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Vaiman M, Mizrakli Y, Gavriel H. Comparative analysis of approaches to the Wharton's duct during surgery of the submandibular gland: A retrospective case-control study. Clin Otolaryngol 2024; 49:475-480. [PMID: 38699810 DOI: 10.1111/coa.14176] [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: 08/13/2023] [Revised: 03/13/2024] [Accepted: 04/20/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION We investigated complications and recurrence rates after surgical techniques for sialolith removal with intact and resected Wharton's duct of the submandibular gland. METHODS The retrospective case-control analysis of a series analysed 271 surgical operations (2003-2022) for sialolithiasis performed at a hospital department of Otolaryngology-Head and Neck Surgery. The study compared two approaches: (1) pure endoscopic technique or pinpoint stone removal with Wharton's duct left intact and (2) transoral duct dissection or pinpoint stone removal technique, after which the duct was shortened. While choosing the surgical option, the size of the stone, the location of the stone, and the presence of multiple stones were taken into account. The rates of complications (lingual nerve paraesthesia, duct stenosis, drooling, and sialoadenitis), the incidence of foreign bodies, and the rate of recurrence during follow-up of ≥18 months were compared. RESULTS 323 sialoliths were removed from 271 patients. Of these 323 calculi, 150 were removed by the first approach and 173 by the second approach. The calculi varied in diameter from 2 to 38 mm with an average diameter of 8.2 mm. For all 271 patients, the rate of recurrence was 4.8%, but 11 recurrent cases (8.7%) appeared after the first approach surgeries and 2 cases (1.4%) after the second approach surgeries (p = .03). Other variables did not show statistically significant differences. CONCLUSIONS Surgical removal of the submandibular calculi, ending with shortening of Wharton's duct, reduces the recurrence rate for sialolithiasis but does not affect the rate of postsurgical complications.
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Affiliation(s)
- Michael Vaiman
- Department of Otolaryngology-Head and Neck Surgery, Shamir Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Mizrakli
- Department of Otolaryngology-Head and Neck Surgery, Shamir Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Gavriel
- Department of Otolaryngology-Head and Neck Surgery, Shamir Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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2
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Graillon N, Marty P, Foletti JM, Chossegros C, Frandjian H. Idiopathic dilatation of the submandibular gland duct. Int J Oral Maxillofac Surg 2024; 53:389-392. [PMID: 37845088 DOI: 10.1016/j.ijom.2023.09.011] [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: 07/19/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
Lithiasis and stenosis may cause salivary duct dilatation due to the increased pressure in the duct upstream of the obstruction. Idiopathic dilatations, also called megaducts, with no associated increase in pressure, have only been described in the parotid gland. The aim of this study was to describe the characteristics of submandibular duct dilatation unrelated to lithiasis, stenosis, or an imperforate duct, to report the existence of submandibular megaducts. This retrospective single-centre study included patients treated at La Conception University Hospital, Marseille, France, between 2007 and 2019. Patients with submandibular duct dilatation of ≥4 mm confirmed by magnetic resonance imaging sialography (sialo-MRI), who also underwent sialendoscopy to identify any associated stenosis, were included. Patients with lithiasis, stenosis, an imperforate ostium, or a history of trauma or surgery to the floor of the mouth were excluded. Five patients (three female, two male) aged 30-76 years with idiopathic duct dilatations in nine submandibular glands were included. The most commonly reported symptoms were submandibular swelling, pruritus, and discomfort, mostly outside mealtimes. Recurrence of symptoms after treatment was frequent. This study is novel in describing submandibular megaducts as opposed to dilatation caused by high pressure associated with stenosis, with confirmation by sialo-MRI and sialendoscopy.
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Affiliation(s)
- N Graillon
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France; Laboratoire de Bioméchanique Appliquée (LBA), Gustave Eiffel University/Aix-Marseille University, Marseille, France.
| | - P Marty
- Department of Oral and Maxillofacial Surgery, Clinique Saint Pierre d'Ottignies, Ottignies-Louvain la Neuve, Belgium
| | - J-M Foletti
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France; Laboratoire de Bioméchanique Appliquée (LBA), Gustave Eiffel University/Aix-Marseille University, Marseille, France
| | - C Chossegros
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
| | - H Frandjian
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
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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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Finegersh A, Chang J, Lee YJ, Sirjani D. Suture Stenting After Sialendoscopy: A Novel Technique That Reduces Risk of Recurrent Parotitis. Laryngoscope 2024; 134:614-621. [PMID: 37338090 DOI: 10.1002/lary.30828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Chronic sialadenitis is associated with decreased quality of life and recurrent infections. While sialendoscopy with stenting is effective in relieving symptoms of sialadenitis, currently available stents are rigid and poorly tolerated by patients, leading to early removal and potential for adverse scarring. This study examines whether sutures can be used as a stenting material to improve patient comfort and reduce recurrence risk. METHODS This is a retrospective cohort study of a consecutive series of adult patients with chronic sialadenitis undergoing sialendoscopy with or without suture stenting. Data were collected between 2014 and 2018 with a 3-year follow-up period ending in 2021. The primary outcome measure was recurrence of sialadenitis within 3 years of surgery. Secondary outcomes were stent dislodgement and patient-reported discomfort. RESULTS We included 63 patients with parotid sialadenitis of whom 28 underwent suture stenting and 35 did not receive stenting after sialendoscopy. Stents were well tolerated, with a mean duration of 34.5 days, and only 2 of 28 stents (7.1%) accidentally dislodged within the first week. Suture stenting significantly reduced symptom recurrence after sialendoscopy (OR = 0.09, 95% CI 0.02-0.45, p = 0.003; 3-year sialadenitis recurrence rate: 7.1% vs. 45.7%, p = 0.005). Cox multivariate regression for clinicodemographic variables showed an HR of 0.04 (95% CI 0.01-0.19, p < 0.001) for the risk of symptom recurrence. CONCLUSIONS AND RELEVANCE Suture stenting after sialendoscopy is low cost, available across all institutions, well-tolerated by patients, and highly efficacious in reducing risk of recurrent sialadenitis after sialendoscopy. LEVEL OF EVIDENCE 3 Laryngoscope, 134:614-621, 2024.
