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Hwang K, Park CY. Challenging Dogmas in Plastic Surgery. J Craniofac Surg 2024:00001665-990000000-01918. [PMID: 39265190 DOI: 10.1097/scs.0000000000010625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 08/11/2024] [Indexed: 09/14/2024] Open
Abstract
In medicine, dogmas are subject to evolution and refinement as new research and technologies emerge. The aim of this study was to search for dogmas which were challenged and potentially revised in the plastic surgery field. A search on PubMed for "dogma and plastic surgery" yielded 80 papers. The queries "surgical dogma and craniofacial surgery" and "surgical dogma and flap" returned 9 and 21 papers, respectively. "Surgical dogma and hand" and "surgical dogma and wound healing" produced 41 and 25 papers, respectively. Removing 35 duplicate papers, 141 abstracts were reviewed. Of these, 78 were excluded, leaving 63 papers for analysis. The dogmas being challenged within the field of plastic surgery were classified into various categories. The distribution of these challenged dogmas was as follows: wound healing: 14.29%, epinephrine use: 9.52%, flap surgery: 7.94%, breast reconstruction: 6.35%, rhinoplasty: 7.94%, hand surgery: 4.76%, pressure sores: 4.76%, chemical peel: 4.76%, and hand injuries: 3.17%. The widespread focus on improving wound healing techniques indicates a need for more effective treatments and faster recovery times. Significant attention has been directed toward the use of epinephrine, particularly in fingers, which may reflect ongoing debates about its safety. Innovations and improvements in flap surgery could lead to better reconstructive outcomes. Challenging existing dogma is a vital process and a driving force in the advancement of clinical science. These challenges and potential revisions reflect the dynamic nature of plastic surgery, where ongoing research, patient outcomes, and evolving societal norms drive continuous improvement and adaptation in practices and principles.
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Affiliation(s)
- Kun Hwang
- Department of Plastic Surgery, Armed Forces Capital Hospital, Bundang-gu, Seongnam-City, Gyeonggi-do, Republic of Korea
- Department of Anatomy, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Chan Yong Park
- Division of Trauma and Acute Care Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea
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Chiesa-Estomba CM, Sanchez-Barrueco A, Cammaroto G, Lechien JR, Mayo-Yanez M, Cenjor C, Capaccio P, Saga-Gutierrez C. Prophylactic antibiotics in sialendoscopy: a randomized clinical trial. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08773-z. [PMID: 39001923 DOI: 10.1007/s00405-024-08773-z] [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: 04/22/2024] [Accepted: 06/03/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE Antibiotics have been prescribed routinely in sialendoscopy procedures to reduce the risk of postoperative infection, despite the limited evidence supporting this practice. Being necessary to assess the need for antibiotics in Sialendoscopy, aiming to provide evidence-based guidance to clinicians regarding antibiotic administration in this procedure. MATERIALS & METHOD A prospective, randomized, double-blind, controlled clinical trial to evaluate the of prophylactic antibiotics in Sialendoscopy was designed. RESULTS A total of 80 patients were included in this study, including 57 females (71.8%) and 23 males (28.8%). In terms of prophylaxis, 36 patients (45%) received prophylactic treatment, and 44 patients (55%) did not. The occurrence of infectious events was observed in 2 patients (5.6%) with prophylaxis and 4 patients (9.1%) without prophylaxis. However, this difference was not statistically significant (p = 0.556). CONCLUSION In conclusion, our prospective, randomized clinical trial aimed to address the debate regarding the use of prophylactic antibiotics in sialendoscopy. Our study's findings suggest that the routine use antibiotics may not be necessary to prevent postoperative infections in sialendoscopy procedures. These results have important implications for clinical practice, potentially reducing the unnecessary use of antibiotics and addressing concerns related to antibiotic resistance and adverse drug reactions.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology, Osakidetza Donostia University Hospital, Biodonostia Research Institute, San Sebastian, 20014, Spain.
- Otorhinolaryngology Department, Faculty of Medicine, Deusto University, Bizkaia, Spain.
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
| | - Alvaro Sanchez-Barrueco
- ENT and Cervicofacial Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Otorhinolaryngology Department, Faculty of Medicine, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Giovanni Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, 47121, Italy
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
| | - Jerome R Lechien
- Department of Otolaryngology and Head and Neck Surgery, Division of Laryngology and Broncho-Esophagology, UMONS Research Institute for Health Sciences and Technology, EpiCURA Hospital, University of Mons, Mons, Belgium
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Miguel Mayo-Yanez
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Galicia, 15006, A Coruña, Spain
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Carlos Cenjor
- ENT and Cervicofacial Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Otorhinolaryngology Department, Faculty of Medicine, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Pasquale Capaccio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
| | - Carlos Saga-Gutierrez
- Department of Otorhinolaryngology, Osakidetza Donostia University Hospital, Biodonostia Research Institute, San Sebastian, 20014, Spain
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Zhao YN, Zheng DN, Qu LY, Xie XY, Liu DG, Yu GY. Removal of intraglandular calculi in Wharton's duct: clinical outcome and treatment algorithm. Int J Oral Maxillofac Surg 2024; 53:382-388. [PMID: 38092608 DOI: 10.1016/j.ijom.2023.12.001] [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: 06/02/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 04/16/2024]
Abstract
The aim of this study was to propose a treatment strategy for intraglandular submandibular calculi based on calculus site. Seventy-three consecutive patients with impalpable intraglandular submandibular calculi were enrolled retrospectively. The calculi were classified as either post-hilar type, central type, or superficial type. Treatment approaches included transoral duct slitting (TDS), interventional basket retrieval (IBR), intraductal laser lithotripsy (ILL), and transcervical lithotomy (TCL). Complete calculus removal with gland preservation was achieved in 64 patients (87.7%). The success rate for post-hilar, central, and superficial calculi was 86.4% (51/59), 90.9% (10/11), and 100% (3/3), respectively. The treatment approach applied in patients with treatment success was TDS in 32 cases, IBR in 20, ILL in nine, and TCL in three. During follow-up (median 17.3 months), one patient experienced gland atrophy and three had ductal stenosis; the remaining 60 patients (93.8%, 60/64) had good clinical outcomes. In the eight failure cases operated by TDS, the deeply situated calculi could not be detached despite the parenchymal incision in five cases, while the procedure was ceased due to the patient's inability to cooperate in the other three cases. In the remaining failure case, the submandibular gland was sacrificed after calculus extraction via TCL. Application of the proposed treatment algorithm might help preserve gland function in patients with intraglandular submandibular calculi.
