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Bertram J, Nieri C, Reed L, Gillespie MB. Sialendoscopy Findings Associated with Positive Minor Salivary Gland Biopsy. Laryngoscope 2024; 134:1183-1189. [PMID: 37776242 DOI: 10.1002/lary.31085] [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: 01/23/2023] [Revised: 08/27/2023] [Accepted: 09/20/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To determine the sialendoscopy findings associated with positive findings on minor salivary gland biopsy. STUDY DESIGN Single-center retrospective study. METHODS Patients ≥18 years old who underwent sialendoscopy from 2016 to 2022 and were evaluated for SS via labial minor salivary gland biopsy. Biopsy positive and negative patients were compared on the primary outcome measure of sialendoscopy findings. Data were abstracted from the sialendoscopy operative notes and included involved gland, location of ductal pathology, and the presence of scarring, stenosis, mucus plugs, webs, and dilations. Additional characteristics included demographics, presenting symptoms, caffeine or tobacco, use of drying medications, and need for additional treatments. RESULTS The final cohorts included 22 biopsy positive and 21 biopsy negative patients with a total of 42 glands in the biopsy positive and 37 glands in the biopsy negative groups. Biopsy positive patients were found to require dilation at the hilum and distal duct at significantly higher rates than biopsy negative patients (p < 0.0001). However, there was no statistical difference in scarring, stenosis severity, mucus, webs, or dilations between each group. CONCLUSION The outcomes of this study suggest that there are no distinct sialendoscopy findings associated with biopsy positive patients. The presence of significant distal stenosis on sialendoscopy may be associated with positive minor salivary biopsy. Other endoscopic parameters are likely more consistent with non-specific chronic sialadenitis. LEVEL OF EVIDENCE 3 Laryngoscope, 134:1183-1189, 2024.
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Affiliation(s)
- Jessica Bertram
- Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Chad Nieri
- Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Leighton Reed
- Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - M Boyd Gillespie
- Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
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Yura Y, Hamada M. Outline of Salivary Gland Pathogenesis of Sjögren's Syndrome and Current Therapeutic Approaches. Int J Mol Sci 2023; 24:11179. [PMID: 37446355 DOI: 10.3390/ijms241311179] [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: 06/04/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Sjögren's syndrome (SS) is an autoimmune disease characterized by the involvement of exocrine glands such as the salivary and lacrimal glands. The minor salivary glands, from which tissue samples may be obtained, are important for the diagnosis, evaluation of therapeutic efficacy, and genetic analyses of SS. In the onset of SS, autoantigens derived from the salivary glands are recognized by antigen-presenting dendritic cells, leading to the activation of T and B cells, cytokine production, autoantibody production by plasma cells, the formation of ectopic germinal centers, and the destruction of salivary gland epithelial cells. A recent therapeutic approach with immune checkpoint inhibitors for malignant tumors enhances the anti-tumor activity of cytotoxic effector T cells, but also induces SS-like autoimmune disease as an adverse event. In the treatment of xerostomia, muscarinic agonists and salivary gland duct cleansing procedure, as well as sialendoscopy, are expected to ameliorate symptoms. Clinical trials on biological therapy to attenuate the hyperresponsiveness of B cells in SS patients with systemic organ involvement have progressed. The efficacy of treatment with mesenchymal stem cells and chimeric antigen receptor T cells for SS has also been investigated. In this review, we will provide an overview of the pathogenesis of salivary gland lesions and recent trends in therapeutic approaches for SS.
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Affiliation(s)
- Yoshiaki Yura
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan
| | - Masakazu Hamada
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan
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Wu CB, Xue L, Zhou Q. Treatment Strategy for Chronic Obstructive Parotitis Related to Diabetes: A Retrospective Analysis of 12 Cases. Front Pharmacol 2022; 13:869872. [PMID: 35847021 PMCID: PMC9277455 DOI: 10.3389/fphar.2022.869872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: The aim of this study was to describe our experience in treating chronic obstructive parotitis (COP) related to diabetes. Methods: Twelve patients with COP related to diabetes were selected for the study. A sialendoscope was introduced from the orifice to investigate the ductal wall and lumen. During the operation, chymotrypsin and gentamicin were injected. All patients were followed up for 6 months. Preoperative and postoperative visual analog scale (VAS) evaluations and salivary gland scintigraphy (SGS) examinations were applied to evaluate the therapeutic effect; differences were considered statistically significant at p < 0.05. Results: A sialendoscope was successfully used under local anesthesia in all members of the cohort. As shown by the endoscope, mucus plugs were the most common feature. Some adhered tightly to the ductal wall. We also found ductal congestion in some cases. The postoperative VAS scores and SGS counts were both significantly lower than the preoperative values (p < 0.05). Conclusion: Chymotrypsin administration during interventional sialendoscopy is significantly effective in the treatment of diabetes-related COP.