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Affiliation(s)
- Andrey Finegersh
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Julia Chang
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Loma Linda University, Loma Linda, California, USA
| | - Yu-Jin Lee
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
| | - Davud Sirjani
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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Liljekvist MS, Foghsgaard J, Howitz MF. Sialendoscopy for pediatric salivary gland disorders: a study of safety and effect. Eur Arch Otorhinolaryngol 2023; 280:1927-1937. [PMID: 36478117 DOI: 10.1007/s00405-022-07747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Sialendoscopy has become the preferred modality for managing pediatric salivary gland disorders (PSGD) including juvenile recurrent parotitis (JRP) and sialolithiasis. The literature remains sparse, but several case series have reported good outcomes and few complications. The aim of this study was to investigate the safety and efficacy of sialendoscopy for PSGD in a Danish setting. METHODS From a national sialendoscopy database, we included records of children who had undergone sialendoscopy for PSGD at our clinic over a 6-year period. Clinical and intraoperative data, follow-up and e-mail surveys after 1, 3 and 5 years were retrieved for analysis. RESULTS We included 52 procedures on 50 glands (32 parotid, 18 submandibular) in 49 children. Of eligible patients, 90% attended clinical follow-up, 80% answered the survey after 1 year, 80% after 3 years and 60% after 5 years. JRP was diagnosed in 33 cases, obstructive causes in 18 cases. Complications noted were ductal perforation (2%), transient lingual nerve affection (4%) and infection (2%). For JRP patients, overall symptoms had improved for 96% after 3 months, 81% after 1 year and 83% after 3 years. For patients suffering from obstruction, overall symptoms were improved for 93% after 3 months and for 100% after 1 year. CONCLUSION Sialendoscopy is a safe procedure for PSGD, and effective for sialolithiasis and symptom reduction in JRP.
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Affiliation(s)
- Mads S Liljekvist
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark.
| | - Jakob Foghsgaard
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
| | - Michael F Howitz
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
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Capaccio P, Gaffuri M, Canzi P, Pignataro L. Recurrent obstructive salivary disease after sialendoscopy. A narrative literature review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:S95-S102. [PMID: 37698106 PMCID: PMC10159639 DOI: 10.14639/0392-100x-suppl.1-43-2023-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/12/2023] [Indexed: 09/13/2023]
Abstract
Over the last 20 years, interventional sialendoscopy has become the therapy of choice for the management of obstructive salivary disorders, favouring a significant reduction in the number of patients undergoing traditional sialadenectomy. The overall success rate of sialendoscopy is around 90% as reported by the largest case series published; recurrence is expected in about 10% of cases, and the patient should be informed about the possibility to undergo further conservative procedures to improve symptoms. Adequate pre-operative assessment, based on ultrasonography, cone beam 3D CT and MR-sialography, is mandatory to reduce the risk of unsuccessful procedures and, therefore, recurrence of obstructive sialadenitis; moreover, in case of recurrence, the surgeon should be experienced enough to manage these cases and be able to perform additional interventions, such as transoral/transfacial sialendoscopy-assisted procedures and imaging-assisted procedures in case of difficult anatomical situations. Botulinum toxin injection and traditional sialadenectomy would be considered as possible salvage treatments in case of failure of all conservative approaches.
