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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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Liljekvist MS, Foghsgaard J, Howitz MF. Sialendoscopy for pediatric salivary gland disorders: a study of safety and effect. Eur Arch Otorhinolaryngol 2023; 280:1927-1937. [PMID: 36478117 DOI: 10.1007/s00405-022-07747-3] [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: 07/05/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Sialendoscopy has become the preferred modality for managing pediatric salivary gland disorders (PSGD) including juvenile recurrent parotitis (JRP) and sialolithiasis. The literature remains sparse, but several case series have reported good outcomes and few complications. The aim of this study was to investigate the safety and efficacy of sialendoscopy for PSGD in a Danish setting. METHODS From a national sialendoscopy database, we included records of children who had undergone sialendoscopy for PSGD at our clinic over a 6-year period. Clinical and intraoperative data, follow-up and e-mail surveys after 1, 3 and 5 years were retrieved for analysis. RESULTS We included 52 procedures on 50 glands (32 parotid, 18 submandibular) in 49 children. Of eligible patients, 90% attended clinical follow-up, 80% answered the survey after 1 year, 80% after 3 years and 60% after 5 years. JRP was diagnosed in 33 cases, obstructive causes in 18 cases. Complications noted were ductal perforation (2%), transient lingual nerve affection (4%) and infection (2%). For JRP patients, overall symptoms had improved for 96% after 3 months, 81% after 1 year and 83% after 3 years. For patients suffering from obstruction, overall symptoms were improved for 93% after 3 months and for 100% after 1 year. CONCLUSION Sialendoscopy is a safe procedure for PSGD, and effective for sialolithiasis and symptom reduction in JRP.
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Affiliation(s)
- Mads S Liljekvist
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark.
| | - Jakob Foghsgaard
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
| | - Michael F Howitz
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
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Chang C, Wang H. Ultrasound shear wave elastography for patients with sialolithiasis undergoing interventional sialendoscopy. Laryngoscope Investig Otolaryngol 2023; 8:76-81. [PMID: 36846401 PMCID: PMC9948575 DOI: 10.1002/lio2.1007] [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: 12/16/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Objective Ultrasound shear wave elastography is an objective tool to evaluate the stiffness of human tissues. Patients with sialolithiasis could be treated by interventional sialendoscopy with a high success rate. Sialolithiasis could be extracted, and the diseased gland could be preserved and evaluated after treatment. Whether ultrasound shear wave elastography could be used for objective outcome measurement and short-term follow-up of the parenchyma of gland in patients with sialolithiasis remains unclear. Methods This retrospective self-controlled study was conducted. Patients with sialolithiasis treated by interventional sialendoscopy and followed by high-resolution ultrasound shear wave elastography were selected between January and September 2017. Results Seventeen patients with sialolithiasis (mean age: 39.63 ± 12.49 years), including 10 women and 7 men, were enrolled. Fifteen patients had sialolithiasis in the submandibular gland and two in the parotid gland. The preoperative value of shear wave velocity was significantly higher in the diseased gland than in the contralateral normal gland (p < .001; 95% confidence interval [CI], 0.3915-0.6046). After successful treatment by interventional sialendoscopy surgery, the shear wave velocity of the diseased gland decreased significantly (p = 0.001; 95% CI, -0.38792 to -0.20474). However, there was a significant difference between the diseased and contralateral normal glands (p = 0.001; 95% CI, 0.0423-0.2895) after 1.55 months of surgery. Conclusion Ultrasound shear wave elastography could be an adjuvant tool to distinguish sialolithiasis-affected diseased glands from contralateral normal glands and assess the short-term treatment outcome objectively. The changing trend of shear wave velocity could help monitor the healing process of the parenchyma in the diseased gland after treatment. Level of Evidence 4.