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Borner U, Anschuetz L, Caversaccio M, von Werdt M, Panosetti E, Keghian J, Remacle M. A Retrospective Analysis of Multiple Affected Salivary Gland Diseases: Diagnostic and Therapeutic Benefits of Interventional Sialendoscopy. EAR, NOSE & THROAT JOURNAL 2022:1455613221081911. [PMID: 35324340 DOI: 10.1177/01455613221081911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Multiple affected salivary gland diseases are rare compared to single gland diseases and represent a major diagnostic challenge. These cases are commonly neglected in the scientific literature, despite the considerable suffering of these patients. The aim of this retrospective study was to report disease characteristics, diagnostic pathways, and therapeutic options, including sialendoscopic treatment of multiple affected salivary gland disorders. METHODS Patients experiencing multiple affected salivary gland diseases treated between 2013 and 2020 were consecutively identified. Data regarding demographics, clinical presentation, disease characteristics, treatment, complications, and follow-up were analyzed retrospectively. RESULTS In total, 71 patients were identified with these diseases and included obstructive disease without sialolithiasis (n = 22), inflammation (n = 15), immune disease (n = 19), radioiodine-induced sialadenitis (RAI) (n = 5), sialadenosis (n = 2), and juvenile recurrent parotitis (JRP) (n = 8). Diagnostic and therapeutic sialendoscopy was performed on 113 salivary glands in 42 patients, leading to completely (n = 27, 64.3%) or partially (n = 11, 26.2%) improved symptoms in most cases. In total, 4 patients did not improve after interventional therapy. CONCLUSIONS Multiple affected salivary gland diseases are rare and diagnostically challenging. Interventional sialendoscopy offers an effective and safe therapeutic option and should be considered in this specific cohort.
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Affiliation(s)
- Urs Borner
- Department of Otorhinolaryngology - Head and Neck Surgery, 27252Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, 37464Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Lukas Anschuetz
- Department of Otorhinolaryngology - Head and Neck Surgery, 27252Inselspital, Bern University Hospital, Bern, Switzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology - Head and Neck Surgery, 27252Inselspital, Bern University Hospital, Bern, Switzerland
| | - Moritz von Werdt
- Department of Otorhinolaryngology - Head and Neck Surgery, 27252Inselspital, Bern University Hospital, Bern, Switzerland
| | - Eugène Panosetti
- Department of Otorhinolaryngology, Head and Neck Surgery, 37464Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Jérôme Keghian
- Department of Otorhinolaryngology, Head and Neck Surgery, 37464Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Marc Remacle
- Department of Otorhinolaryngology, Head and Neck Surgery, 37464Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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[Effect of topical injection of cyclosporine A on saliva secretion and inflammation in the submandibular gland of non-obese diabetic mice]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53. [PMID: 34393240 PMCID: PMC8365053 DOI: 10.19723/j.issn.1671-167x.2021.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate the effects of topical administration of cyclosporine A (CsA) on salivary secretion and inflammation of the submandibular glands in non-obese diabetic (NOD) mice. METHODS Female NOD mice, 21 aged 14 weeks and 18 aged 21 weeks were selected and randomly divided into low-dose group, high-dose group and control group on average. CsA was injected into submandibular glands. One week later the saliva stimulated by pilocarpine was collected and measured. The submandibular glands were collected to make paraffin sections. The lymphocyte infiltration in submandi-bular gland was observed by microscope after hematoxylin-eosin (HE) staining. The number of lymphocyte infiltration foci was counted to calculate the focus sore and the ratio of lymphocyte infiltration area to total gland area was figured up by Leica image analysis system. The expressions of inflammatory cytokines tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-4 (IL-4), IL-13, IL-17F, IL22 and IL-23a in the submandibular glands of the NOD mice were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Cell apoptosis in the submandibular gland was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). The levels of serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), alanine aminotransferase (ALT), aspertate aminotransferase (AST), alkaline phosphatase (ALP), albumin (ALB) and γ-glutamyl transferase (GGT) were measured by automatic biochemical analyzer to evaluate liver and kidney functions. RESULTS After topical injection of CsA in the submandibular gland, the stimulated salivary flow rate of the 14- and 21-week-old NOD mice significantly increased compared with the control group (P < 0.01 or P < 0.05), and the number and area of lymphocyte infiltration foci in the 14-week-old NOD mice low-dose group significantly decreased compared with the control group (P < 0.01). Low and high dose of CsA had similar effects on reducing inflammation and improving salivary secretion. The overall level of inflammatory cytokines in the submandibular gland did not decrease significantly. The number of cell apoptosis of submandibular gland in the NOD mice treated with CsA decreased compared with the control group, but there was no statistically significant difference. Topical injection of CsA had no adverse effect on liver and kidney function in the NOD mice. CONCLUSION Topical injection of CsA can reduce lymphocyte infiltration in submandibular gland of NOD mice and improve salivary secretion.
