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Breaking it down: Review and management of sialendoscopy device malfunctions. Am J Otolaryngol 2022; 43:103400. [PMID: 35210113 DOI: 10.1016/j.amjoto.2022.103400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/05/2022] [Accepted: 02/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The present study was aimed at determining common causes of sialendoscopy device malfunctions and identifying a uniform algorithm to manage device failures. MATERIALS AND METHODS The FDA Manufacturer and User Facility Device Experience (MAUDE) database was searched for various keywords related to sialendoscopy. Reports between the dates of December 1, 2009 to March 31, 2020 were downloaded for review and included in the study. Variables such as: device, the iatrogenic injury type, and subsequent surgical or medical intervention were collected and details of the malfunction were categorized based on the type of malfunction. RESULTS 206 medical device reports were identified; 47 of them which met inclusion criteria (106 were duplicate cases and 53 were irrelevant to the present study). The majority of device malfunctions involved salivary stone extractor baskets (SSEBs), (40/47; 85.1%), followed by malfunctions of balloon dilators (3/47; 6.4%) and sialendoscopes (2/47; 4.3%). Retention of the SSEB was noted in 85% of the SSEB malfunctions. CONCLUSIONS Given that sialendoscopy is an increasingly popular technique that relies on devices, it is inevitable that device failures will occur for a multitude of reasons. Working to prevent these malfunctions from occurring is the most effective method of harm reduction. Though it is important that sialendoscopists have a discrete, algorithmic approach to manage them when they occur.
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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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Koch M, Schapher M, Sievert M, Mantsopoulos K, Iro H. Intraductal Fragmentation in Sialolithiasis Using Pneumatic Lithotripsy: Initial Experience and Results. Otolaryngol Head Neck Surg 2021; 167:457-464. [PMID: 34637368 PMCID: PMC9442634 DOI: 10.1177/01945998211051296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report initial experience in using a pneumatic lithotripter to treat salivary stones. STUDY DESIGN Level IV retrospective study. SETTING University hospital and tertiary referral center. METHODS A pneumatic lithotripter was used to treat salivary stones after these were diagnosed. Probes with diameters of 0.7 mm were used. Total fragmentation was intended in all stones. Stone fragments were removed using several instruments in serial sialendoscopies to achieve complete stone clearance. RESULTS A total of 62 patients with 77 stones were treated. Forty-three submandibular stones were treated in 34 patients, and 34 parotid stones were treated in 28 patients. An operating pressure of 2.5 bar and a single frequency mode were used. Complete fragmentation was achieved in all but one of the treated stones in both glands (98.7%). Among the patients, 90.32% became stone free and 100% symptom free. Multiple stones were treated in 24.19% of the patients, and multimodal therapy was also carried out in 24.19%. All of the glands were preserved. CONCLUSIONS The pneumatic lithotripter proved to be effective in the treatment of sialolithiasis. Stone size, location, and the gland involved were important clinical factors. The device was sufficient to achieve success without any increased risk for complications in the patients or damage to the sialendoscopes.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Hardcastle T, Rasul U, de Paiva Leite S, Zheng K, Donaldson G, Ahmad Z, Morton RP. The Manukau Salivary Symptoms Score for Assessing the Impact of Sialendoscopy in Recurrent Obstructive Sialadenitis. Otolaryngol Head Neck Surg 2021; 166:461-467. [PMID: 34253080 DOI: 10.1177/01945998211017444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the Manukau Salivary Symptom Score (MSSS) questionnaire as a validated tool to assess obstructive sialadenitis-specific symptoms to both indicate disease severity and assess the outcome after sialendoscopic procedures. STUDY DESIGN A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic chronic obstructive salivary gland disease (COSGD). SETTING Department of Otolaryngology-Head and Neck Surgery at the Manukau Surgical Centre, Auckland, New Zealand, between June 2010 and September 2019. METHODS A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic COSGD. Patients completed the MSSS preoperatively and at postoperative follow-up. Statistical tests were used to compare pre- and postoperative answers. Cronbach's α was used to measure internal consistency. Finally, construct validity was determined by comparing the 5-question MSSS questionnaire to the preexisting 20-question Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. RESULTS Postoperatively, patients had significant improvements in pain, eating, talking, swelling, and quality of life (P < .001). The MSSS questionnaire was found to have high internal consistency (α = 0.938). Questions in the MSSS had a very strong positive correlation with 3 COSS questions, a strong positive correlation with 8, a moderate positive correlation with 4, and a weak positive correlation with 1. Four COSS questions were not considered relevant and were not included in the MSSS questionnaire. CONCLUSION The MSSS questionnaire is a simple, validated questionnaire that is useful for assessing the impact of sialendoscopy in patients with COSGD.
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Affiliation(s)
- Tim Hardcastle
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Usman Rasul
- University Hospital Hairmyres, National Health Service Lanarkshire, Scotland, UK
| | - Sandro de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Kevin Zheng
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | | | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
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Obstructive Sialadenitis: Stones and Stenoses. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Moorthy A, Bachalli PS, Krishna S, Murthy S. Sialendoscopic Management of Obstructive Salivary Gland Pathology: A Retrospective Analysis of 236 Cases. J Oral Maxillofac Surg 2020; 79:1474-1481. [PMID: 33359107 DOI: 10.1016/j.joms.2020.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To analyze and assess the results of treating obstructive salivary gland pathology by sialendoscopy or sialendoscopic-assisted surgery and analyze the difference in submandibular and parotid gland pathology. PATIENTS AND METHODS Between December 2012 and March 2020, 211 patients (236 procedures) underwent sialendoscopy/sialendoscopic-assisted surgery for treatment of obstructive salivary gland pathology. The cases were retrospectively analyzed for type of pathology, symptomatic relief, type of intervention (endoscopy alone or combined with open surgery), recurrence of symptoms, number of gland excisions, and complications encountered. Sialolith cases (n = 117) were treated by sialendoscopic/sialendoscopy-assisted surgical sialolithotomy using basket or graspers. Strictures (n = 69) were treated by serial dilatation or balloon dilatation with or without intraductal steroid. Mucous plugs (n = 26) were managed by sialendoscopic lavage and occasional retrieval using wire baskets. RESULTS There were 123 submandibular sialendoscopies in 118 patients and 113 parotid sialendoscopies in 95 patients. Of the 123 submandibular sialendoscopies, 99 were treated for sialolithiasis, 14 for strictures, 3 for mucous plugs, and 2 for foreign bodies. Of the 95 parotid sialendoscopies, 18 were treated for sialolithiasis, 55 for strictures, 23 for mucous plugs, and 1 for foreign body. The success rate was 85.3% for submandibular gland treatment and 92% for parotid gland treatment. About 62.7% of cases were treated by combined method (sialendoscopy with open approach) in submandibular gland and 50% in parotid gland. The number of gland excisions performed was 5 (2.1%). CONCLUSIONS Sialendoscopy although associated with a gradual learning curve can be used for all cases of obstructive salivary gland pathology with excellent success rate and minimum morbidity. Parotid gland obstructive pathology is distinct from that seen in the submandibular gland, with strictures and mucous plugs contributing to most cases. Diagnosing and treatment planning for strictures and mucous plugs should therefore be as seamless as that for sialoliths.