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Affiliation(s)
- Pasquale Capaccio
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - Michele Gaffuri
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Pignataro
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Skalias A, Garefis K, Markou K, Nikolaidis V, Konstantinidis I. The effectiveness and safety of sialendoscopy for sialolithiasis in children: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:3053-3063. [PMID: 36781439 DOI: 10.1007/s00405-023-07877-2] [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: 11/06/2022] [Accepted: 02/07/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Sialendoscopy is a new, minimally invasive method that is becoming increasingly more popular than traditional methods for the treatment of sialolithiasis. In this systematic review and meta-analysis, the effectiveness and safety of this method in children with sialolithiasis are investigated. METHODS Inclusion criteria were children with sialolithiasis. The information sources were databases MEDLINE and PubMed Central (through PubMed), ScienceDirect, Cochrane Central Register of Controlled Trials (CENTRAL), citation indexes Scopus and Google Scholar, trial registries, and "gray literature". The last search was performed on September 18, 2022. The risk of bias in included studies was assessed using ROBINS-I tool (Risk Of Bias In Non-randomized Studies of Interventions). The pooled proportion of weighted means was calculated for the quantitative synthesis of available data. RESULTS The effectiveness of the method was estimated at 95.5% (95% CI 89.8-99.3%), from 13 studies including 133 cases. The safety was estimated at 97.2% (95% CI 91.8-100%), from 10 studies including 113 cases. CONCLUSION The limitations of this study, briefly summarized, are the small number of included studies, the fact that they are mostly retrospective, the difficult application of the guidelines suggested by the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane handbook due to the nature of this specific condition and intervention, and the difficulty in assessing reporting bias. The results of the current study indicate that sialendoscopy is an effective and safe method for the treatment of sialolithiasis in children and should be implemented in daily clinical practice.
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Affiliation(s)
- Antonios Skalias
- Department of Otorhinolaryngology, Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
| | - Konstantinos Garefis
- 2nd Academic Otorhinolaryngology, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Konstantinos Markou
- 2nd Academic Otorhinolaryngology, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Vasileios Nikolaidis
- 2nd Academic Otorhinolaryngology, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Iordanis Konstantinidis
- 2nd Academic Otorhinolaryngology, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
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Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification. J Clin Med 2023; 12:jcm12031129. [PMID: 36769777 PMCID: PMC9917658 DOI: 10.3390/jcm12031129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Identifying a submandibular (Wharton's) duct punctum often hinders sialendoscopy; however, there is a paucity of evidence on whether the appearance of Wharton's duct papilla impacts the sialendoscopic procedure. A classification of Wharton's duct papillae based on the macroscopic appearance, size of dilatation probes, and sialendoscopic approach was proposed herein. The classification describing four main types of papillae, A, B, C, and D, was prospectively evaluated on 351 Wharton's duct papillae in 315 patients. For each papillae type, the demographic/clinical data, intraoperative complications, and time required for sialendoscope introduction were analyzed. Estuary-like papilla (type A) was commonly seen after spontaneous stone extrusion, had no intraoperative complications noted, and had the shortest time required for the sialendoscope introduction. Normal papilla (type B) was the most frequently observed papilla (48.1%), reflecting diverse underlying pathology, while difficult papilla (type C) was often associated with unfavorable anatomical variations of the mandible or floor of the mouth. Substantially closed papilla (type D) had the highest rate of intraoperative complications, namely, perforation with a false passage, and required the longest time for the sialendoscope introduction. In seven patients (2.0%), the entrance into the duct was feasible only through the fistula, while the sialendoscope introduction failed in eight patients (2.3%). In conclusion, the appearance of Wharton's duct papillae may be influenced by the underlying pathology. Based on the proposed classification, papilla typology affects the duration of sialendoscope introduction and may influence the frequency of intraoperative complications.
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Rai V, Walvekar RR, Verma J, Monga U, Rai D, Munjal M. Laser-Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes. Laryngoscope 2022; 132:2344-2349. [PMID: 35289948 DOI: 10.1002/lary.30106] [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: 11/09/2021] [Revised: 02/04/2022] [Accepted: 02/26/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To analyze the long-term symptomatic results of laser-assisted sialolithotripsy (LAS) in cases of obstructive sialolithiasis and correlate with objective criteria using diagnostic sialendoscopy (DS) as a method of examination. METHODS This is a retrospective study comprising 50 consecutive patients who underwent holmium-YAG LAS and completed follow-up of at least 6 months. Symptom scoring and endoscopic scoring were done at 6 weeks and 6 months intervals for further study purposes. RESULTS At the end of 6 weeks post-LAS, 70% patients were asymptomatic (A-sym) and only 30% had residual symptoms (Sym). However, obstructed duct (OB-duct) was observed on endoscopic scoring in 88% due to stenosis, residual stones, or both stenosis and residual stones. The obstructed ducts were treated in outpatient clinic and followed up over time, leading to 98% of patients being in A-sym group at the end of study period of 6 months. At the end of study, 82% of patients had clear duct (CL-duct). CONCLUSION Holmium LAS is a viable option for the management of intermediate-sized stones. LAS if used judiciously, and in properly selected cases, has high rate of stone fragmentation and symptom resolution. A vigilant postoperative protocol taking into account residual mealtime symptoms and altered salivary characteristics combined with early DS can help identify and treat patients with residual stone fragments and ductal stenosis. LEVEL OF EVIDENCE 3 Laryngoscope, 132:2344-2349, 2022.