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Affiliation(s)
- Y-N Zhao
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - D-N Zheng
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - L-Y Qu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - X-Y Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - D-G Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China.
| | - G-Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
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Chiesa-Estomba CM, Lechien JR, Vaira LA, Brunet A, Cammaroto G, Mayo-Yanez M, Sanchez-Barrueco A, Saga-Gutierrez C. Exploring the potential of Chat-GPT as a supportive tool for sialendoscopy clinical decision making and patient information support. Eur Arch Otorhinolaryngol 2024; 281:2081-2086. [PMID: 37405455 DOI: 10.1007/s00405-023-08104-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023]
Abstract
INTRODUCTION Sialendoscopy has emerged in the last decades as a groundbreaking technique, offering a minimally invasive approach for exploring and managing salivary gland disorders. More recently, the advent of chatbots, powered by advanced natural processing language and artificial intelligence algorithms, has revolutionized the way healthcare professionals and patients access and analyze medical information and potentially will support soon the clinical decision-making process. MATERIALS AND METHODS A prospective, cross-sectional study was designed to assess the level of agreement between Chat-GPT and 10 expert sialendoscopists aiming the capabilities of Chat-GPT to further improve the management of salivary gland disorders. RESULTS The mean level of agreement was 3.4 (SD: 0.69; Min: 2, Max: 4) for Chat-GPT's answers while it was 4.1 (SD: 0.56; Min: 3, Max: 5) for the group of EESS (p < 0.015). The overall Wilcoxon signed-rank test yielded a significance level of p < 0.026 when comparing the level of agreement between Chat-GPT and EESS. The mean number of therapeutic alternatives suggested by Chat-GPT was 3.33 (SD: 1.2; Min: 2, Max: 5), while it was 2.6 (SD: 0.51; Min: 2, Max: 3) for the group of EESS; p = 0.286 (95% CI - 0.385 to 1.320). CONCLUSION Chat-GPT represents a promising tool in the clinical decision-making process within the salivary gland clinic, particularly for patients who are candidates for sialendoscopy treatment. Additionally, it serves as a valuable source of information for patients. However, further development is necessary to enhance the reliability of these tools and ensure their safety and optimal use in the clinical setting.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology, Donostia University Hospital, Biodonostia Research Institute, Osakidetza, 20014, San Sebastian, Spain.
- Otorhinolaryngology Department, Faculty of Medicine, Deusto University, Bilbo, Spain.
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.
- Young Confederation of European Otorhinolaryngology, Head and Neck Surgery, Vienna, Austria.
| | - Jerome R Lechien
- Division of Laryngology and Broncho-Esophagology, Department of Otolaryngology and Head and Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Biomedical Sciences Department, School of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France
| | - Aina Brunet
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Giovanni Cammaroto
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, 47121, Forlì, Italy
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France
| | - Miguel Mayo-Yanez
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Otorhinolaryngology, Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006, A Coruña, Galicia, Spain
- Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France
| | - Alvaro Sanchez-Barrueco
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- ENT and Cervicofacial Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Otorhinolaryngology Department, Faculty of Medicine, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Carlos Saga-Gutierrez
- Department of Otorhinolaryngology, Donostia University Hospital, Biodonostia Research Institute, Osakidetza, 20014, San Sebastian, Spain
- Otorhinolaryngology Department, Faculty of Medicine, Deusto University, Bilbo, Spain
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
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Tarazis K, Garefis K, Chatziavramidis A, Konstantinidis I. Recurrent Sialolithiasis following Intraoral Deep Hilar/Intraparenchymal Stone Removal from Wharton's Duct. J Clin Med 2024; 13:909. [PMID: 38337603 PMCID: PMC10856032 DOI: 10.3390/jcm13030909] [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: 01/16/2024] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Submandibular gland (SMG) sialolithiasis treatment has shifted significantly, favouring minimal invasiveness. Nonetheless, transoral stone removal remains viable for distal, deep hilar, and intraparenchymal stones. However, data are limited regarding recurrence and revision surgery; (2) Patients/Methods: This retrospective study included 226 patients with SMG stones treated using Wharton's duct slitting and marsupialisation over nine years; 138 had deep hilar or intraparenchymal stones, while 88 had distal stones. Of the former group, 18 experienced symptom recurrence post-surgery, 12 with stones and 6 with duct stenosis; (3) Results: Of the 126 patients without recurrent stones, 71% were male and 29% were female. Their mean age was 51.02 ± 9.36 years. The stones of the 126 patients without recurrence had a diameter of 8.3 mm ± SD: 4 mm, which was significantly smaller than those of the patients who experienced recurrence (13.8 mm ± SD: 2.4 mm; p < 0.05). The mean estimated stone growth recurrence rate was 8.4 ± SD: 1.8 mm per year. A secondary operation was performed 34 ± SD: 14.7 months after the first. Of the patients with recurrence, 91.7% were treated under general anaesthesia. The preferred treatment for 58.4% of patients was intraoral revision operation; the remainder underwent total gland resection. The mean follow-up period was 43 ± SD: 18 months; (4) Conclusions: The rate of revision surgery was relatively low. In recurrent SMG sialolithiasis, new stones may grow faster than the primary stones, which are already larger than those in patients without recurrence. The slitting and marsupialisation of Wharton's duct can treat recurrent cases.
