removability of salivary stones from the parotid gland are immobile stones in the deeper salivary duct system. A combined endoscopic and transcutaneous approach gives access to these stones with possible preservation of the parotid gland. METHODS A total of 10 consecutive patients were treated using the combined approach for the management of sialolithiasis of the parotid gland. The patients had previously undergone a sialendoscopy under local anesthesia and were proven to have large, immobile salivary stones in the salivary duct. RESULTS In all patients, the procedure was successfully conducted with extraction of impacted stones. In 60% of the patients, a temporary stenting of the salivary duct was performed. All patients showed good clinical results with restored drainage of the salivary duct system and preserved gland function.
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Affiliation(s)
- Stefanie Mikolajczak
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne , Cologne , Germany
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22
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Schwarz D, Kabbasch C, Scheer M, Mikolajczak S, Beutner D, Luers JC. Comparative analysis of sialendoscopy, sonography, and CBCT in the detection of sialolithiasis. Laryngoscope 2014; 125:1098-101. [DOI: 10.1002/lary.24966] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/12/2014] [Accepted: 09/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
- David Schwarz
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | | | - Martin Scheer
- Department of Oral and Maxillofacial Surgery; Johannes Wesling Hospital; Minden Germany
| | - Stefanie Mikolajczak
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | - Jan C. Luers
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
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Sialendoscopy - a diagnostic and therapeutic approach subjectively rated by patients. Wideochir Inne Tech Maloinwazyjne 2014; 9:505-10. [PMID: 25561986 PMCID: PMC4280409 DOI: 10.5114/wiitm.2014.44176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 02/10/2014] [Accepted: 04/30/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Sialendoscopy is a miniinvasive procedure which shows the excretory ducts of the salivary glands. AIM To evaluate patient satisfaction with sialendoscopy in submandibular and parotid gland sialolithiasis. MATERIAL AND METHODS The study group included 100 consecutive patients with sialolithiasis, treated by means of sialendoscopy. The analysis was designed prospectively. The patients answered closed questions of our own, in-house made questionnaire. RESULTS The number of sialendoscopic procedures necessary for symptom resolution ranged from 1 to 3. The mean value was 1.2 and the median was 1. In 64 patients (64%) one procedure was sufficient for symptom resolution, while 10 (10%) and 8 (8%) patients required 2 and even 3 procedures, respectively. Sixty-three patients (63%) did not report any postoperative complications; 33 patients (33%) reported transient swelling of the submandibular region and 4 patients (4%) reported inflammation of the salivary gland. The level of treatment efficacy was 82%. Among 53 patients treated using sialendoscopy for the first time 92.3% rated this approach subjectively as a very good or good technique, whereas among 47 patients who had previously undergone non-endoscopic treatment, this percentage increased to 96.4%. The general level of satisfaction with the applied method did not depend on the age, gender, duration of ailments, the number of previously performed procedures or the number of sialendoscopic procedures necessary to obtain improvement and postoperative complications. CONCLUSIONS Sialendoscopy may be performed practically in any case without risking the patient's discomfort or unpleasant experience. Assessment of sialendoscopy by the patients confirmed the minimally invasive character of this technique.
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O’Connor R, Mitchell DA, Brennan PA. Focused review of investigation, management and outcomes of salivary gland disease in specialty-specific journals. Br J Oral Maxillofac Surg 2014; 52:483-90. [DOI: 10.1016/j.bjoms.2014.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 03/17/2014] [Indexed: 11/27/2022]
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Kiringoda R, Eisele DW, Chang JL. A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders. Laryngoscope 2014; 124:2696-701. [DOI: 10.1002/lary.24787] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/28/2014] [Accepted: 05/22/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
| | - David W. Eisele
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
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Luers JC, Petry-Schmelzer JN, Hein WG, Gostian AO, Hüttenbrink KB, Beutner D. Fragmentation of salivary stones with a 980nm diode laser. Auris Nasus Larynx 2014; 41:76-80. [DOI: 10.1016/j.anl.2013.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 04/23/2013] [Accepted: 06/21/2013] [Indexed: 10/26/2022]
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