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Affiliation(s)
- Aditya Moorthy
- Consultant, Department of Oral and Maxillofacial Surgery- Rangadore Memorial Hospital, Trust-Well Hospital, Apollo Hospitals, Bangalore, India
| | - Prithvi S Bachalli
- Consultant, Department of Oral and Maxillofacial Surgery- Rangadore Memorial Hospital, Trust-Well Hospital, Apollo Hospitals, Bangalore, India
| | - Shreya Krishna
- Associate Consultant, Department of Oral and Maxillofacial Surgery- Rangadore Memorial Hospital, Bangalore, India.
| | - Sreenivasa Murthy
- Consultant, Department of ENT, Columbia Asia Hospitals, Bangalore, India
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Koch M, Schapher M, Mantsopoulos K, Iro H. Intraductal Lithotripsy in Sialolithiasis Using the Calculase III™ Ho:YAG Laser: First Experiences. Lasers Surg Med 2020; 53:488-498. [PMID: 32997838 DOI: 10.1002/lsm.23325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/24/2020] [Accepted: 09/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES To report the first experiences with a newly available Ho:YAG laser system for the treatment of salivary stones. STUDY DESIGN/MATERIALS AND METHODS A retrospective study in a tertiary referral center was conducted. Patients diagnosed with sialolithiasis were treated in Erlangen using the Calculase III™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany). Preset parameters had a frequency of 4 Hz and energy of 0.8-1.2 J, resulting in 3.2-4.8 W. Following total fragmentation, one to two serial sialendoscopies were performed to achieve complete fragment clearance. RESULTS A total of 55 stones in 49 patients were treated; 17 stones in 15 submandibular glands and 38 in 34 parotids. In total, 61 laser lithotripsies (range 1-3 per stone) were performed using various modes (long, short, and burst) and with preset parameters of 4 Hz and energy of 0.8-1.2 J, resulting in effective power of 3.2-4.8 W. Complete fragmentation was achieved in all the accessible stones. Sialendoscopes, fibers, or the mode used had no significant influence on success rates. A multimodal therapy concept was employed to treat stones in 12.24% of the cases; 95.92% of the patients were ultimately stone-free, and all became symptom-free. All glands were preserved. CONCLUSIONS The new Calculase III™ Ho:YAG laser was effective in the treatment of sialolithiasis with no increased risk of complications in the patients or damage to the sialendoscopes. Clinical factors such as the type of gland involved, or the location and size of stones had a greater impact on success rates than the technical or preset parameters. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Chiesa-Estomba CM, Saga-Gutierrez C, Calvo-Henriquez C, Lechien JR, Cartier C, Mayo-Yanez M, Larruscain-Sarasola E, Ayad T, Walvekar RR. Laser-Assisted Lithotripsy With Sialendoscopy: Systematic Review of YO-IFOS Head and Neck Study Group. EAR, NOSE & THROAT JOURNAL 2020; 100:42S-50S. [PMID: 32442031 DOI: 10.1177/0145561320926281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Sialolithiasis is the most common cause of symptomatic obstructive sialadenitis. Sialendoscopy represent a minimally invasive technique that has evolved significantly in the last 2 decades, with high success rates in managing sialolithiasis and allowing gland preservation. Lithotripsy assisted or not by laser represents the fragmentation of stone or lithiasis within the salivary duct followed immediately by removal of the fragmented pieces. Material and Methods: A systematic review investigating the role of laser-assisted lithotripsy with sialendoscopy (LAS) in the treatment of sialolithiasis was performed. RESULTS Sixteen papers meet inclusion criteria. The mean maximum diameter of lithiasis was 7.11 mm (min: 2 mm/max: 17 mm; standard deviation [SD]: 2.33; 95% CI = 1.573-4.463). Success rate described ranging from 71% to 100% with a mean of 87.3% (SD: 7.21; 95% CI: 5.326-11.158) and the gland preservation rate was 97%. Considering only "non retrievable-non floating stones" studies that include both parotid and submandibular stones: Eight clinical retrospectives, nonrandomized studies and 1 prospective, nonrandomized study report results from parotid and submandibular gland lithiasis. According to this, the most common gland involved was the submandibular gland (n = 153; 65.1%), in comparison to the parotid gland (n = 82; 34.8%). CONCLUSION The current evidence supports LAS as a conservative, efficient, safe, and gland-preserving alternative technique, in experienced hands, for management of mid-size sialolith removal from major salivary glands, when the indication is appropriate.