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Affiliation(s)
| | | | | | - Iordanis Konstantinidis
- 2nd Academic ORL, Head and Neck Surgery Department Aristotle University of Thessaloniki, Papageorgiou Hospital, 56403 Thessaloniki, Greece; (K.T.); (K.G.); (A.C.)
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Sánchez Barrueco A, Alcalá Rueda I, Ordoñez González C, Sobrino Guijarro B, Santillán Coello J, Tapia GD, Guerra Gutiérrez F, Campos González A, Brenna A, Cenjor Españo C, Villacampa Aubá JM. Transoral removal of submandibular hilar lithiasis: results on the salivary duct system, glandular parenchyma, and quality-of-life recovery. Eur Arch Otorhinolaryngol 2023; 280:5031-5037. [PMID: 37410145 PMCID: PMC10562331 DOI: 10.1007/s00405-023-08081-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE(S) To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. METHODS Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. RESULTS Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). CONCLUSIONS TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton's duct, and enhancement patients' QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.
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Affiliation(s)
- Alvaro Sánchez Barrueco
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Ignacio Alcalá Rueda
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | | | | | - Jessica Santillán Coello
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Gonzalo Díaz Tapia
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | | | - Alfonso Campos González
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Alessandra Brenna
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
| | - Carlos Cenjor Españo
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - José Miguel Villacampa Aubá
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
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Cetinkaya V, Bonnet R, Le Thuaut A, Corre P, Mourrain-Langlois E, Delemazure-Chesneau AS, Bertin H. A comparative study of three-dimensional cone beam computed tomographic sialography and ultrasonography in the detection of non-tumoral salivary duct diseases. Dentomaxillofac Radiol 2023; 52:20220371. [PMID: 37052400 PMCID: PMC10304847 DOI: 10.1259/dmfr.20220371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To compare the overall diagnostic outcomes of 3D-CBCT sialography and ultrasonography (US) in the detection of sialolithiasis, ductal dilatation, and ductal stenosis. METHODS This retrospective monocentric study compared the two imaging modalities carried out in the same patients referred for salivary symptoms of the parotid and submandibular glands. The primary endpoint was the capacity of the imaging procedure to diagnose a lesion. The secondary objectives were the detection rates according to the type of lesion, analysis of the causes of failure, and the parameters of radiation exposure and safety (for 3D-CBCT sialography). RESULTS Of the 236 patients who received a 3D-CBCT sialography in our institution, 157 were ultimately included in the per-protocol analysis. 3D-CBCT sialography allowed detection of ductal lesions in 113 patients versus 86 with US. The two imaging modalities yielded congruent interpretations in 104 out of 157 subjects (66.2%). Higher sensitivity and negative predictive value were observed with 3D-CBCT sialography compared with US, irrespective of the lesions studied: 0.85 vs 0.65 and 0.70 vs 0.44, respectively. Regarding the sialolithiasis, both 3D-CBCT sialography and US allowed identification of lesions with high sensitivity and negative predictive value (0.80 vs 0.75 and 0.88 vs 0.78, respectively). CONCLUSIONS US remains the first-line examination for exploration of the salivary lesions. 3D-CBCT sialography is an alternative in case of inconclusive US, and prior to any endoscopic procedure.
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Affiliation(s)
- Volkan Cetinkaya
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, Nantes, France
| | - Raphael Bonnet
- Chirurgie maxillo-faciale et stomatologie, Private practicioner, Clinique Brétéché, Nantes, France
| | - Aurélie Le Thuaut
- Plateforme de méthodologie et biostatistique, Direction de la recherche et de l’innovation, CHU de Nantes, Nantes, France
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de Boutray M, Pons M, Graillon N, Chossegros C, Reyre A, Chagnaud C, Varoquaux A. Stensen's Duct Stenosis Balloon Dilatation: Long-term Evaluation of Clinical Outcomes and Quality of Life Impacts. Otolaryngol Head Neck Surg 2023; 168:696-703. [PMID: 35503255 DOI: 10.1177/01945998221097636] [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: 01/08/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To conduct a long-term retrospective evaluation of the safety and effectiveness of sialographic balloon dilatation in Stensen's duct stenosis (SDS). STUDY DESIGN Retrospective cohort. SETTING Single-institution academic tertiary referral center. METHODS All SDS balloon dilatations (SSBDs) performed from 2011 to 2017 were monitored. Pain relief was evaluated by a numeric rating scale at 3-year follow-up at least. Long-term glandular swelling frequency patterns, quality of life (QoL), and drug consumption were retrospectively assessed. Procedure-related complications were recorded. RESULTS Twenty-one SSBD procedures were recorded (mean ± SD age, 55 ± 12 years), all performed under local anesthesia. SSBD led to complete dilatation in 7 patients (33%), residual stenosis in 8 (38%), and no dilatation (failure) in 6 (29%). Retrospective analysis of clinical outcomes was possible for 17 patients, 71% of whom presented with long-term pain relief, at a mean relief of 3.2 points on the numeric rating scale (P < .001). Long after SSBD, patients presented with a mean decrease of 15.4 glandular swellings per month (P < .001). Medical consumption was reduced to 18% of patients taking some drugs because of SDS after SSBD vs 71% before. SSBD showed an impact on QoL in >80% of patients, with mean improvements of 26% and 25% in the percentage point reduction of physical and mental QoL, respectively (P < .001). No complications were noted except temporary discomfort due to the procedure. CONCLUSION Despite the advent of sialendoscopy-guided techniques, SSBD should be considered for SDS treatment, as it is a safe procedure and provides sustained pain relief.