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Coca KK, Gillespie MB, Beckmann NA, Zhu R, Nelson TM, Witt RL. Sialendoscopy and Sjogren's Disease: A Systematic Review. Laryngoscope 2020; 131:1474-1481. [PMID: 33141438 DOI: 10.1002/lary.29233] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study is a systematic review of the literature which seeks to estimate the expected treatment outcomes of a patient with Sjogren's syndrome (SS) undergoing therapeutic sialendoscopy. STUDY DESIGN Systematic Review. METHODS PubMed, Scopus, and Cochrane library databases were used to search for studies published as of August 2020 regarding the treatment outcomes of SS with sialendoscopy. The key search terms included "Sjogren's syndrome" and "sialendoscopy." Only studies in the English language involving more than one human patient were included. PRISMA guidelines were followed in study inclusion and data extraction. The primary outcome assessed was improvement in patient symptoms. RESULTS Six studies met criteria and were analyzed in this review, including 125 patients undergoing sialendoscopy of parotid and/or submandibular glands as well as 25 controls. Of these patients, 90% were female with an age range of 18 to 79 years. There was significant diversity in outcome reporting tools. The outcomes of symptom improvement were pooled qualitatively based on improvement noted in each study. Outcomes were defined as partial improvement if the measured outcomes improved and complete improvement if measured outcomes resolved entirely. Despite the limited number of studies on this topic, this meta-analysis suggests that a similar study of therapeutic sialendoscopy could expect to provide at least temporary improvement of symptoms 90% to 99% of the time. CONCLUSIONS This review provides support for the application of sialendoscopy in the treatment of SS salivary disease. Larger studies with consistent outcome reporting tools and control groups are needed to validate these results and provide a consistent therapy protocol. Laryngoscope, 131:1474-1481, 2021.
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Affiliation(s)
- Kimberly K Coca
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Nicholas A Beckmann
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Rongshun Zhu
- Division of Biostatistics - Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Tamara M Nelson
- Medical Library Research and Learning Services, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Robert L Witt
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.,Delaware ENT-Head and Neck Surgery, Christiana Care, Wilmington, Delaware, U.S.A
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van Ginkel MS, Glaudemans AW, van der Vegt B, Mossel E, Kroese FG, Bootsma H, Vissink A. Imaging in Primary Sjögren's Syndrome. J Clin Med 2020; 9:E2492. [PMID: 32756395 PMCID: PMC7463854 DOI: 10.3390/jcm9082492] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/14/2022] Open
Abstract
Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by dysfunction and lymphocytic infiltration of the salivary and lacrimal glands. Besides the characteristic sicca complaints, pSS patients can present a spectrum of signs and symptoms, which challenges the diagnostic process. Various imaging techniques can be used to assist in the diagnostic work-up and follow-up of pSS patients. Developments in imaging techniques provide new opportunities and perspectives. In this descriptive review, we discuss imaging techniques that are used in pSS with a focus on the salivary glands. The emphasis is on the contribution of these techniques to the diagnosis of pSS, their potential in assessing disease activity and disease progression in pSS, and their contribution to diagnosing and staging of pSS-associated lymphomas. Imaging findings of the salivary glands will be linked to histopathological changes in the salivary glands of pSS patients.
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Affiliation(s)
- Martha S. van Ginkel
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.M.); (F.G.K.); (H.B.)
| | - Andor W.J.M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Bert van der Vegt
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Esther Mossel
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.M.); (F.G.K.); (H.B.)
| | - Frans G.M. Kroese
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.M.); (F.G.K.); (H.B.)
| | - Hendrika Bootsma
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.M.); (F.G.K.); (H.B.)