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Affiliation(s)
- Carlos Miguel Chiesa-Estomba
- Otorhinolaryngology Head and Neck Surgery Department, 16650Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Basque Country, Spain.,Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France
| | - Carlos Saga-Gutierrez
- Otorhinolaryngology Head and Neck Surgery Department, 16650Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Basque Country, Spain
| | - Christian Calvo-Henriquez
- Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology, 59535Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jérome Rene Lechien
- Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Human Anatomy & Experimental Oncology, 54521University of Mons, Mons, Belgium
| | - César Cartier
- Division of Otolaryngology Head & Neck Surgery, 26905Centre Hospitalier de l'Université, de Montpellier, France
| | - Miguel Mayo-Yanez
- Otorhinolaryngology, Head and Neck Surgery Department, 16811Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
| | - Ehkiñe Larruscain-Sarasola
- Otorhinolaryngology Head and Neck Surgery Department, 16650Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Basque Country, Spain.,Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France
| | - Tareck Ayad
- Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Division of Otolaryngology-Head & Neck Surgery, 25443Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Rohan R Walvekar
- Department of Otolaryngology Head & Neck Surgery, 12258Louisiana State University Health Science Center, New Orleans, LA, USA
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Hakim MA, McCain JP, Ahn DY, Troulis MJ. Minimally Invasive Endoscopic Oral and Maxillofacial Surgery. Oral Maxillofac Surg Clin North Am 2019; 31:561-567. [DOI: 10.1016/j.coms.2019.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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McCain JP, Montero J. Surgical Retrieval of Submandibular Stones. Atlas Oral Maxillofac Surg Clin North Am 2018; 26:111-117. [PMID: 30077319 DOI: 10.1016/j.cxom.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Joseph P McCain
- American Board of Oral and Maxillofacial Surgery, Miami Oral and Maxillofacial Surgery, Baptist Medical Arts Building, 8940 North Kendall Drive, Suite E604, Miami, FL 33176, USA
| | - Jose Montero
- Endoscopic Maxillofacial Surgery, Miami Oral and Maxillofacial Surgery, Baptist Medical Arts Building, 8940 North Kendall Drive, Suite E604, Miami, FL 33176, USA.
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12
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Guastaldi FPS, da Silva JSP, Troulis MJ, Lahey E. Surgical Retrieval of Parotid Stones. Atlas Oral Maxillofac Surg Clin North Am 2018; 26:105-110. [PMID: 30077318 DOI: 10.1016/j.cxom.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Fernando Pozzi Semeghini Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA
| | - Jose Sandro Pereira da Silva
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA
| | - Maria J Troulis
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA.
| | - Edward Lahey
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA
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Kondo N, Yoshihara T, Yamamura Y, Kusama K, Sakitani E, Seo Y, Tachikawa M, Kujirai K, Ono E, Maeda Y, Nojima T, Tamiya A, Sato E, Nonaka M. Treatment outcomes of sialendoscopy for submandibular gland sialolithiasis: The minor axis of the sialolith is a regulative factor for the removal of sialoliths in the hilum of the submandibular gland using sialendoscopy alone. Auris Nasus Larynx 2018; 45:772-776. [DOI: 10.1016/j.anl.2017.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 08/06/2017] [Accepted: 09/05/2017] [Indexed: 11/25/2022]
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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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Koch M, Iro H. Salivary duct stenosis: diagnosis and treatment. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:132-141. [PMID: 28516976 PMCID: PMC5463521 DOI: 10.14639/0392-100x-1603] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022]
Abstract
The management of stenoses of the major salivary glands had undergone a significant change during the last 15-20 years. Accurate diagnosis forms the basis of adapted minimal invasive therapy. Conventional sialography and MR-sialography are useful examination tools, and ultrasound seems to be a first-line investigational tool if salivary duct stenosis is suspected as cause of gland obstruction. Sialendoscopy is the best choice to establish final diagnosis and characterise the stenosis in order to plan accurate treatment. In all major salivary glands, inflammatory stenosis can be distinguished from fibrotic stenosis. In the parotid duct system, an additional stenosis associated with various abnormalities of the duct system has been reported. Conservative therapy is not sufficient in the majority of cases. The development of a minimally invasive treatment regime, in which sialendoscopy plays a major role, has made the preservation of the gland and its function possible in over 90% of cases. Ductal incision procedures are the most important measure in submandibular duct stenoses, but sialendoscopy becomes more important in the more centrally located stenoses. Sialendoscopic controlled opening and dilation is the dominating method in parotid duct stenoses. In 10-15% of cases, success can be achieved after a combined treatment regime had been applied. This review article aims to give an overview on the epidemiology, diagnostics and current state of the art of the treatment of salivary duct stenoses.
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Affiliation(s)
- M Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
| | - H Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
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Purcell YM, Kavanagh RG, Cahalane AM, Carroll AG, Khoo SG, Killeen RP. The Diagnostic Accuracy of Contrast-Enhanced CT of the Neck for the Investigation of Sialolithiasis. AJNR Am J Neuroradiol 2017; 38:2161-2166. [PMID: 28838906 DOI: 10.3174/ajnr.a5353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/16/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Sialolithiasis is a common benign pathology affecting the salivary glands but it is unclear if contrast-enhanced CT, which is commonly used for investigation of head and neck pathology, can identify calculi as accurately as noncontrast CT. The aim of this study was to assess the diagnostic accuracy of contrast-enhanced CT of the neck in the diagnosis of sialolithiasis compared with noncontrast CT of the neck used as the criterion standard. MATERIALS AND METHODS This was a retrospective, case-control study of 92 consecutive cases in 90 patients who underwent both noncontrast CT of the neck and contrast-enhanced CT of the neck in 2 tertiary referral centers from January 2011 to December 2015 for investigation of sialolithiasis. Axial 3-mm-section images were assessed by a fellowship-trained diagnostic neuroradiologist and diagnostic neuroradiology fellow in consensus. Blinded assessment of the contrast-enhanced CT of the neck was performed first, followed by noncontrast CT of the neck after a 2-week interval. The presence or absence of a stone and stone location and size were documented. Statistical analysis was undertaken to assess the agreement between CT protocols and calculate the sensitivity and specificity of contrast-enhanced CT of the neck. RESULTS Fifty calculi were identified on noncontrast CT of the neck in 31 cases; and 48 calculi, in 31 cases on contrast-enhanced CT of the neck. No calculi were identified in the remaining 61 cases. The sensitivity and specificity of contrast-enhanced CT of the neck in the detection of sialolithiasis was 96% (95% CI, 86.3%-99.5%) and 100% (95% CI, 94.1%-100%), respectively. The positive predictive value of contrast-enhanced CT of the neck was 100% (95% CI, 92.6%-100%), and the negative predictive value was 96.8% (95% CI, 89%-99.6%). The accuracy of contrast-enhanced CT of the neck in diagnosing the presence or absence of salivary calculi was 98%. CONCLUSIONS Contrast-enhanced CT of the neck is accurate in the detection of sialolithiasis, with no difference in diagnostic accuracy compared with noncontrast CT of the neck.