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Affiliation(s)
- Marie de Boutray
- Department of Otorhinolaryngology and Maxillofacial Surgery, Gui de Chauliac University Hospital, Montpellier University School of Medicine, Montpellier, France
| | - Mélanie Pons
- Department of Maxillofacial Surgery, La Conception University Hospital, Aix-Marseille University, Marseille, France
- Department of Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - Nicolas Graillon
- Department of Maxillofacial Surgery, La Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Cyrille Chossegros
- Department of Maxillofacial Surgery, La Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Anthony Reyre
- Department of Radiology, La Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Christophe Chagnaud
- Department of Radiology, La Conception University Hospital, Aix-Marseille University, Marseille, France
- Aix-Marseille University, CNRS, CRMBM-CEMEREM (UMR73-39), Marseille, France
| | - Arthur Varoquaux
- Department of Radiology, La Conception University Hospital, Aix-Marseille University, Marseille, France
- Aix-Marseille University, CNRS, CRMBM-CEMEREM (UMR73-39), Marseille, France
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Kataoka Y, Kojima Y, Ishibashi R, Nakao Y, Yamamura K, Takahashi S, Hashiba T, Matsue T. Transoral removal of a hilo-parenchymal submandibular sialolith. Clin Case Rep 2022; 10:e05903. [PMID: 35664512 PMCID: PMC9137105 DOI: 10.1002/ccr3.5903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/15/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
In sialolithiasis, the lithiasis is often large and located at the junction of the middle and posterior third of the duct, in the hilum region. In such cases, transoral approach for submandibular lithiases (TASL) is a useful treatment of choice in patients with large submandibular stones that can be palpated bimanually.
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Affiliation(s)
| | | | | | - Yuji Nakao
- Self‐Defence Forces Central HospitalSetagaya‐kuJapan
| | - Koji Yamamura
- Self‐Defence Forces Central HospitalSetagaya‐kuJapan
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10
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Huang Y, Liang PS, Yang YC, Cai WX, Tao Q. Nomogram to predict the risk of endoscopic removal failure with forceps/baskets for treating submandibular stones. World J Clin Cases 2022; 10:2710-2720. [PMID: 35434109 PMCID: PMC8968823 DOI: 10.12998/wjcc.v10.i9.2710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/26/2021] [Accepted: 02/13/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endoscopic removal with forceps/baskets is favored in treating submandibular stones due to its minimal invasiveness. However, recent studies have found that endoscopic removal failure (ERF) is not unusual, and stones in such cases still need to be removed with other surgical methods. If the risk of ERF can be predicted preoperatively, it could be helpful for surgeons when choosing the appropriate therapy.
AIM To develop a predictive nomogram for the risk of ERF when treating submandibular stones based on their preoperative clinical features.
METHODS A total of 180 patients with 211 submandibular stones treated from January 2012 to December 2020 were included in the current study. Based on the preoperative clinical features of the stones, independent risk factors for ERF were identified by logistic regression analysis. The stones were then randomly divided into training and testing sets. A nomogram was constructed to predict the risk of ERF using the training set and then validated using both sets. The predictive performance of the nomogram was assessed by calibration curves and the concordance index (C-index).
RESULTS Three independent predictors, location (P = 0.040), transverse diameter (P < 0.001) and longitudinal diameter (P < 0.001) measured on the cone beam computed tomography (CBCT) images of the submandibular stones, were identified and included in the predictive nomogram. Calibration curves of the nomogram showed good agreement between the predicted and observed probabilities in both sets. The C-index in the training set was 0.917 (95%CI, 0.875-0.959) and that in the testing set was 0.925 (95%CI, 0.862-0.989).
CONCLUSION A nomogram based on the location, transverse and longitudinal diameters on CBCT images of submandibular stones showed satisfactory efficacy in predicting the risk of ERF preoperatively when treating submandibular stones.
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Affiliation(s)
- Yun Huang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, Guangdong Province, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, Guangdong Province, China
| | - Pei-Sheng Liang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, Guangdong Province, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, Guangdong Province, China
| | - Yao-Cheng Yang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, Guangdong Province, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, Guangdong Province, China
| | - Wei-Xin Cai
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, Guangdong Province, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, Guangdong Province, China
| | - Qian Tao
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, Guangdong Province, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, Guangdong Province, China
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11
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Koch M, Mantsopoulos K, Müller S, Sievert M, Iro H. Treatment of Sialolithiasis: What Has Changed? An Update of the Treatment Algorithms and a Review of the Literature. J Clin Med 2021; 11:231. [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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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen–Nuremberg, 91054 Erlangen, Germany; (K.M.); (S.M.); (M.S.); (H.I.)