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Affiliation(s)
- Varun Rai
- Department of ENT, Sir Ganga Ram Hospital, New Delhi, India
| | - Rohan R Walvekar
- Otolaryngology & Head Neck Surgery, LSUHSC, New Orleans, Louisiana, USA
| | - Jatin Verma
- Department of ENT, Sir Ganga Ram Hospital, New Delhi, India
| | - Uday Monga
- Department of ENT, Sir Ganga Ram Hospital, New Delhi, India
| | - Devinder Rai
- Department of ENT, Sir Ganga Ram Hospital, New Delhi, India
| | - Manish Munjal
- Department of ENT, Sir Ganga Ram Hospital, New Delhi, India
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Pušnik L, Jerman A, Urbančič J, Aničin A. Sialendoscopy in Management of Juvenile Recurrent Parotitis-A Single Centre Experience. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1632. [PMID: 36360360 PMCID: PMC9688286 DOI: 10.3390/children9111632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
Juvenile recurrent parotitis is a rare inflammatory disease of the parotid gland that shares diverse therapeutic management between institutions. Sialendoscopy has been demonstrated as an efficient diagnostics and therapeutic method with minimal complications; however, due to the rarity of the disease and limited data, there is a lack of universal guidelines on its optimal management. Herein, we retrospectively analysed patients with juvenile recurrent parotitis who had the sialendoscopy performed at our tertiary centre. Descriptive data were retrieved along with the number of swelling episodes one year before and after the sialendoscopy intervention. In the last decade, twenty-nine sialendoscopic procedures were performed at our clinics on twenty-one patients diagnosed with juvenile recurrent parotitis. Most of them underwent the procedure under general anaesthesia (86%). In the year before and after the sialendoscopic procedure, the patients had 3.9 ± 2.7 and 0.2 ± 0.4 episodes of swelling per year, respectively. The difference proved to be statistically significant (p < 0.0001). The complete resolution was noted in sixteen patients (76%); however, the procedure was not repeated on the same side of any patient. Solely one patient had a relapse of the disease reported more than twelve months after the sialendoscopy, nonetheless, one of his exacerbation episodes was already reported in the first year after the sialendoscopy. The mean follow-up period of patients was 48.6 months (range, 13−116 months). All things considered, this study emphasises sialendoscopy as an effective minimally invasive diagnostic and therapeutic tool for the management of juvenile recurrent parotitis.
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Affiliation(s)
- Luka Pušnik
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Anže Jerman
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
| | - Jure Urbančič
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
| | - Aleksandar Aničin
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
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Goyal M, Singh PP, Batra A. Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population. J Maxillofac Oral Surg 2022; 21:715-724. [DOI: 10.1007/s12663-020-01472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022] Open
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12
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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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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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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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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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Coca K, Benaim E, Reed L, Mamidala M, Gillespie MB. Outcomes of Submandibular Stone Removal With and Without Salivary Endoscopes. Laryngoscope 2021; 132:754-760. [PMID: 34378799 DOI: 10.1002/lary.29815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/08/2021] [Accepted: 08/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS For patients with submandibular sialolithiasis, there are many gland-preserving treatment options including sialendoscopy. Sialendoscopy, however, requires expensive instrumentation with limited availability, which may not be required for routine cases. The objective of this study is to compare the outcomes of patients with submandibular sialolithiasis undergoing sialendoscopy versus those undergoing transoral incisional sialithotomy. STUDY DESIGN Longitudinal, prospective study of patient undergoing gland-preserving therapy for submandibular sialolithiasis. METHODS The study was a prospective, nonrandomized trial of 30 patients with submandibular sialolithiasis who received gland-preserving treatment by either sialendoscopy-assisted techniques (Scope group; 14 patients) or transoral sialithotomy with or without dochoplasty (No Scope group; 16 patients). Factors analyzed between the two groups included age, race, gender, size of stone, location of stone, gland(s) involved, surgical method, and modified salivary Oral Health Impact Profile (sOHIP) scores before and after therapy. RESULTS There were no significant differences between the Scope and No Scope groups regarding age, race, or gender. There was a significant difference in stone size between the groups, with the No Scope group having larger stones on average. Both treatments led to statistically significant symptomatic improvement in sOHIP scores. There was no statistically significant difference in salivary quality of life improvement between the Scope and No Scope groups (P = .33). CONCLUSIONS Sialendoscopy is an important diagnostic and therapeutic tool in the management of salivary disorders, but is not associated with improved outcomes in gland-preserving treatments for routine submandibular sialolithiasis. Transoral stone removal alone may have equivalent symptomatic outcomes in the management of select sialoliths. LEVEL OF EVIDENCE III Laryngoscope, 2021.
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Affiliation(s)
- Kimberly Coca
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Ezer Benaim
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Leighton Reed
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Madhu Mamidala
- 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
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Abstract
Simple sialendoscopy procedures may be performed in the outpatient clinic with few complications. This process spares patients the risks, increased cost, and time burdens of sialendoscopy under general anesthesia. Sialendoscopy procedures may be incorporated into the outpatient practice after gaining experience with these procedures in the operating room. Diagnostic sialendoscopy, dilation of stenosis, and endoscopic sialolithotomies of small, freely mobile stones are appropriate for in-office sialendoscopy in many instances.