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Affiliation(s)
- Chia‐Fan Chang
- Department of Otolaryngology‐Head and Neck SurgeryTaipei Veterans General HospitalTaipeiTaiwan,Faculty of Medicine, School of MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Hsin‐Kai Wang
- Department of RadiologyTaipei Veterans General HospitalTaipeiTaiwan,Department of Medical Imaging and Radiological TechnologyYuanpei University of Medical TechnologyHsinchuTaiwan
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Benito DA, Shaver TB, Cox R, Strum DP, Mehta V, Shim T, Chillakuru Y, Badger C, Joshi AS. Cost-analysis of in-office versus operating room sialendoscopy: Comparison of cost burden and outcomes. Am J Otolaryngol 2022; 43:103424. [PMID: 35339773 DOI: 10.1016/j.amjoto.2022.103424] [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: 02/08/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Office-based procedures in otolaryngology are increasingly utilized to increase efficiency, reduce cost, and eliminate risks associated with surgery. Gland-preserving surgical management of sialadenitis and sialolithiasis are often performed in the operating room, although many surgeons are moving this practice to clinic. We aim to determine the difference in patient charges and perioperative outcomes for salivary gland procedures performed in the clinic versus the OR. METHODS Retrospective series of patients presenting with sialolithiasis, acute or chronic sialadenitis, and stricture between 2010 and 2019. Demographics, perioperative variables, setting, and charge data were collected. RESULTS 528 patients underwent operative intervention (n = 427 office, n = 101 OR). Cohort demographics were comparable. Sialolithiasis was the most common presenting diagnosis in both cohorts. Both cohorts had similar rates of complete (p = 0.09) and partial (p = 0.97) response to treatment. A higher percentage of patients in the OR group reported no improvement (21.4 vs 12.2%, p = 0.034). Overall complications were similar (p = 0.582). Mean charges were statistically greater in the OR ($5560.35 OR vs $1298.33 office, p < 0.001). Operative time was significantly reduced in the office group (21.8 min vs 60.85 min, p < 0.001). CONCLUSIONS Appropriately selected patients can be successfully treated in outpatient clinic without compromising patient safety or quality while significantly reducing the financial burden to patients and the healthcare system.
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Van Cleemput T, Vanpoecke J, Coropciuc R, Politis C. Sialendoscopy: A Four-Year Single Center Experience. J Oral Maxillofac Surg 2021; 79:2285-2291. [PMID: 34331872 DOI: 10.1016/j.joms.2021.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Sialendoscopy is a relatively new technique designed to diagnose and treat benign obstructive salivary gland disease using a minimally invasive approach. The purpose of this study is to present our experiences regarding the use of sialendoscopy in the form of a 4-year, single center experience and to demonstrate its usefulness in oral and maxillofacial practice. METHODS We collected data on patients who underwent sialendoscopy at the Oral-Maxillofacial Surgery Department of UZ Leuven between November 2015 and August 2019, including age, gender, sex, initial clinical presentation and symptoms, gland involvement, type of diagnostic investigations, diagnosis, localization of the obstruction, therapeutic intervention, surgeon, type of anesthesia, materials used, complications, secondary treatment, duration of follow-up, and outcome. Statistical analyses were performed, chi-squared was used to compare the different variables with P < .05 being considered significant. RESULTS During the 4-year timeframe, a total of 44 patients (31 female, 13 male) underwent sialendoscopy in a total of 47 procedures. The average age at time of sialendoscopy was 47.4 years. The most frequent cause of obstruction was sialolithiasis (70%). Cone-beam computed tomography (CBCT) was the most accurate preoperative investigation for the diagnosis of lithiasis (57%). Symptom improvement occurred in 57.9% of patients, with a complication rate of 11%. None of the complications were permanent. CONCLUSION Sialendoscopy can be considered safe and effective for both the diagnosis and treatment of benign obstructive salivary gland disease, with a useful place in oral and maxillofacial surgical practice. We recommend the inclusion of CBCT and/or ultrasound in the diagnostic workup prior to endoscopy.