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12
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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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13
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Delagranda A, Bohrer M, Ferdynus C, Waubant A, Dufour X, Rubin F. Economic analysis of the contribution of sialendoscopy in managing non-tumoral principal salivary gland pathology in the Réunion Island: Economic evaluation following the CHEERS methodology. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:129-134. [PMID: 34772642 DOI: 10.1016/j.anorl.2021.10.004] [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] [Indexed: 11/18/2022]
Abstract
GOALS Cost analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Réunion Island, a French overseas territory. OBJECTIVES Calculation and comparison of median pricing (i.e., median payment to the healthcare establishment) per patient before and after the introduction of sialendoscopy, in the only regional establishment practicing sialendoscopy and in the whole of Réunion Island. Material and method A multicenter retrospective cost study was conducted over an 8-year period, before and after the introduction of sialendoscopy (period A: 2011-2014 and period B: 2015-2018), according to the CHEERS guidelines for economic studies, and included inpatients with non-tumoral pathology of the main salivary glands, whether treated by sialendoscopy or not. RESULTS Two hundred sixty-five patients were included, 139 of whom were treated by sialendoscopy: 74 in 2011-2014 and 191 in 2015-2018. Between the two periods, median pricing in the only center practicing sialendoscopy did not vary significantly: €3468 vs. €3368 (i.e., +2.9% (P=0.1)). In the Island as a whole, pricing increased significantly: €598 vs. €2332, (i.e., +390% (P<0.0001)). CONCLUSION Sialendoscopy is cost-effective in France in the public healthcare sector if outpatient management is optimal, but significantly increases the public health budget. It makes it possible to recruit and manage previously untreated patients (small stones, salivary strictures, etc.).
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Affiliation(s)
- A Delagranda
- Service Oto-rhino-laryngologie et chirurgie cervico-faciale, clinique Saint-Charles, 11, boulevard René-Lévesque, 85000 La-Roche-sur-Yon, France.
| | - M Bohrer
- Service d'information médicale, CHU de Felix-Guyon, 2, allée des Topazes, 97400 Saint-Denis, Reunion
| | - C Ferdynus
- Unité de soutien méthodologique, CHU de Felix-Guyon, 2, allée des Topazes, 97400 Saint-Denis, Reunion; Inserm, CIC 1410, 97410 Saint-Pierre, Reunion
| | - A Waubant
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, CHU de Felix-Guyon, 2, allée des Topazes, 97400 Saint-Denis, Reunion
| | - X Dufour
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, CHU de Jean-Bernard, 2, rue de la Milétrie, 86000 Poitiers, France
| | - F Rubin
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, clinique Saint-Vincent, 8, rue de Paris, 97400 Saint-Denis, Reunion
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14
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Delagranda A, Bohrer M, Ferdynus C, Waubant A, Dufour X, Rubin F. Medical analysis of the contribution of sialendoscopy in managing non-tumoral main salivary gland pathology in Reunion Island: Observational study following STROBE guidelines. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:135-139. [PMID: 34772641 DOI: 10.1016/j.anorl.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
GOALS To perform a medical analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Reunion Island, a French overseas territory. MATERIAL AND METHOD A multicenter retrospective observational study was conducted for an 8-year period, before and after introduction of sialendoscopy (2011-2014 and 2015-2018), following STROBE guidelines. OBJECTIVES To compare populations treated before (period A) and after (period B) the introduction of sialendoscopy in terms of clinical characteristics, and analyze the characteristics of patients treated by sialendoscopy. RESULTS Two hundred and sixty-five patients were included: 74 in 2011-2014 and 191 in 2015-2018; 139 had sialendoscopy. Populations A and B were comparable except for the proportion of parotids treated (9% vs. 31%, respectively; P<0.0001), and smaller stones (11mm vs. 7.4mm, respectively; P=0.003). One hundred and ten pure sialendoscopies and 29 combined routes (20.8%) were performed: 63% submandibular and 37% parotid. Median age was 46 years. The M/F sex ratio was 0.96. Thirty-seven patients presented stenosis. There were 10 cases of papillary catheterization failure (7.1%), and 16 false routes or creation of false channels (11.5%), including 9 during the learning period. The rate of crossover to gland resection decreased: 10.45% for 2015-2016 and 5.56% for 2017-2018. CONCLUSION Although follow-up ranged between 12 and 55months (median, 30months), sialendoscopy appeared to be a useful and reliable technique, with a role in therapeutic strategy for the management of non-tumoral salivary pathologies in Reunion Island.
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Affiliation(s)
- A Delagranda
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, clinique Saint-Charles, 11, boulevard René-Lévesque, 85000 La Roche-sur-Yon, France.
| | - M Bohrer
- Service d'information médicale, CHU Felix-Guyon, 2, allée des Topazes, 97400 Saint-Denis, Reunion
| | - C Ferdynus
- Unité de soutien méthodologique, CHU Felix-Guyon, 2, allée des Topazes, 97400 Saint-Denis, Reunion; Inserm, CIC 1410, 97410 Saint-Pierre, Reunion
| | - A Waubant
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, CHU Felix-Guyon, 2, allée des Topazes, 97400 Saint-Denis, Reunion
| | - X Dufour
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, CHU Jean-Bernard, 2, rue de la Milétrie, 86000 Poitiers, France
| | - F Rubin
- Service oto-rhino-laryngologie et chirurgie cervico-faciale, clinique Saint-Vincent, 8, rue de Paris, 97400 Saint-Denis, Reunion
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15
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Vanden Daele A, Drubbel J, Van Lierde C, Meulemans J, Delaere P, Vander Poorten V. Long-term outcome of a cohort of 272 patients undergoing sialendoscopy. Clin Otolaryngol 2021; 47:138-145. [PMID: 34674373 DOI: 10.1111/coa.13882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/13/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the cohort of patients undergoing sialendoscopic intervention for improvement of symptoms and gland-related quality of life at long-term follow-up. DESIGN This is a retrospective review of medical records with a prospective follow-up by questionnaire. SETTING & PARTICIPANTS All patients undergoing sialendoscopy at the University Hospitals Leuven Department of Otorhinolaryngology, Head and Neck Surgery between March 2008 and June 2020. MAIN OUTCOME MEASURES The electronic files of the patients were searched for information about their sialendoscopic procedure and follow-up consultations. We also send the patients a questionnaire by mail to assess symptom control and gland-related quality of life at long-term follow-up. RESULTS Two hundred seventy-two sialendoscopies were performed in 221 patients. Median follow-up time was 37 months. The sialendoscopies were performed in 130 patients for lithiasis, in 66 for stenosis, in 14 for recurrent parotitis of childhood, in 8 for recurrent sialadenitis of unknown origin and in 3 for radioiodine-induced sialadenitis. Complications occurred in 11 of 272 sialendoscopies (4%). Those were iatrogenic perforations, temporary lingual nerve paresthesia and swelling of the floor of the mouth. 53% of patients returned the questionnaire, for a total of 146 evaluable sialendoscopies. The majority of the responders indicated that sialendoscopy had improved their symptoms (83.6%). Salivary glands could be preserved in 89% of the responder group. The highest percentage of patients reporting residual symptoms was found in the RPC group (81.3%) and the lowest in the lithiasis group (16.2%). Besides age, no statistical differences in demographic and pathological features between the responder and non-responder groups were found, supporting generalisation of the responders' results to the entire cohort. CONCLUSIONS This study confirms the good long-term outcomes of sialendoscopic interventions in patients with chronic sialadenitis of different aetiologies and a high rate of gland preservation.