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Affiliation(s)
- Y M Purcell
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - R G Kavanagh
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - A M Cahalane
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - A G Carroll
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
| | - S G Khoo
- Otolaryngology (S.G.K.), St. Vincent's University Hospital, Elm Park, Dublin, Ireland
- Departments of Otolaryngology (S.G.K.)
| | - R P Killeen
- From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
- Radiology (R.P.K.), Royal Victoria Eye and Ear Hospital, Dublin, Ireland
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Trujillo O, Drusin MA, Pagano PP, Askin G, Rahmati R. Evaluation of Monitored Anesthesia Care in Sialendoscopy. JAMA Otolaryngol Head Neck Surg 2017; 143:769-774. [PMID: 28520832 DOI: 10.1001/jamaoto.2017.0181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance In the United States, sialendoscopy is most often performed under general anesthesia with endotracheal intubation (GETA); however, monitored anesthesia care (MAC) may be a viable alternative. Objective To investigate patient characteristics and outcomes following sialendoscopy performed under MAC or GETA to assess the potential of MAC as an alternative anesthetic option. Design, Setting, and Participants A retrospective review of medical records on patients who underwent sialendoscopy between October 1, 2011, and August 31, 2014, was performed. Patient characteristics, salivary stone characteristics, intraoperative findings, operative time (OT), anesthesia time (AT), and outcomes were evaluated. Data analysis was performed from November 1, 2015, to March 1, 2016. Main Outcomes and Measures Operative and anesthetic times for sialendoscopy under MAC and GETA. Results Sixty-five patients underwent 70 sialendoscopy procedures: 27 performed under MAC, 43 under GETA. Overall, 37 of 65 (56.9%) patients were women, with 17 (63.0%) in the MAC group and 20 (52.6%) in the GETA group. Mean (SD) patient age was 49.4 (17.3) and 47.2 (16.2) years for the MAC and GETA cohorts, respectively. Median (25th-75th quartiles) OT in minutes for MAC cases was significant for no stones (49.0 [31.0-49.0]) and stones (41.0 [28.0-92.0]) present; nonsignificant findings were stones in the Wharton (46.0 [28.0-92.0]) and Stenson (37.0; 1 case) ducts. For GETA cases, significance was also demonstrated for no stones (55.0 [52.0-91.0]) and stones (77.0 [56.0-107.0]) present; nonsignificant findings were stones in the Wharton (79.0 [56.0-107.0]) and Stenson (65.0 [49.0-98.0]) ducts. The AT in minutes for MAC cases was significant for no stones (33.0 [30.0-39.0]) and stones (38.0 [32.0-55.0]) present; nonsignificant findings were stones in the Wharton (60.0 [32.0-55.0]) and Stenson (37.0; 1 case) ducts. For GETA cases, findings were also significant for no stones (61.0 [52.0-67.0]) and stones (59.0 [53.0-67.0]) present; nonsignificant findings were stones in the Wharton (60.0 [54.0-69.0]) and Stenson (52.0 [48.0-61.0]) ducts. Conclusions and Relevance This study suggests that sialendoscopy under MAC has faster median OT and AT, regardless of varying case circumstances, such as the presence or lack of stones, successful stone removal, stone size (>5 mm), stone location, and sialendoscopy-assisted open procedures. Sialendoscopy under MAC may be a reasonable anesthetic alternative to GETA in an appropriate setting with an experienced surgeon, experienced anesthesiologist comfortable with administering MAC, cases with small (<4-mm) singular stones, and patients comfortable with undergoing the procedure without GETA.
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Affiliation(s)
- Oscar Trujillo
- Department of Otolaryngology-Head and Neck Surgery, New York Presbyterian/Columbia University Medical Center, New York, New York
| | - Madeleine A Drusin
- Department of Otolaryngology-Head and Neck Surgery, New York Presbyterian/Columbia University Medical Center, New York, New York
| | - Parwane P Pagano
- Department of Anesthesiology, Columbia University Medical Center, New York, New York
| | - Gulce Askin
- Department of Anesthesiology, Columbia University Medical Center, New York, New York
| | - Rahmatullah Rahmati
- Department of Otolaryngology-Head and Neck Surgery, New York Presbyterian/Columbia University Medical Center, New York, New York
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Serbetci E, Sengor GA. Sialendoscopy: Experience with the First 60 Glands in Turkey and a Literature Review. Ann Otol Rhinol Laryngol 2017; 119:155-64. [DOI: 10.1177/000348941011900303] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives We performed a retrospective analysis to contribute to the increasing number of reports on sialendoscopy in the literature and give basic concepts for beginners at the same time. Methods Between 2004 and 2009, 83 patients with symptoms of ductal obstruction of the major salivary glands were admitted to our clinic. Diagnostic and/or interventional sialendoscopy was applied to 60 glands (33 submandibular and 27 parotid) of 54 patients. A holmium:yttrium-aluminum-garnet laser or a pneumatic lithotripter was used for intraductal stone fragmentation. Results Sialendoscopy revealed no disorder in 2 cases, and in 38 glands (28 submandibular and 10 parotid) sialolithiasis was the underlying disease. Fifteen glands (5 submandibular and 10 parotid) were found to have other main disorders such as stenosis, synechia, or kink formation. Other findings included sialodochitis in 6 glands (2 submandibular and 4 parotid), a polyp in 1 parotid gland, mucus plugs in 21 glands (6 submandibular and 15 parotid), ductal ectasia in 4 glands (2 submandibular and 2 parotid), and ductal collapse in 1 parotid gland. The overall interventional success rate was 83% of all cases, and no complications occurred. Conclusions The success rate of the interventional sialendoscopy performed in the current study shows consistency with the results given in the related medical literature. In the age of sialendoscopy, the adjunctive intraoral surgeries can be argued to be safer, easier, and more successful than before. Sialendoscopy may be considered to be the best practice not only in sialolithiasis, but also in other treatments of obstructive ductal disorders.