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18
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Giotakis AI, Fischlechner R, Dejaco D, Gottfried T, Riechelmann H. [Prognostic factors for successful outcome in sialendoscopy for sialolithiasis]. Laryngorhinootologie 2021; 101:228-237. [PMID: 34058775 PMCID: PMC8885298 DOI: 10.1055/a-1510-9548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hintergrund
Der Erfolg der Sialendoskopie hängt von mehreren Faktoren ab. Im Jahr 2008 wurde die Lithiasis-Stenosis-Dilatation (LSD) -Klassifikation zur genaueren Beschreibung des Stein-Gang-Verhältnisses eingeführt. Neben dem Nutzen der LSD-Klassifikation untersuchten wir weitere prä- und intraoperativ erhobene Einflussfaktoren auf den Erfolg der Sialendoskopie bei Sialolithiasis.
Methode
PatientInnen mit Sialolithiasis der Glandula submandibularis und Glandula parotis, die zwischen September 2018 und März 2020 eine primäre Sialendoskopie erhielten, wurden retrospektiv untersucht. Die Steingröße, Steinlokalisation und LSD-Klassifikation wurden unter anderem als prognostische Einflussfaktoren untersucht.
Ergebnisse
Insgesamt wurden 37 PatientInnen retrospektiv untersucht. Eine erfolgreiche Steinextraktion wurde bei 12/37 (32 %) PatientInnen durchgeführt. Bei Erfolg betrug die mediane Steingröße 3,7 mm, verglichen mit 10 mm bei Misserfolg (Mann-Whitney-Test; p < 0,0001). Bei Erfolg waren 11/12 Steine distal lokalisiert, verglichen mit 13/25 proximal lokalisierten Steinen bei Misserfolg (Pearson-Chi-Quadrat-Test; p = 0,010). Bei Erfolg wurden 10/12 Steine als L1S0D0 klassifiziert, während 15/25 bei Misserfolg als L3aS0D0-Steine klassifiziert wurden (Pearson-Chi-Quadrat-Test; p = 0,001). Für distal lokalisierte Steine, die kleiner als 5 mm waren, lag die Erfolgsrate bei 100 %. Für proximal lokalisierte Steine, die größer als 4 mm waren, lag die Erfolgsrate bei 0 %. Für die als L1S0D0 klassifizierten Steine betrug die Erfolgsrate 60–100 %.
Schlussfolgerung
Distal lokalisierte Steine und Steine kleiner als 5 mm in einem ansonsten unauffälligen Gangsystem können als prognostisch günstige Faktoren angesehen werden. Zukünftige Studien sollten anhand größerer Datenmengen die LSD-Klassifikation, das Volumen der Steine und deren Gangorientierung bzw. deren Abstand von der Papille untersuchen.
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Affiliation(s)
- Aris I Giotakis
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Rene Fischlechner
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Daniel Dejaco
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Timo Gottfried
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Herbert Riechelmann
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
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19
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Şengör GA, Bilgili AM. A Novel Approach for the Treatment of Sialolithiasis that Preserves Salivary Duct Anatomy. Ann Otol Rhinol Laryngol 2021; 131:268-276. [PMID: 34049458 DOI: 10.1177/00034894211018926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The sialendoscopy era in the treatment of salivary gland stones has reduced the use of classical surgical methods. However, the miniature ducts and tools may cause difficulties in removing large sialoliths. Therefore, invasive combined oral surgeries or gland resection may be considered. We searched for the most suitable method in order to stay in line with the minimally invasive approach that preserves the ductus anatomy, and that can reduce the surgical fears of patients. MATERIALS AND METHODS The study included 84 cases (23 parotid and 61 submandibular) in whom stones were fragmented by pneumatic lithotripsy and removed between January 2015 and January 2020. The parotid cases comprised 7 females and 16 males, and the submandibular cases comprised 25 females and 36 males. Intraductal lithotripsy was performed using pneumatic lithotripter. This study has fourth level of evidence. RESULTS Based on total number of cases (n = 84), success rate was 67/84 (79.7%) immediately after sialendoscopy, and overall success rate was 77/84 (91.6%). Based on number of stones treated (n = 111), our immediate success rate was 94/111 (84.6%), and overall success rate was 104/111 (93.7%). The success criteria were complete removal of the stone and fragments in a single sialendoscopy procedure and resolution of symptoms. CONCLUSIONS We successfully treated salivary gland stones, including L3b stones, in our patient cohort with sialendoscopy combined with pneumatic lithotripsy. The lithotripsy method that we have adapted seems to be more useful and cost-effective compared to its alternatives. We were also able to preserve the ductus anatomy and relieve patients' concerns.Level of Evidence: Level IV.