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Affiliation(s)
- Arike Vanden Daele
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Joekio Drubbel
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Charlotte Van Lierde
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Jeroen Meulemans
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Pierre Delaere
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Vincent Vander Poorten
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
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16
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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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17
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Xie L, Wang Z, Shi H, Yu C, Zheng L. Sialendoscopy-assisted combined approach for parotid sialolithotomy: Our long-term experience. Oral Dis 2021; 29:165-174. [PMID: 34519131 DOI: 10.1111/odi.14021] [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: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To assess the long-term outcome of sialendoscopy-assisted combined approach for parotid sialolithotomy with gland preservation. PATIENTS AND METHODS A retrospective study of patients treated with a combined sialendoscopic and open approach was conducted between 2011 and 2020. Demographic data of patients such as operative technique, stone size, stone location, complications, and symptom relief were collected. Patients were followed up via clinical examination and questionnaires. RESULTS Seventy-four patients were included and underwent endoscopy-assisted combined operations for the removal of 98 parotid stones. Of the 98 stones, 92(94%) stones were completely removed and 6(6%) were partially removed. At a mean follow-up of 47.1 ± 35 months, 65 of 74 patients (88%) achieved long-term success. Patients with stone incomplete removal were significantly more often to develop the recurrence of obstructive symptoms (p = 0.000) There were no cases of facial nerve injury or fistula formation. Gland function was preserved in 73 of 74 patients (99%). CONCLUSIONS The combined approach for parotid stones is a safe and gland-preserving alternative to parotidectomy. The techniques described here show high success rates and good long-term results, and they avoided the need for gland resection in >95% of cases.
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Affiliation(s)
- Lisong Xie
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhijun Wang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Huan Shi
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chuangqi Yu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lingyan Zheng
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, China
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18
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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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19
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Araújo RV, Milani BA, Martins IS, Vilela Dias EM, Bernaola-Paredes WE. An Extraoral Surgical Approach to Treat Chronic Submandibular Sialolithiasis - A Case Series. Ann Maxillofac Surg 2020; 10:537-542. [PMID: 33708613 PMCID: PMC7944014 DOI: 10.4103/ams.ams_102_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/25/2020] [Accepted: 06/28/2020] [Indexed: 11/04/2022] Open
Abstract
Sialolithiasis is the most common cause of sialadenitis in the submandibular gland, in which the highest incidence of this condition occurs, among the major salivary glands. This could be explained by the anatomy of Wharton's duct, and the chemical composition of the saliva produced by this gland. There are several alternatives and techniques for the treatment of sialolithiasis, including lithotripsy, sialoendoscopy, and conservative removal of the sialoliths or complete removal of the submandibular gland, through the transoral and extraoral routes for access to the gland. To determine the form of treatment, characteristics such as topography, diameter, and location of the sialolith in the duct are observed. The aim of this case series was to show our experience gained in two clinical cases of submandibular gland excision through an extraoral approach, using the submandibular access technique. In addition, we discussed the cause of sialolithiasis in these patients and after follow-up, compared the clinical results we obtained with this technique with those reported in the current literature. The submandibular approach or Risdon access continues to be a safe approach to removing the submandibular gland, as it is a commonly used technique and obtained satisfactory results, as shown in these cases. However, the major disadvantages were the less favorable esthetic results and paralysis of the marginal mandibular branch of the facial nerve.