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Affiliation(s)
- Erhun Serbetci
- Otorhinolaryngology Group, Nisantasi ENT Group, Istanbul, Turkey
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Ng SK, Chan JYK, Wong EWY, Vlantis AC. Diagnostic accuracy of sialendoscopy referenced to current imaging modalities. SURGICAL PRACTICE 2017. [DOI: 10.1111/1744-1633.12239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Siu-Kwan Ng
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Jason Ying-Kuen Chan
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Eddy Wai-Yeung Wong
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Alexander Chris Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
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Capaccio P, Torretta S, Pignataro L, Koch M. Salivary lithotripsy in the era of sialendoscopy. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2017; 37:113-121. [PMID: 28516973 PMCID: PMC5463518 DOI: 10.14639/0392-100x-1600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 01/17/2023]
Abstract
The traditional management of obstructive salivary disorders has been replaced by minimally-invasive gland-preserving techniques including shock-wave lithotripsy, sialendoscopy, interventional radiology and endoscopically video-assisted trans-oral and cervical stone retrieval, of which sialendoscopy is considered to be the method of first choice. Primary endoscopically controlled stone extraction without prior fragmentation is only possible in 15-20% of cases; in more than 80%, fragmentation is necessary because of the size, impactation and location of the stone, or an alternative treatment such as transoral duct surgery or combined approaches are required. Moreover, about 10-20% of all stones cannot be adequately accessed by means of a sialendoscope or any alternative surgical method and, in such cases, extra-corporeal shock wave lithotripsy (ESWL) is the treatment of choice. However, in endoscopically accessible stones, ESWL is being gradually replaced by endoscopically assisted intra-corporeal techniques, including endoscopically guided laser and pneumatic intracorporeal lithotripsy. We describe the currently most widely used techniques for salivary lithotripsy, including ESWL, and endoscopically guided laser, electrohydraulic, electrokinetic and pneumatic intra-corporeal lithotripsy, and discuss their indications given the widespread use of advanced rehabilitative sialendoscopy and combined therapeutic approaches.
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Affiliation(s)
- P. Capaccio
- Department of Biomedical, Surgical and Dental Sciences
| | - S. Torretta
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - L. Pignataro
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - M. Koch
- Department of Otorhinolaryngology, Head and Neck Surgery; Friedrich Alexander University of Erlangen Nuremberg, Germany
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Koch M, Iro H. Extended and treatment-oriented classification of parotid duct stenosis. Laryngoscope 2016; 127:366-371. [PMID: 27346484 DOI: 10.1002/lary.26079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To provide an extended and treatment-oriented classification of parotid duct stenosis that might be useful in the management of this condition. STUDY DESIGN Retrospective study in a tertiary referral center. METHODS A total of 550 symptomatic stenoses of the parotid gland excretory duct in 445 patients were analyzed. Sialendoscopy was performed with semirigid endoscopes. The tissue quality, location, grade of luminal narrowing, and length and number of the stenoses were assessed. RESULTS Inflammation-dominant stenosis (type 1) was found in 8.9% of the patients, web-associated fibrous stenosis (type 2) in 19.5%, and fibrous (type 3) in 71.6%. Multiple stenoses (≥3) were found in 2.8% of patients, and bilateral stenoses in 11.9%. Type 1 stenoses differed significantly from type 3 stenoses, with lower grades. Type 3 stenoses showed significantly higher grades of luminal narrowing than the other two types (P = .0001). Type 2 stenoses were significantly shorter in comparison with the other two types (P = .0001). Multiple stenoses were observed significantly more often in type 2 than in type 3 stenoses (P = .0001). Due to these differences, the type of stenosis appears to be the most important criterion in the treatment-oriented classification. CONCLUSIONS Significant differences between the different stenoses were observed. Type 1 stenosis may be considered as a precursor of type 3 stenosis, but type 2 stenosis showed significantly different characteristics. The differences prescribed in this classification may be helpful in the management of parotid duct stenoses. LEVEL OF EVIDENCE 4. Laryngoscope, 2016 127:366-371, 2017.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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Aubin-Pouliot A, Delagnes EA, Chang JL, Ryan WR. Sialendoscopy-assisted surgery and the chronic obstructive sialadenitis symptoms questionnaire: A prospective study. Laryngoscope 2016; 126:1343-8. [DOI: 10.1002/lary.25759] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2015] [Indexed: 01/16/2023]
Affiliation(s)
- Annick Aubin-Pouliot
- Department of Otolaryngology-Head and Neck Surgery; University of California-San Francisco; San Francisco California U.S.A
| | - Elise A. Delagnes
- Salivary Gland Surgery Center; and the School of Medicine; University of California-San Francisco; San Francisco California U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery; University of California-San Francisco; San Francisco California U.S.A
| | - William R. Ryan
- Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Oncologic and Endocrine Surgery; University of California-San Francisco; San Francisco California U.S.A
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Koch M, Mantsopoulos K, Schapher M, von Scotti F, Iro H. Intraductal pneumatic lithotripsy for salivary stones with the StoneBreaker: Preliminary experience. Laryngoscope 2016; 126:1545-50. [DOI: 10.1002/lary.25849] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Felix von Scotti
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
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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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25
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The Chronic Obstructive Sialadenitis Symptoms Questionnaire to assess sialendoscopy-assisted surgery. Laryngoscope 2015; 126:93-9. [DOI: 10.1002/lary.25521] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 05/29/2015] [Accepted: 06/23/2015] [Indexed: 11/07/2022]
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Pace CG, Hwang KG, Papadaki M, Troulis MJ. Interventional Sialoendoscopy for Treatment of Obstructive Sialadenitis. J Oral Maxillofac Surg 2014; 72:2157-66. [DOI: 10.1016/j.joms.2014.06.438] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/12/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022]
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Koch M, Künzel J, Iro H, Psychogios G, Zenk J. Long-term results and subjective outcome after gland-preserving treatment in parotid duct stenosis. Laryngoscope 2014; 124:1813-8. [DOI: 10.1002/lary.24534] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/18/2013] [Accepted: 11/18/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Julian Künzel
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Georgios Psychogios
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
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Phillips J, Withrow K. Outcomes of Holmium Laser–Assisted Lithotripsy with Sialendoscopy in Treatment of Sialolithiasis. Otolaryngol Head Neck Surg 2014; 150:962-967. [DOI: 10.1177/0194599814524716] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/30/2014] [Indexed: 08/30/2023]
Abstract
ObjectivesThe purpose of the current study was to compare outcomes and complication rates of sialolithiasis treated with intracorporeal holmium laser lithotripsy in conjunction with salivary endoscopy with those treated with simple basket retrieval or a combined endoscopic/open procedure.Study DesignCase‐comparison study.SettingTertiary hospital.MethodsReview of prospectively collected data of patients who underwent treatment for sialolithiasis by the senior author during 2011 to 2013. Patient demographics, operative techniques, surgical findings, clinical outcomes, and complications were recorded. Additional information regarding symptoms and satisfaction with treatment was obtained via standardized telephone questionnaire at the time of the data analysis.ResultsThirty‐one patients were treated for sialolithiasis. Sialoliths averaged 5.9 mm in size (range, 2‐20 mm) and were comparable between both groups. Sixty‐eight percent were in the submandibular gland (n = 21), with the remaining 32% in the parotid gland (n = 10). Fifty‐two percent of patients (n = 16) were treated endoscopically with intracorporeal holmium laser lithotripsy, while the remaining 48% (n = 15) were treated with salivary endoscopy techniques other than laser lithotripsy. Successful stone removal without additional maneuvers occurred in 81% of the laser cases and 93% of the nonlaser group. Patients in the laser group reported an average improvement of symptoms of 95% compared with 90% of the nonlaser group when adjusted for outliers. Complications in all patients included ductal stenosis (n = 2) and salivary fistula (n = 1).ConclusionThe results of our series show favorable results with the use of intracorporeal holmium laser lithotripsy for the endoscopic management of sialolithiasis with minimal adverse events.