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Affiliation(s)
| | - Ahmet Mert Bilgili
- Medical Faculty Department of Otolaryngology, Cyprus International University, Nicosia, Cyprus
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20
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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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21
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Shauly O, Joskowicz L, Istoyler E, Nadler C. Parotid salivary ductal system segmentation and modeling in Sialo-CBCT scans. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING: IMAGING & VISUALIZATION 2021. [DOI: 10.1080/21681163.2020.1866670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- O. Shauly
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - L. Joskowicz
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - E.G. Istoyler
- Oro-Maxillofacial Imaging, Oral Medicine Department, Hadassah School of Dental Medicine, the Hebrew of University, Jerusalem, Israel
| | - C. Nadler
- Oro-Maxillofacial Imaging, Oral Medicine Department, Hadassah School of Dental Medicine, the Hebrew of University, Jerusalem, Israel
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22
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Stenosis and stenosis-like lesions in the submandibular duct: Detailed clinical and sialendoscopy-based analysis and proposal for a classification. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:486-495. [DOI: 10.1016/j.oooo.2020.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/08/2020] [Accepted: 05/25/2020] [Indexed: 11/20/2022]
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de Paiva Leite SH, Morton RP, Ahmad Z, Marchal F. Do Postoperative Oral Corticosteroids Improve Results After Sialendoscopy for Ductal Stenosis? Laryngoscope 2020; 131:E1503-E1509. [PMID: 32990331 DOI: 10.1002/lary.29111] [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: 06/16/2020] [Revised: 08/26/2020] [Accepted: 09/11/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study aims to review the effects of short- and long-term oral administration of postoperative corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis due to ductal stenosis. STUDY DESIGN Prospective comparative study. METHODS A prospective observational study was conducted at Manukau Surgical Center in Auckland, New Zealand, where patients undergoing sialendoscopic surgery for recurrent obstructive sialadenitis due to ductal stenoses were reviewed. Univariable and multivariable analysis, and also logistic regression were performed to identify variables correlated with the likelihood of the need for revision surgery for persistent or recurrent symptoms. RESULTS In this study, sialendoscopy was performed in 142 patients: 162 parotid glands (86.6%) and 25 submandibular glands (13.4%). Postoperative oral steroids were prescribed for 48 patients (34%); 19 (13%) were prescribed for less than 7 days and 29 (20%) for more than 7 days. In total, 33 patients (23.2%) required a revision sialendoscopy during follow-up due to recurrence of symptoms. Oral steroids prescribed for more than 7 days after a sialendoscopy reduced the likelihood of a revision procedure by 93% when compared with patients who did not receive this medication, and by 96% when compared with patients who received steroids for less than 7 days. CONCLUSION The results showed that in our population oral administration of corticosteroids for more than 7 days after sialendoscopy for the treatment of recurrent obstructive sialadenitis due to ductal stenosis markedly reduced the need for later revision surgery. Routine use of corticosteroids for more than 7 days is recommended after sialendoscopy in patients with ductal stenosis. LEVEL OF EVIDENCE II Laryngoscope, 131:E1503-E1509, 2021.
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Affiliation(s)
- Sandro Henrique de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,University of Auckland, Auckland, New Zealand
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Chiesa-Estomba CM, Saga-Gutierrez C, Calvo-Henriquez C, Lechien JR, Cartier C, Mayo-Yanez M, Larruscain-Sarasola E, Ayad T, Walvekar RR. Laser-Assisted Lithotripsy With Sialendoscopy: Systematic Review of YO-IFOS Head and Neck Study Group. EAR, NOSE & THROAT JOURNAL 2020; 100:42S-50S. [PMID: 32442031 DOI: 10.1177/0145561320926281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Sialolithiasis is the most common cause of symptomatic obstructive sialadenitis. Sialendoscopy represent a minimally invasive technique that has evolved significantly in the last 2 decades, with high success rates in managing sialolithiasis and allowing gland preservation. Lithotripsy assisted or not by laser represents the fragmentation of stone or lithiasis within the salivary duct followed immediately by removal of the fragmented pieces. Material and Methods: A systematic review investigating the role of laser-assisted lithotripsy with sialendoscopy (LAS) in the treatment of sialolithiasis was performed. RESULTS Sixteen papers meet inclusion criteria. The mean maximum diameter of lithiasis was 7.11 mm (min: 2 mm/max: 17 mm; standard deviation [SD]: 2.33; 95% CI = 1.573-4.463). Success rate described ranging from 71% to 100% with a mean of 87.3% (SD: 7.21; 95% CI: 5.326-11.158) and the gland preservation rate was 97%. Considering only "non retrievable-non floating stones" studies that include both parotid and submandibular stones: Eight clinical retrospectives, nonrandomized studies and 1 prospective, nonrandomized study report results from parotid and submandibular gland lithiasis. According to this, the most common gland involved was the submandibular gland (n = 153; 65.1%), in comparison to the parotid gland (n = 82; 34.8%). CONCLUSION The current evidence supports LAS as a conservative, efficient, safe, and gland-preserving alternative technique, in experienced hands, for management of mid-size sialolith removal from major salivary glands, when the indication is appropriate.