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Affiliation(s)
- Renan Veiga Araújo
- Department of Oral and Maxillofacial Surgery, Campo Limpo Medical Center, Sao Paulo, Brazil
| | - Basílio Almeida Milani
- Department of Oral and Maxillofacial Surgery, Campo Limpo Medical Center, Sao Paulo, Brazil
| | - Ivan Solani Martins
- Department of Oral and Maxillofacial Surgery, Hospital Sirio-Libanes, Sao Paulo, Brazil
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Carbonnel E, Le Roux MK, Chossegros C, Scemama U, Graillon N. Tips & tricks for transoral approach for submandibular lithiasis (TASL). JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:736-739. [DOI: 10.1016/j.jormas.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022]
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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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22
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Galli P, Ceva A, Foletti JM, Iline N, Giorgi R, Chossegros C, Graillon N. Salivary Gland Lithiasis Recurrence After Minimally-Invasive Surgery: Incidence, Risk Factors and Prevention. Laryngoscope 2020; 131:794-799. [PMID: 32786079 DOI: 10.1002/lary.28991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/07/2020] [Accepted: 07/14/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the recurrence rate of lithiasis following minimally invasive surgery to identify risk factors and mechanisms for recurrence of salivary gland lithiasis. STUDY DESIGN Retrospective case series. METHODS A retrospective study was conducted including all patients treated for salivary gland lithiasis by minimally invasive surgery, such as sialendoscopy, intracorporeal lithotripsy, extracorporeal lithotripsy, transoral approach, and combined approach in our Department. We analyzed the recurrence rate of salivary lithiasis, their topography and timeline. RESULT Three hundred four patients were included in this study, the mean age was 49 years (range 12-90 years), and the mean duration of follow-up was 19.8 months (range 0-66 months). Fifteen patients (5%) presented secondary lithiasis. In all but one case, recurrences involved the same gland as primary lithiasis, and most frequently the submandibular gland. Recurrences occurred from 3 to 46 months postoperatively. Fourteen patients, who presented recurrence, had been initially treated by transoral approach. Recurrent lithiasis were treated by transoral approach or submandibulectomy. CONCLUSION Salivary gland lithiasis recurrence was rare after minimally invasive salivary gland surgery. This study reinforced the concept that salivary gland lithiasis should be considered as a duct pathology. LEVEL OF EVIDENCE 4 Laryngoscope, 131:794-799, 2021.
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Affiliation(s)
- Philippe Galli
- Department of Maxillofacial Surgery and Stomatology, APHM, Conception university hospital, Marseille, France
| | - Antoine Ceva
- Department of Maxillofacial Surgery and Stomatology, APHM, Conception university hospital, Marseille, France
| | - Jean-Marc Foletti
- Department of Maxillofacial Surgery and Stomatology, APHM, Conception university hospital, Marseille, France.,IFSTTAR, Laboratory of Applied Biomechanics, Aix Marseille University, Marseille, France
| | - Nicolas Iline
- BioSTIC, Biostatistics and Information and Communication Technologies, APHM, Timone university hospital, Marseille, France
| | - Roch Giorgi
- BioSTIC, Biostatistics and Information and Communication Technologies, APHM, Timone university hospital, Marseille, France.,Economic, Social and Health Sciences. & Medical Information Processing, SESSTIM, INSERM, APHM, Timone university Hospital, Marseille, France
| | - Cyrille Chossegros
- Department of Maxillofacial Surgery and Stomatology, APHM, Conception university hospital, Marseille, France.,CNRS, LPL, Aix Marseille University, Aix-en-Provence, France
| | - Nicolas Graillon
- Department of Maxillofacial Surgery and Stomatology, APHM, Conception university hospital, Marseille, France.,IFSTTAR, Laboratory of Applied Biomechanics, Aix Marseille University, Marseille, France
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Avishai G, Ben-Zvi Y, Ghanaiem O, Chaushu G, Gilat H. Sialolithiasis-Do Early Diagnosis and Removal Minimize Post-Operative Morbidity? ACTA ACUST UNITED AC 2020; 56:medicina56070332. [PMID: 32630773 PMCID: PMC7404452 DOI: 10.3390/medicina56070332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 01/09/2023]
Abstract
Background and objectives: Sialolithiasis is an inflammation of a salivary gland due to obstruction of salivary flow by a sialolith. We aim to assess potential factors that may predict lower morbidity following endoscopically assisted per-oral sialolith removal. Materials and Methods: Retrospective cohort study. Retrospective review of 100 records of patients with sialolithiasis, following surgical sialolith removal. A single medical center (Department of oral and maxillofacial surgery-Rabin Medical Center, Beilinson & Hasharon-Israel) survey. Data were gleaned from the patient files based on a structured questionnaire. Factors that may predict morbidity were evaluated using linear regression equation. Results: 59 of the subjects were men and 41 were women. The mean age of the patients in the study was 50 ± 17.5 years. Sialolith volume and past antibiotic treatment were positively associated while age was negatively associated with hospitalization duration. Conclusion: Early sialolith diagnosis and removal may lower postoperative morbidity.
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Affiliation(s)
- Gal Avishai
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, 49414 Petach-Tikva, Israel; (Y.B.-Z.); (G.C.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, 69978 Tel Aviv, Israel;
- Correspondence: ; Tel.: +97-254-4336-464
| | - Yehonatan Ben-Zvi
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, 49414 Petach-Tikva, Israel; (Y.B.-Z.); (G.C.)