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Affiliation(s)
- Tim Van Cleemput
- OMFS IMPATH research group, Faculty of Medicine, Clinical intern, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium; Professor and Chairperson, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Jasper Vanpoecke
- OMFS IMPATH research group, Faculty of Medicine, Clinical intern, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium; Professor and Chairperson, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ruxandra Coropciuc
- OMFS IMPATH research group, Faculty of Medicine, Clinical intern, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium; Professor and Chairperson, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH research group, Faculty of Medicine, Clinical intern, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium; Professor and Chairperson, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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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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Vila PM, Olsen MA, Piccirillo JF, Ogden MA. Rates of sialoendoscopy and sialoadenectomy in 5,111 adults with private insurance. Laryngoscope 2018; 129:602-606. [PMID: 30556133 DOI: 10.1002/lary.27243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine frequencies and trends in sialoendoscopy and sialoadenectomy for the treatment of obstructive, nonneoplastic submandibular gland disease in the United States. METHODS Epidemiologic study of insurance claims from 2006 to 2013 in a large, private insurance claims database. Rates were calculated for patients undergoing one or both index procedures. RESULTS A total of 5,111 adults with sialadenitis who underwent sialoendoscopy or submandibular gland excision were included. Mean age was 47.6 years, and patients undergoing sialoendoscopy were less likely to be male (relative risk [RR] = 0.84; 95% confidence interval [CI], 0.78-0.89), more likely to have sialoadenitis without stones (RR = 1.60; 95% CI, 1.53-1.66), and had a similar number of comorbidities (RR = 1.00; 95% CI, 0.91-1.06) compared to patients undergoing sialoadenectomy. The most common complication after sialoadenectomy was surgical site infection (1.4%; 95% CI, 1.1-1.8%), and complications after sialoendoscopy were rare. From 2007 to 2013, use of sialoendoscopy increased from 0.13 (95% CI, 0.08-0.18) to 0.42 (95% CI, 0.40-0.45) per 100 thousand people, and sialoadenectomy decreased from 2.41 (95% CI, 2.39-2.42) to 1.43 (95% CI, 1.40-1.44) per 100 thousand. The highest mean rate of sialadenectomy was seen in the south (2.15 per 100,000; 95% CI, 2.13-2.16), the lowest was in the west (1.6 per 100,000; 95% CI, 1.57-1.62), and it decreased in all regions over time. CONCLUSION Utilization of sialoendoscopy has increased over time, and the overall rate of sialoadenectomy is decreasing. Both procedures are safe for treatment of patients with sialadenitis and sialolithiasis. Future research should examine whether availability of sialoendoscopy leads to a decreased rate of sialoadenectomy in patients with salivary gland disease. LEVEL OF EVIDENCE 2c Laryngoscope, 129:602-606, 2019.
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Affiliation(s)
- Peter M Vila
- Department of Otolaryngology-Head and Neck Surgery
| | | | | | - M Allison Ogden
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, U.S.A
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Costs of sialendoscopy and impact on health-related quality of life. Eur Arch Otorhinolaryngol 2018; 276:233-241. [PMID: 30430242 PMCID: PMC6338794 DOI: 10.1007/s00405-018-5196-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/02/2018] [Indexed: 12/28/2022]
Abstract
Purpose To analyse costs related to the diagnosis and treatment of patients with sialolithiasis and sialadenitis managed with sialendoscopy, and to prospectively evaluate the impact of sialendoscopy on health-related quality of life (HRQoL) in a longitudinal follow-up study. Methods All patients undergoing sialendoscopy or sialendoscopy-assisted surgery at a tertiary care university hospital between January 2014 and May 2016 were identified from a surgical database, and the direct hospital costs were retrospectively evaluated from 1 year before to 1 year after the sialendoscopy. The 15D HRQoL questionnaire and a questionnaire exploring the use of health care services during the preceding 3 months were mailed to the patients before sialendoscopy as well as at 3 and 12 months after the operation. Results A total of 260 patients were identified. Mean total hospital costs, costs related to the sialendoscopy, and complications were significantly higher in sialolithiasis patients than in patients with other diagnoses. 74 patients returned the baseline 15D questionnaire, and 51 patients all three 15D questionnaires. At baseline, the dimensions “discomfort and symptoms” and “distress” were lower in patients than in age- and gender-standardised general population, but the total 15D score did not differ significantly. The dimension “discomfort and symptoms” improved significantly at 3 and 12 months postoperatively, and the mean total HRQoL score improved in patients with sialolithiasis at 3 months postoperatively. Conclusions The costs related to sialendoscopy are substantial and the cost-effectiveness of sialendoscopy warrants further studies. However, sialendoscopy seems to reduce patients’ discomfort and ailments and to improve HRQoL at least in patients with sialolithiasis.