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Affiliation(s)
- Carlos Miguel Chiesa-Estomba
- Otorhinolaryngology Head and Neck Surgery Department, 16650Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Basque Country, Spain.,Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France
| | - Carlos Saga-Gutierrez
- Otorhinolaryngology Head and Neck Surgery Department, 16650Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Basque Country, Spain
| | - Christian Calvo-Henriquez
- Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology, 59535Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jérome Rene Lechien
- Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Human Anatomy & Experimental Oncology, 54521University of Mons, Mons, Belgium
| | - César Cartier
- Division of Otolaryngology Head & Neck Surgery, 26905Centre Hospitalier de l'Université, de Montpellier, France
| | - Miguel Mayo-Yanez
- Otorhinolaryngology, Head and Neck Surgery Department, 16811Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
| | - Ehkiñe Larruscain-Sarasola
- Otorhinolaryngology Head and Neck Surgery Department, 16650Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Basque Country, Spain.,Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France
| | - Tareck Ayad
- Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Division of Otolaryngology-Head & Neck Surgery, 25443Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Rohan R Walvekar
- Department of Otolaryngology Head & Neck Surgery, 12258Louisiana State University Health Science Center, New Orleans, LA, USA
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25
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Foggia MJ, Peterson J, Maley J, Policeni B, Hoffman HT. Sialographic analysis of parotid ductal abnormalities associated with Sjogren's syndrome. Oral Dis 2020; 26:912-919. [PMID: 32031309 DOI: 10.1111/odi.13298] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To analyze the location and degree of parotid ductal abnormalities associated with Sjogren's syndrome (SS) and to correlate findings with the duration of the disease. To develop a classification system based on contemporary sialography techniques and employ the system to grade findings on sialograms. To assess the role for therapeutic intervention in patients with SS. METHODS Retrospective chart review of a consecutive series of 337 sialograms done by the senior investigator over a 10-year period identified 26 sialograms in patients who met the criteria for SS as defined by the American-European Consensus Group (2002). A classification system was developed to grade the degree of ductal abnormalities identified on the sialograms. Individual, initial blinded review of these sialograms was performed by two head and neck radiologists to identify and grade abnormalities. Radiographic findings were correlated with patient history including symptom duration. RESULTS All patients with SS had stenoses within the ductal system. About 73.1% of patients had stenoses in each branch of the ductal system (primary, secondary, and tertiary ducts). In 19% of patients, the main duct was of normal caliber despite the presence of stenosis in the more proximal ducts (secondary and tertiary ducts). Peripheral (proximal) duct dilation was characterized among those affected in patterns classified as destructive (34.6%), cavitary (26.9%), globular (11.5%), or punctate (11.5%). A statistically significant positive correlation (p = .0360) was identified between symptom duration and degree of main ductal stenosis. CONCLUSION Sialography may be useful to objectively assess the degree of parotid ductal damage in SS employing a newly proposed classification system. This assessment may assist clinicians in tailoring management to selectively include ductal dilation.
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Affiliation(s)
- Megan J Foggia
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Joseph Peterson
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Joan Maley
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Bruno Policeni
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Henry T Hoffman
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Goncalves M, Mantsopoulos K, Schapher M, Iro H, Koch M. Ultrasound in the Assessment of Parotid Duct Stenosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2935-2943. [PMID: 30907015 DOI: 10.1002/jum.14999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/03/2019] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Parotid duct stenosis may occur with or without accompanying ductal anomalies, with associated differences in their pathogenesis and management. By identifying the characteristics of a stenosis, ultrasound (US) can assist in tailored management of parotid duct stenosis. The objective of this study was therefore to describe the US characteristics of parotid duct stenoses and to evaluate criteria for whether and in what ways these can be distinguished from each other by using US. METHODS A total of 108 patients who presented with parotid duct stenoses (130 parotid glands) were examined with high-resolution US between 2014 and 2017. The stenoses were assessed for duct dilatation, location, signs of ductal anomalies (circular encroachments/webs, duct bending/kinking, and presence of a megaduct) and the echogenicity of the gland parenchyma. RESULTS Ultrasound was able to distinguish between stenoses associated with ductal anomalies and those without anomalies. Webs (82.5% versus 7.8%; P < .001), kinking (75.0% versus 3.3%; P < .001), and a megaduct (87.50% versus 15.63%; P < .001) and a tendency toward normal echogenicity in the gland parenchyma (77.5% versus 25.6%; P < .001) were significantly associated with ductal anomalies. Stenoses associated with ductal anomalies also had significantly larger duct diameters in comparison with those without anomalies (mean ± SD, 9.19 ± 3.65 versus 3.27 ± 2.17 mm; P < .001). CONCLUSIONS This study describes US parameters that allow more detailed characterization of parotid stenoses with or without accompanying ductal anomalies. Differentiating between these at an early stage may be helpful for decision making on the further management in these patients.