| | - Omar Ghanaiem
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, 69978 Tel Aviv, Israel;
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, 49414 Petach-Tikva, Israel; (Y.B.-Z.); (G.C.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, 69978 Tel Aviv, Israel;
| | - Hanna Gilat
- Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, 69978 Petach Tikva, Israel;
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Outcomes of Pneumatic Lithotripsy Versus Holmium Laser-Assisted Lithotripsy With Sialendoscopy in Management of Submandibular Sialolithiasis. J Craniofac Surg 2020; 31:1974-1977. [DOI: 10.1097/scs.0000000000006607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Sialendoscopy-Assisted Duct Transposition in Ectopic Accessory Parotid Gland: Case Report and Surgical Management. J Oral Maxillofac Surg 2020; 78:557-563. [DOI: 10.1016/j.joms.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 11/19/2022]
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Brooks JK, Jones JL, Price JB. Possible association of sialolithiasis with HIV infection and highly active antiretroviral therapy: A case report. SPECIAL CARE IN DENTISTRY 2020; 40:298-302. [DOI: 10.1111/scd.12455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/05/2020] [Accepted: 02/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- John K. Brooks
- Department of Oncology and Diagnostic SciencesUniversity of Maryland School of Dentistry Baltimore Maryland
| | - Joyce L. Jones
- Department of Internal MedicineThe Johns Hopkins University School of Medicine Baltimore Maryland
| | - Jeffery B. Price
- Department of Oncology and Diagnostic SciencesUniversity of Maryland School of Dentistry Baltimore Maryland
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Robardey G, Le Roux M, Foletti J, Graillon N, Gormezano M, Varoquaux A, Lan R, Chossegros C. The Stensen's duct line: A landmark in parotid duct and gland injury and surgery. A prospective anatomical, clinical and radiological study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:337-340. [DOI: 10.1016/j.jormas.2019.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
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28
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Duong LT, Kakiche T, Ferré F, Nawrocki L, Bouattour A. Management of anterior submandibular sialolithiasis. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2019. [DOI: 10.1051/mbcb/2018039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Sialolithiasis is defined by the presence of a calculus within the salivary gland or its excretory system. It primarily affects the submandibular gland at a frequency of 80%. Involving many factors, the exact aetiology and pathogenesis of salivary calculi remain to be discussed. Body: The purpose of this article is to expose the different aspects of the pathology. Aetiological factors, the diagnostic approach which requires the use of imaging tests as well as the medical and surgical management of anterior submandibular sialolithiasis, will be described. A decision tree regarding the type of management and a table summarizing the main differential diagnoses will be proposed. Conclusion: Submandibular sialolithiases are a common salivary gland disorder. The treatment of sialolithiasis must be early and remains mainly surgical. The level of cooperation as well as the patient's medical and surgical history should guide the management of this type of disorder of the salivary system.
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29
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Schafer DR, Glass SH. A Guide to Yellow Oral Mucosal Entities: Etiology and Pathology. Head Neck Pathol 2019; 13:33-46. [PMID: 30693453 PMCID: PMC6405798 DOI: 10.1007/s12105-018-0977-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/17/2018] [Indexed: 12/17/2022]
Abstract
When faced with an uncertain clinical pathosis in the oral cavity, identifying the color of the mucosal lesion helps to narrow down a differential diagnosis. Although less common than red and white lesions, yellow lesions encompass a small group of distinct mucosal pathologic entities. Adipose tissue, lymphoid tissue, and sebaceous glands are naturally occurring yellow constituents of the oral cavity and become apparent with associated developmental or neoplastic lesions. Reactive and inflammatory lesions can create a yellow hue due to purulence, necrosis, and calcification. Some systemic diseases are known to deposit yellow bi-products such as amyloid or bilirubin into the oral mucosa of an affected person, and while not always yellow, unusual entities like verruciform xanthoma and granular cell tumor fall under the umbrella of yellow lesions given their occasional propensity to demonstration the color. This chapter aims to explore the unique group that is yellow lesions presenting in the oral mucosa.
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Affiliation(s)
- Duane R. Schafer
- 0000 0004 0386 9246grid.267301.1University of Tennessee Health Sciences Center College of Dentistry, Memphis, TN USA
| | - Sarah H. Glass
- 0000 0004 0458 8737grid.224260.0Virginia Commonwealth University School of Dentistry, Richmond, VA USA
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Lafont J, Graillon N, Hadj Saïd M, Tardivo D, Foletti JM, Chossegros C. Extracorporeal lithotripsy of salivary gland stone: A 55 patients study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 119:375-378. [PMID: 29571815 DOI: 10.1016/j.jormas.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 03/03/2018] [Accepted: 03/18/2018] [Indexed: 11/26/2022]
Abstract
Sialolithiasis are the most frequent salivary gland disease, mainly affecting the submandibular gland. With the advent of minimally invasive techniques, total salivary gland removal should not be considered as the first-line treatment anymore. Extracorporeal Shock Wave Lithotripsy (ESWL) is an alternative to surgery preserving the gland. The objective of our retrospective study was to evaluate the efficiency of ESWL on pain and obstructive syndrome in patients suffering from sialolithiasis. The global result felt by the patients was also considered. All patients treated between October 2009 and July 2016 for sialolithiasis by ESWL in our department were included. They were divided into two groups according to the concerned gland: a parotid gland (PG) and a submandibular gland (SMG) group. Our retrospective telephone questionnaire consisted in 4 questions about their symptomatology before and after ESWL, including pain self-evaluation before and after treatment. They were finally asked to evaluate the global result of the ESWL treatment: excellent, good, mean, or poor. In total, 55 patients were included in this study, 38 patients in PG group and 17 patients in SMG group. We observed a decrease of pain and obstructive syndrom after ESWL procedure in both groups. Better results were found on the obstructive syndrome in the PG group. Very few side-effects were reported by patients. Given that it has very few side effects, ESWL can easily be considered as first line treatment for sialolithiasis to avoid heavier treatments such as surgery. It should be the first-line treatment for symptomatic parotid sialolithiases. The treatment of symptomatic submandibular sialolithiases depends on the topography of the lithiasis.
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Affiliation(s)
- J Lafont
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France; Oral surgery department, odontology, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France.
| | - N Graillon
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - M Hadj Saïd
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 7268 ADES, EFS, CNRS, medical school-north sector, Aix-Marseille university, boulevard Pierre-Dramard, 13344 Marseille, France
| | - D Tardivo
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 7268 ADES, EFS, CNRS, medical school-north sector, Aix-Marseille university, boulevard Pierre-Dramard, 13344 Marseille, France
| | - J M Foletti
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial & plastic surg department, Nord hospital, AP-HM, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France
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