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Affiliation(s)
- James Phillips
- Department of Surgery Division of Otolaryngology HNS University of Alabama–Birmingham Birmingham Alabama USA
| | - Kirk Withrow
- Department of Surgery Division of Otolaryngology HNS University of Alabama–Birmingham Birmingham Alabama USA
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Dabirmoghaddam P, Hosseinzadehnik R. Interventional sialendoscopy with endoscopic sialolith removal without fragmentation. Indian J Otolaryngol Head Neck Surg 2014; 65:111-5. [PMID: 24427549 DOI: 10.1007/s12070-012-0573-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 08/29/2012] [Indexed: 11/29/2022] Open
Abstract
We performed a retrospective analysis to review the results and complications of sialendoscopy and to identify the overall success rate of mechanical stone retrieval without fragmentation in our patients with sialolithiasis. Between 2009 and 2011, 33 patients with sialolithiasis underwent interventional sialendoscopy. Patients with sialoliths larger than 7 mm in the Wharton's duct and 5 mm in the Stensen's duct or intraparenchymal stones were not included in this study. Grasping forceps, wire baskets and graspers was used for stone removal. The mean age at presentation was 41.7 (range, 29-62) years with a male to female ratio of approximately 1:2. The average size of the stones ranged from 2 to 6 mm. The overall success rate for endoscopic stone retrieval was 78 % (26 of 33) and three patients required a combined approach with intraoral incisions for stone removal. The major complication rate was 3 % (1 of 33) caused by submandibular duct perforation. The endoscopic retrieval of salivary stones is a safe and effective technique in selected cases. As instruments for stone fragmentation are expensive and not available everywhere, selecting patients with small and medium sized stones could lead to successful results in majority of cases.
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Affiliation(s)
- Payman Dabirmoghaddam
- Otolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa'adi Ave., 1145765111 Tehran, Iran
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30
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Ianovski I, Morton RP, Ahmad Z. Patient-perceived outcome after sialendoscopy using the glasgow benefit inventory. Laryngoscope 2014; 124:869-74. [DOI: 10.1002/lary.24343] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/15/2013] [Accepted: 07/15/2013] [Indexed: 12/15/2022]
Affiliation(s)
- Ilia Ianovski
- Department of Otolaryngology-Head and Neck Surgery; Counties Manukau District Health Board; Auckland New Zealand
| | - Randall P. Morton
- Department of Otolaryngology-Head and Neck Surgery; Counties Manukau District Health Board; Auckland New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery; Counties Manukau District Health Board; Auckland New Zealand
- Department of Surgery; University of Auckland; Auckland New Zealand
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Martellucci S, Pagliuca G, de Vincentiis M, Greco A, Fusconi M, De Virgilio A, Gallipoli C, Gallo A. Ho:Yag Laser for Sialolithiasis of Wharton’s Duct. Otolaryngol Head Neck Surg 2013; 148:770-4. [DOI: 10.1177/0194599813479914] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To assess the feasibility of intracorporeal lithotripsy with holmium YAG laser under sialoendoscopic guidance for sialolithiasis of Wharton’s duct. Study Design Case series with planned data collection. Setting Tertiary referral university hospital. Methods This study was conducted on 16 patients with sialolithiasis of Wharton’s duct. Diagnosis was confirmed at ultrasound examination. Patients with stones ranging from 5 to 8 mm in diameter were enrolled in the study. The selected patients underwent intracorporeal lithotripsy with holmium Yag laser under endoscopic control. Debris was removed using sialoendoscopic forceps or a wire basket during the same procedure. After a 3-month follow-up, radiological tests were rerun. Results Stone fragmentation was possible in all cases. All patients experienced a regular postoperative course. Postoperative ultrasound examinations revealed residual stones in 3 patients, 1 of whom was asymptomatic. Three patients complained of residual symptoms after 3 months of follow-up. These patients were treated successfully during a second sialoendoscopic procedure. Conclusions In our experience, endoscopic laser lithotripsy was proved to be a feasible technique for Wharton’s duct lithiasis in clinical practice.