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Bawazeer N, Carvalho J, Djennaoui I, Charpiot A. Sialendoscopy under conscious sedation versus general anesthesia. A comparative study. Am J Otolaryngol 2018; 39:754-758. [PMID: 30220479 DOI: 10.1016/j.amjoto.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/30/2018] [Accepted: 09/11/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Sialendoscopy is a minimally invasive emerging approach, the general surgical technique has been published but many essential questions still need to be addressed with the aim of improving outcomes. For instance, should we systematically perform sialendoscopy under conscious sedation (CS) or general anesthesia (GA)? What are the limitations of CS? The objective of this study is to compare these two modalities. METHODOLOGY A retrospective study of 70 patients who had undergone a sialendoscopy between 2014 and 2016 (34 under GA and 36 under CS). Comparisons were made between these two groups in term of operative time, stone size and location, tolerability, operative success and post-operative pain. RESULT The patients' mean age was 45.33 years. The operative success rate among the GA group was 79.4% vs. 88.9% in the CS group (P = 0.276), while complications for both groups were comparable. All patients considered the intervention under CS to be tolerable. CONCLUSION Sialendoscopy under CS or GA demonstrated the ability to access large and distal stones among the different salivary glands with an excellent tolerability. Anesthesia type should be based on surgeon and patient preference Nevertheless, patient reassurance and surgeon experience are important to producing a good result with CS.
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Affiliation(s)
- Naif Bawazeer
- Department of Otolaryngology-Head & Neck Surgery, Umm Al-Qura University, Saudi Arabia.
| | - Jean Carvalho
- Department of Otorhinolaryngology and Head and Neck Surgery, Hautepierre Hospital, University of Strasbourg, France
| | - Idir Djennaoui
- Department of Otorhinolaryngology and Head and Neck Surgery, Hautepierre Hospital, University of Strasbourg, France
| | - Anne Charpiot
- Department of Otorhinolaryngology and Head and Neck Surgery, Hautepierre Hospital, University of Strasbourg, France
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Jokela J, Tapiovaara L, Lundberg M, Haapaniemi A, Bäck L, Saarinen R. A Prospective Observational Study of Complications in 140 Sialendoscopies. Otolaryngol Head Neck Surg 2018; 159:650-655. [DOI: 10.1177/0194599818782418] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Johanna Jokela
- 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
| | - Marie Lundberg
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leif Bäck
- 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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Gallo A, Capaccio P, Benazzo M, De Campora L, De Vincentiis M, Farneti P, Fusconi M, Gaffuri M, Lo Russo F, Martellucci S, Ottaviani F, Pagliuca G, Paludetti G, Pasquini E, Pignataro L, Puxeddu R, Rigante M, Scarano E, Sionis S, Speciale R, Canzi P. Outcomes of interventional sialendoscopy for obstructive salivary gland disorders: an Italian multicentre study. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 36:479-485. [PMID: 28177330 PMCID: PMC5317126 DOI: 10.14639/0392-100x-1221] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/19/2016] [Indexed: 12/18/2022]
Abstract
Interventional sialendoscopy has become the predominant therapeutic procedure for the management of obstructive salivary disorders, but only a few multicentre studies of large series of patients with a long-term follow-up have been published. This Italian multicentre study involved 1152 patients (553 females; mean age 50 years) who, after at least a clinical and ultrasonographic evaluation, underwent a total of 1342 diagnostic and interventional sialendoscopies, 44.6% of which involved the parotid gland. 12% (n = 138) of patients underwent multiple treatments. The procedure was successful in 1309 cases. In 33 cases (2.4%) the procedure could not be concluded mainly because of complete duct stenosis (21 cases). Salivary stones were the main cause of obstruction (55%), followed by ductal stenosis and anomalies (16%), mucous plugs (14.5%) and sialodochitis (4.7%). Complete therapeutic success was obtained in 92.5% of patients after one or more procedures, and was ineffective in < 8%. Untoward effects (peri and postoperative complications) were observed in 5.4% of cases. Sialendoscopy proved to be an effective, valid and safe procedure in the diagnostic and therapeutic management of non-neoplastic obstructive salivary gland diseases.