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
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Keshet N, Aricha A, Friedlander-Barenboim S, Aframian DJ, Nadler C. Novel parotid sialo-cone-beam computerized tomography features in patients with suspected Sjogren's syndrome. Oral Dis 2018; 25:126-132. [PMID: 30070035 DOI: 10.1111/odi.12946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/19/2018] [Accepted: 07/11/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Sjogren's syndrome (SjS) causes salivary gland impairment leading to oral dryness. Parotid sialo-cone-beam computerized tomography (sialo-CBCT) demonstrates ductal architecture and to a lesser extent gland activity. This study characterizes radiographic features of patients suspected for SjS and looks for a possible correlation with the diagnosis of SjS. METHODS The clinical and radiographic data of suspected SjS/dry mouth patients referred for sialo-CBCT in 2011-2014 were reviewed retrospectively. Two observers studied the scans for various radiographic features including duct morphology, level of branching, ductopenia and sialectasia. These features were analysed taking the specific clinical data and two sets of SjS criteria: The 2002 American-European Consensus Group (AECG) and the 2012 American College of Rheumatology (ACR) Group. RESULTS Sialo-CBCT scans of 67-referred patients suffering from dry mouth (115 parotid glands) were included. Intraradiographic association was found between ductopenia and all other radiographic parameters. Minimal, yet important, radiographic differences were found between left and right parotid glands. AECG-confirmed-SjS patients showed strong correlation with radiographic features, whereas ACR 2012-confirmed-SjS patients did not. CONCLUSION Sialo-CBCT demonstrates novel radiographic features which may clarify the diagnosis of SjS. Further studies are needed to determine the role of sialo-CBCT in diagnosis of SjS.
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Affiliation(s)
- Naama Keshet
- Department of Oral Medicine, Sedation, and Maxillofacial Imaging, Sjogren's Syndrome Center, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Adi Aricha
- Department of Oral Medicine, Sedation, and Maxillofacial Imaging, Sjogren's Syndrome Center, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel.,Oro-Maxillofacial Imaging, Department of Oral Medicine, Sedation, and Maxillofacial Imaging, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel
| | | | - Doron J Aframian
- Department of Oral Medicine, Sedation, and Maxillofacial Imaging, Sjogren's Syndrome Center, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Chen Nadler
- Department of Oral Medicine, Sedation, and Maxillofacial Imaging, Sjogren's Syndrome Center, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel.,Oro-Maxillofacial Imaging, Department of Oral Medicine, Sedation, and Maxillofacial Imaging, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel
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9
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Aframian DJ, Keshet N, Nadler C. Cone beam computerized tomography sialography-An emerging novel diagnostic tool for Sjogren's syndrome. Oral Dis 2018; 24:191-193. [DOI: 10.1111/odi.12736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 08/07/2017] [Accepted: 08/07/2017] [Indexed: 12/17/2022]
Affiliation(s)
- DJ Aframian
- Department of Oral Medicine, Sedation and Maxillofacial Imaging; Sjogren's Syndrome Center; Hebrew University Hadassah School of Dental Medicine; Jerusalem Israel
| | - N Keshet
- Department of Oral Medicine, Sedation and Maxillofacial Imaging; Sjogren's Syndrome Center; Hebrew University Hadassah School of Dental Medicine; Jerusalem Israel
| | - C Nadler
- Department of Oral Medicine, Sedation and Maxillofacial Imaging; Sjogren's Syndrome Center; Hebrew University Hadassah School of Dental Medicine; Jerusalem Israel
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Jokela J, Haapaniemi A, Mäkitie A, Saarinen R. Sialendoscopy in treatment of adult chronic recurrent parotitis without sialolithiasis. Eur Arch Otorhinolaryngol 2017; 275:775-781. [PMID: 29290052 DOI: 10.1007/s00405-017-4854-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this prospective study was to evaluate the efficacy of sialendoscopy in the management of adult chronic recurrent parotitis without sialolithiasis. In addition, preliminary results of an initial randomized placebo-controlled trial of single-dose intraductal steroid injection given concurrently with sialendoscopy, are presented. METHODS Forty-nine adult patients with chronic recurrent parotitis without sialoliths were included in this study. They underwent sialendoscopy and were randomized to receive either a concurrent intraductal injection of isotonic saline solution or 125 mg of hydrocortisone. Symptom severity was evaluated with visual analogue scale (VAS) and by recording symptom frequency and course with a multiple-choice questionnaire completed preoperatively and at 3, 6, and 12 months after the procedure. RESULTS The mean VAS score was 5.6 preoperatively and dropped to 2.9 at 3 months, 3.0 at 6 months, and 2.7 at 12 months after the procedure. The VAS score and the frequency of symptoms were significantly lower at 3 (p < 0.001), 6 (p < 0.001) and 12 (p < 0.001) months after the procedure when compared with the preoperative scores indicating that sialendoscopy reduces the symptoms of recurrent parotitis. However, complete permanent resolution of symptoms was rare. Single-dose steroid injection concomitant to sialendoscopy provided no additional benefit, but the current study is not sufficiently powered to determine a clinical difference between the steroid and non-steroid groups. CONLUSION Sialendoscopy appears to reduce the symptoms of chronic recurrent parotitis. While total permanent symptom remission is rare, sialendoscopy can be considered a safe and relatively efficacious treatment method for this patient group.
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Affiliation(s)
- Johanna Jokela
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland.
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - Riitta Saarinen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland
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