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Affiliation(s)
- Salvatore Martellucci
- Department of Surgical Biotechnologies and Science, ENT Section “Sapienza” University of Rome, Italy
| | - Giulio Pagliuca
- Department of Surgical Biotechnologies and Science, ENT Section “Sapienza” University of Rome, Italy
| | - Marco de Vincentiis
- Department of Sensorial Organs, ENT Section “Sapienza” University of Rome, Italy
| | - Antonio Greco
- Department of Sensorial Organs, ENT Section “Sapienza” University of Rome, Italy
| | - Massimo Fusconi
- Department of Sensorial Organs, ENT Section “Sapienza” University of Rome, Italy
| | - Armando De Virgilio
- Department of Sensorial Organs, ENT Section “Sapienza” University of Rome, Italy
| | - Camilla Gallipoli
- Department of Surgical Biotechnologies and Science, ENT Section “Sapienza” University of Rome, Italy
| | - Andrea Gallo
- Department of Surgical Biotechnologies and Science, ENT Section “Sapienza” University of Rome, Italy
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Jones RHB, Findlay GJ. The management of benign salivary disease: a case series. Aust Dent J 2013; 58:112-6. [PMID: 23441801 DOI: 10.1111/adj.12026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2012] [Indexed: 11/27/2022]
Abstract
There are many causes for benign salivary gland disease but the most common relate to inflammation and infection. This usually revolves around duct obstruction and a reduction in the normal salivary flow from the gland into the mouth. This leads to retention of saliva, proximal to the obstruction and ascending infection from the mouth, usually because of the decrease in salivary flow. The increase in tension behind the obstruction causes significant pain and swelling, along with the inevitable infection if the obstruction is not relieved. This paper discusses the various treatments available for benign salivary gland disease, the traditional methods of treatment through to the use of endoscopic techniques which are currently available, including a discussion about the use of sialoendoscopy.
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Affiliation(s)
- R H B Jones
- James Cook University and Townsville Hospital, Queensland. Robert_
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Sequeira SM, Nussenbaum B, Ogden MA. Interventional sialendoscopy after sialadenectomy. Laryngoscope 2013; 123:1204-6. [PMID: 23427057 DOI: 10.1002/lary.23930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 11/05/2012] [Accepted: 11/05/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the use of diagnostic and interventional sialendoscopy in patients with prior parotidectomy or submandibular gland excision and persistent sialadenitis and/or sialolithiasis. STUDY DESIGN Retrospective case series. METHODS Retrospective review of medical records, including demographic data, clinical presentation and exam, radiologic studies, and operative reports. RESULTS Five patients, who had undergone prior sialadenectomy for sialadenitis and/or sialolithiasis, underwent sialendoscopy for persistent symptoms during the study period. Three patients were female and two were male, with ages ranging from 39 to 63 years (median, 47 years). Three patients had prior parotidectomy, and two had prior submandibular gland excision. The duration of time from sialadenectomy to sialendoscopy was 3.25 months to 6 years (median, 26 months). Four of the five patients had successful interventional sialendoscopy, with resolution of their symptoms. These four patients underwent extraction of stones, one of which was previously unrecognized. In one patient, duct cannulation and subsequent sialendoscopy could not be performed owing to scarring at the Stensen's papilla; the patient's symptoms initially persisted after the attempted procedure with gradual improvement. No complications occurred in any patients. Importantly, no sequelae resulted from endoscopic instrumentation and irrigation of salivary ducts that ended in blind pouches. CONCLUSIONS Sialendoscopy is a safe and frequently effective intervention for persistent sialolithiasis and sialadenitis after salivary gland excision. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Sunitha M Sequeira
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri 63110, USA
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Durbec M, Dinkel E, Vigier S, Disant F, Marchal F, Faure F. Thulium-YAG laser sialendoscopy for parotid and submandibular sialolithiasis. Lasers Surg Med 2012; 44:783-6. [DOI: 10.1002/lsm.22094] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2012] [Indexed: 11/11/2022]
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Felton M, Mamais C, Kumar B, Izzat M. Medico-legal aspects of introducing sialendoscopy: A minimally invasive treatment for salivary gland obstruction. Clin Otolaryngol 2012; 37:213-20. [DOI: 10.1111/j.1749-4486.2012.02485.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bouchard C, Magill JC, Nikonovskiy V, Byl M, Murphy BA, Kaban LB, Troulis MJ. Osteomark: a surgical navigation system for oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2011; 41:265-70. [PMID: 22103996 DOI: 10.1016/j.ijom.2011.10.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 10/17/2011] [Accepted: 10/17/2011] [Indexed: 11/29/2022]
Abstract
The purpose of this project was to test a surgical navigation tool designed to help execute a surgical treatment plan. It consists of an electromagnetically tracked pencil that is used to mark bone intraoperatively. The device was tested on a precision block, an ex vivo pig mandible and during performance of six endoscopic vertical ramus osteotomies on pig cadavers. The difference between actual pencil position and that displayed by the computer was measured three times each at ten 2mm holes on the block (n=30 observations) and on the ex vivo mandible (n=11 measurements). Errors between planned and actual osteotomy locations for the cadaver procedures were measured. The mean distance between known and displayed locations was 1.55 ± 0.72 mm on the precision block and 2.10 ± 0.88 mm on the pig mandible. The error measured marking the same point on the block multiple (n=5) times was 0.58 ± 0.37 mm. The mean error on the simulated osteotomies was 2.35 ± 1.35 mm. Osteomark was simple to use and permitted localisation of holes and osteotomies with acceptable accuracy. In the future, the device and algorithms will be revised to further decrease error and the system will be tested on live animals.
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Affiliation(s)
- C Bouchard
- The Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
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Maresh A, Kutler DI, Kacker A. Sialoendoscopy in the diagnosis and management of obstructive sialadenitis. Laryngoscope 2011; 121:495-500. [DOI: 10.1002/lary.21378] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 09/09/2010] [Indexed: 11/11/2022]
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Outcome and relative cost of transoral removal of submandibular calculi. The Journal of Laryngology & Otology 2011; 125:386-9. [DOI: 10.1017/s0022215110002653] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:To examine the outcomes and treatment cost of transoral removal of submandibular calculi, and to compare the outcomes and costs of other reported techniques.Method:Retrospective review of 60 consecutive patients undergoing transoral removal of submandibular calculi. All clinical, operative, post-operative and follow-up data were collated and outcomes analysed.Results:A total of 61 submandibular glands were treated by the transoral approach. Patients with multiple stones (p = 0.034) and stones in the proximal submandibular duct (p = 0.0028) were at greater risk of requiring submandibular gland excision, compared with patients with single stones and stones in the distal duct, respectively. There was a significant difference between the gland preservation rate during the first versus the second half of the study (p = 0.028). Larger calculi were significantly more likely to be seen in the proximal duct (p < 0.001). The mean operating time (28 minutes) and length of hospital stay for transoral removal of submandibular calculi was much less than those for other treatment techniques.