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Affiliation(s)
- A Gallo
- Department of Medico-surgical sciences and biotechnologies, ENT Section, Sapienza University of Rome, Italy
| | - P Capaccio
- Department of Biomedical, Surgical and Dental Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - M Benazzo
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia, Italy
| | - L De Campora
- Department of Otorhinolaryngology, "Fatebenefratelli" Hospital, Roma, Italy
| | - M De Vincentiis
- Department of Sense Organs, ENT Section, Policlinico "Umberto I", Sapienza University of Rome, Italy
| | - P Farneti
- Department of Experimental, Diagnostic and Specialty Medicine, Dimes, Bologna University Medical School, Ear, Nose and Throat Unit of "Sant'Orsola-Malpighi" Hospital, Bologna, Italy
| | - M Fusconi
- Department of Sense Organs, ENT Section, Policlinico "Umberto I", Sapienza University of Rome, Italy
| | - M Gaffuri
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - F Lo Russo
- Department Experimental biomedicine and clinical neurosciences, Otorhinolaryngology Unit, University of Palermo; Italy
| | - S Martellucci
- Department of Medico-surgical sciences and biotechnologies, ENT Section, Sapienza University of Rome, Italy
| | - F Ottaviani
- Department of Clinical Sciences and Community Health, San Giuseppe Hospital, Università degli Studi di Milano, Milan, Italy
| | - G Pagliuca
- Department of Medico-surgical sciences and biotechnologies, ENT Section, Sapienza University of Rome, Italy
| | - G Paludetti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Italy
| | - E Pasquini
- Ear, Nose and Throat Metropolitan Unit, Surgical Department, AUSL Bologna, Italy
| | - L Pignataro
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - R Puxeddu
- Department of Otorhinolaryngology, AOU, PO "S. Giovanni di Dio", University of Cagliari, Italy
| | - M Rigante
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Italy
| | - E Scarano
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Italy
| | - S Sionis
- Department of Otorhinolaryngology, AOU, PO "S. Giovanni di Dio", University of Cagliari, Italy
| | - R Speciale
- Department Experimental biomedicine and clinical neurosciences, Otorhinolaryngology Unit, University of Palermo; Italy
| | - P Canzi
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia, Italy
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13
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Karagozoglu KH, De Visscher JG, Forouzanfar T, van der Meij EH, Jager DJ. Complications of Sialendoscopy in Patients With Sjögren Syndrome. J Oral Maxillofac Surg 2016; 75:978-983. [PMID: 28481749 DOI: 10.1016/j.joms.2016.09.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/21/2016] [Accepted: 09/25/2016] [Indexed: 10/25/2022]
Abstract
PURPOSE Recent literature suggests that sialendoscopy of the major salivary glands could alleviate symptoms of Sjögren syndrome (SS) and restore salivary function. The aim of this study was to evaluate the authors' experience of sialendoscopy of the salivary glands in patients with SS. MATERIALS AND METHODS In this retrospective case series study, the surgical data of patients with SS who had undergone sialendoscopy at the VU University Medical Center (Amsterdam, The Netherlands) from November 2014 through April 2015 were used. Outcome measurements were successful entry to the salivary gland and completion of sialendoscopy as planned. Furthermore, pre- and postoperative complications were scored. Descriptive analysis of the data was performed. RESULTS Surgical data of sialoendoscopic procedures in 26 patients with SS (24 women and 2 men; mean age, 57 yr; range, 27 to 72 yr) were analyzed. Sialendoscopy was successfully performed in 78 of 104 salivary glands (75%; 50 parotid and 28 submandibular glands) in the 26 patients. Sialendoscopy failed in 26 of the 104 sialoendoscopic procedures (25%; 2 parotid and 24 submandibular glands). In 16 salivary glands, the ductal orifice could not be identified. In 7 salivary glands, sialendoscopy could not be performed because of partial or complete stenosis of the salivary duct. In 3 salivary glands, sialendoscopy was not performed because of a ductal perforation. Three patients developed a postoperative infection. CONCLUSION The overall rate of complications was limited and the sialoendoscopic complications in patients with SS could be regarded as minor. Most complications were seen for sialendoscopy of the submandibular glands in this specific patient category. Careful preoperative selection of patients and salivary glands could contribute to a lower rate of complications and more predictable results.
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Affiliation(s)
- K Hakki Karagozoglu
- Consultant Oral and Maxillofacial Surgeon and PhD Candidate, Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Jan G De Visscher
- Associate Professor, Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam; Department of Oral and Maxillofacial Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Tymour Forouzanfar
- Professor and Department Head, Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Erik H van der Meij
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Derk Jan Jager
- Assistant Professor, Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center; Center for Special Care Dentistry (SBT), Amsterdam, The Netherlands
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Erkul E, Gillespie MB. Sialendoscopy for non-stone disorders: The current evidence. Laryngoscope Investig Otolaryngol 2016; 1:140-145. [PMID: 28894810 PMCID: PMC5510257 DOI: 10.1002/lio2.33] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 07/31/2016] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Review the current literature on the use of sialendoscopy in the treatment of non-stone disorders of the major salivary glands. DATA SOURCES Eligible articles that reported on the use of sialendoscopy in the treatment of non-stone disorders were identified using MEDLINE, Embase, and Google Scholar through May 2016. The search used key words sialendoscopy, salivary endoscopy, salivary scope, salivary duct stenosis, salivary duct stricture, Sjogren's disease, radioiodine sialadenitis, salivary duct obstruction, sialadenitis, chronic sialadenitis, juvenile recurrent parotitis, parotitis, and radiation sialadenitis. REVIEW METHODS Full-length prospective and retrospective original articles; systemic reviews; and meta-analysis, including adults and children with adequate data for evaluating the sialendoscopy for non-stone disorders, were included. Individual case reports were excluded. RESULTS There is an increasing trend for the use of sialendoscopy for salivary obstruction caused by a wide variety of non-stone disorders worldwide. The studies of sialendoscopy for non-stone disorders are often retrospective, of smaller sample size, and more subjective in measurement of patient outcome. The most common indications currently for the procedure are scars, juvenile recurrent parotitis, radioiodine sialadenitis, and Sjögren syndrome, respectively. CONCLUSION Although the initial evidence for the use of sialendoscopy for non-stone disorders is not as established as that for stones, it remains a promising gland-preserving tool in the management of non-stone disorders of major salivary glands.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology Gulhane Military Medical Academy, Haydarpasa Training Hospital Istanbul Turkey
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery Medical University of South Carolina Charleston South Carolina U.S.A
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15
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Capaccio P, Torretta S, Di Pasquale D, Rossi V, Pignataro L. The role of interventional sialendoscopy and intraductal steroid therapy in patients with recurrentsine causasialadenitis: a prospective cross-sectional study. Clin Otolaryngol 2016; 42:148-155. [DOI: 10.1111/coa.12681] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 11/29/2022]
Affiliation(s)
- P. Capaccio
- Department of Biomedical, Surgical and Dental Sciences; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milan Italy
| | - S. Torretta
- Department of Clinical Sciences and Community Health; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milan Italy
| | - D. Di Pasquale
- Department of Clinical Sciences and Community Health; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milan Italy
| | - V. Rossi
- 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
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