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Abstract
Sialoliths are the underlying cause of salivary gland obstructive disease in 60%-70% of cases. Modern minimally invasive techniques have enabled accurate diagnosis and findings-specific therapy with the aim of full gland-function preservation. This article provides an overview of the current diagnostic measures for and therapy of sialolithaisis. Ultrasound is the investigation of first choice and is able to recognize stones in well over 90% of cases. Sialendoscopy is a directly visualizing technique which is superior to all other diagnostic measures for the assessment of pathologic changes in the salivary duct system and the detection of stones. Treatment was significantly improved with the introduction of extracorporal shock wave lithotripsy (ESWL), sialographic-controlled techniques, surgical procedures of the duct system and in particular by interventional sialendoscopy. Interventional sialendoscopy, especially when combined with other treatment modalities, has a success rate of 85%-95%. Cases which respond poorly to therapy can be treated successfully with the endoscopic transcutaneous approach in about 90% of cases. When sialendoscopy is performed in combination with other minimally invasive treatment options the gland can be preserved in 95%-98% of all cases.
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Affiliation(s)
- H Iro
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich Alexander Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen.
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Su YX, Wang L, Liao GQ, Liu HC, Liang YJ, Zheng GS. Sialoendoscopic secondary intervention after failure of open sialolithectomy. J Oral Maxillofac Surg 2010; 68:313-8. [PMID: 20116701 DOI: 10.1016/j.joms.2009.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 04/14/2009] [Accepted: 07/25/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Traditionally, sialoadenectomy was always indicated when open sialolithectomy failed. The aim of the present study was to investigate the role of sialoendoscopy as the secondary intervention after failure of open sialolithectomy. PATIENTS AND METHODS A consecutive series of 15 patients with obstructive salivary gland disease with failure of open sialolithectomy were prospectively recruited for our study. All these patients underwent sialoendoscopy under local anesthesia. The reasons for the failure of open sialolithectomy were analyzed, and secondary interventions were performed using sialoendoscopy. RESULTS Failure of open sialolithectomy resulted from 4 main causes. Small stones could not be found after the duct was incised (n = 3); the stones were pushed posteriorly during open surgery (n = 4); the stones located in the anterior part of the duct were removed, but the hilar stones were left untouched (n = 5); and radiolucent stones were missed (n = 3). All the patients were treated successfully by sialoendoscopy. No symptoms or signs of recurrence developed during a median follow-up period of 16 months. CONCLUSIONS Sialoendoscopy can be recommended as an effective secondary intervention after failure of open sialolithectomy.
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Affiliation(s)
- Yu-xiong Su
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen University Guanghua School of Stomatology, Guangzhou, China
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Su YX, Liao GQ, Zheng GS, Liu HC, Liang YJ, Ou DM. Sialoendoscopically assisted open sialolithectomy for removal of large submandibular hilar calculi. J Oral Maxillofac Surg 2010; 68:68-73. [PMID: 20006157 DOI: 10.1016/j.joms.2009.06.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 04/14/2009] [Accepted: 06/30/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The management of large hilar calculi is a technically challenging issue during sialoendoscopic surgery. The aim of the present study was to evaluate the clinical efficacy of sialoendoscopically assisted open sialolithectomy for the removal of large submandibular hilar calculi to avoid sialoadenectomy. PATIENTS AND METHODS The present study was undertaken among patients with sialolithiasis scheduled for sialoendoscopic surgery from August 2005 to October 2008. When we failed to remove large submandibular hilar stones intraductally, we performed sialoendoscopically assisted open sialolithectomy. The clinical characteristics, pre- and intraoperative data, and outcomes were documented in a prospective fashion. RESULTS Of 78 consecutive patients with submandibular sialolithiasis, 18 were treated with sialoendoscopically assisted open sialolithectomy immediately after failure of intraductal removal of calculi by sialoendoscopy. For 17 patients, large hilar sialoliths were successfully removed using this surgical technique. The surgery failed in 1 patient with multiple sialoliths, and the procedure was converted to open sialoadenectomy. Temporary numbness of the tongue for 1 week postoperatively was documented in 3 patients. The patients were followed up for a median period of 18 months without any symptoms or signs of recurrence. CONCLUSION Our results suggest that sialoendoscopically assisted open sialolithectomy is an effective and safe surgical technique to remove large submandibular hilar calculi.
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Affiliation(s)
- Yu-xiong Su
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen University Guanghua School of Stomatology, Guangzhou, China
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Koch M, Zenk J, Iro H. Algorithms for Treatment of Salivary Gland Obstructions. Otolaryngol Clin North Am 2009; 42:1173-92, Table of Contents. [DOI: 10.1016/j.otc.2009.08.002] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Extracorporeal and Intracorporeal Lithotripsy of Salivary Gland Stones: Basic Investigations. Otolaryngol Clin North Am 2009; 42:1115-37, Table of Contents. [DOI: 10.1016/j.otc.2009.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Capaccio P, Torretta S, Pignataro L. The Role of Adenectomy for Salivary Gland Obstructions in the Era of Sialendoscopy and Lithotripsy. Otolaryngol Clin North Am 2009; 42:1161-71, Table of Contents. [DOI: 10.1016/j.otc.2009.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Liu DG, Zhang ZY, Zhang Y, Zhang L, Yu GY. Diagnosis and management of sialolithiasis with a semirigid endoscope. ACTA ACUST UNITED AC 2009; 108:9-14. [DOI: 10.1016/j.tripleo.2009.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 11/15/2008] [Accepted: 01/05/2009] [Indexed: 10/21/2022]
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Walvekar RR, Bomeli SR, Carrau RL, Schaitkin B. Combined approach technique for the management of large salivary stones. Laryngoscope 2009; 119:1125-9. [DOI: 10.1002/lary.20203] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Woo SH, Jang JY, Park GY, Jeong HS. Long-term outcomes of intraoral submandibular stone removal in children as compared with adults. Laryngoscope 2009; 119:116-20. [DOI: 10.1002/lary.20039] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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