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Affiliation(s)
- Miguel Goncalves
- 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
| | - Mirco Schapher
- 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
| | - Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Ding YF, Tseng H, Su CH, Tai CC, Wu YY, Haung CJ, Lee CS, Hung SH. Development of a poly-L-lactide salivary duct stent. Exp Ther Med 2019; 17:2907-2912. [PMID: 30936960 PMCID: PMC6434266 DOI: 10.3892/etm.2019.7308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/12/2018] [Indexed: 11/06/2022] Open
Abstract
Obstructive salivary gland diseases are common conditions that arise following the disruption of the secretary ductal system and usually results in the swelling and pain of the affected gland(s). There has been an increase in the use of sialendoscopy for the treatment and diagnosis of obstructive salivary gland infection. If damage occurs to a duct or papilla following sialendoscopy, a stent may be necessary to prevent restenosis and for maintaining the salivary duct open after complete sialendoscopy. Currently, there are only non-biodegradable salivary duct stents available. The aim of the current study was to establish a methodology for the fabrication of a biodegradable poly-L-lactide (PLLA) salivary duct stent and to examine its function in an animal model. In the current study, PLLA was used to fabricate a salivary duct stent, which was compared with other commercially available non-biodegradable products. The mechanical tests revealed that the tensile strength of the PLLA stent was similar to that of the commercially available non-biodegradable stents. The Young's modulus, which measures the stiffness of a solid material, was significantly higher for the PLLA stent compared with the commercially available non-biodegradable stents. In addition, the current study demonstrated that the PLLA salivary duct stent was easily used with current sialendoscopy techniques, allowing accurate stent placement in an animal model.
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Affiliation(s)
- Yi-Fang Ding
- Department of Otolaryngology, Taipei Medical University Wan-Fang Hospital, Taipei 110, Taiwan, R.O.C
| | - How Tseng
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C.,Department of Biochemistry and Molecular Cell Biology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Chin-Hui Su
- Department of Otolaryngology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C.,Department of Otorhinolaryngology, Mackay Memorial Hospital, Taipei 110, Taiwan, R.O.C
| | - Chien-Cheng Tai
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Yuan-Yi Wu
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Cheng-Ji Haung
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Cheng-Shen Lee
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Shih-Han Hung
- Department of Otolaryngology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C.,Department of Otolaryngology, Taipei Medical University Hospital, Taipei 110, Taiwan, R.O.C
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Le Roux MK, Graillon N, Hadj-Saïd M, Scemama U, Lutz JC, Chossegros C. Stensen duct dilation: Case series of minimally invasive treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:e114-e117. [PMID: 30878397 DOI: 10.1016/j.oooo.2019.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
Abstract
Stensen's duct dilation is a rare condition characterized by a global or partial idiopathic dilation of the Stensen duct. Affected individuals usually show either aesthetically compromised features, such as a tubular-shaped swelling in the cheek, or with mildly painful inflammatory episodes. Three women between ages 61 and 67 years were diagnosed with Stensen duct dilation after sialo-magnetic resonance imaging (MRI). They were treated with botulinum toxin A (BTX-A). Our preliminary results suggest that BTX-A was efficient as a suspensive treatment. BTX-A should remain a first-line treatment of the early silent symptoms of Stensen duct dilation, such as swelling and aesthetic issues. The use of BTX-A avoids more serious procedures and further complications.
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Affiliation(s)
- Marc-Kevin Le Roux
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France.
| | - Nicolas Graillon
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
| | - Mehdi Hadj-Saïd
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
| | - Ugo Scemama
- Aix Marseille University, SPMC EA 3279, Marseille, France; Department of Radiology, Hôpital Nord, Aix-Marseille University, chemin des Bourrely, Marseille, France
| | - Jean-Christophe Lutz
- Stomatology and Maxillo-Facial Surgery Department, Strasbourg University Hospital, Strasbourg cedex, France
| | - Cyrille Chossegros
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
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Koch M, Iro H. Salivary duct stenosis: diagnosis and treatment. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:132-141. [PMID: 28516976 PMCID: PMC5463521 DOI: 10.14639/0392-100x-1603] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022]
Abstract
The management of stenoses of the major salivary glands had undergone a significant change during the last 15-20 years. Accurate diagnosis forms the basis of adapted minimal invasive therapy. Conventional sialography and MR-sialography are useful examination tools, and ultrasound seems to be a first-line investigational tool if salivary duct stenosis is suspected as cause of gland obstruction. Sialendoscopy is the best choice to establish final diagnosis and characterise the stenosis in order to plan accurate treatment. In all major salivary glands, inflammatory stenosis can be distinguished from fibrotic stenosis. In the parotid duct system, an additional stenosis associated with various abnormalities of the duct system has been reported. Conservative therapy is not sufficient in the majority of cases. The development of a minimally invasive treatment regime, in which sialendoscopy plays a major role, has made the preservation of the gland and its function possible in over 90% of cases. Ductal incision procedures are the most important measure in submandibular duct stenoses, but sialendoscopy becomes more important in the more centrally located stenoses. Sialendoscopic controlled opening and dilation is the dominating method in parotid duct stenoses. In 10-15% of cases, success can be achieved after a combined treatment regime had been applied. This review article aims to give an overview on the epidemiology, diagnostics and current state of the art of the treatment of salivary duct stenoses.
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Affiliation(s)
- M Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
| | - H Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
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30
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Nahlieli O. Complications of traditional and modern therapeutic salivary approaches. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:142-147. [PMID: 28516977 PMCID: PMC5463522 DOI: 10.14639/0392-100x-1604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 12/15/2022]
Abstract
The morbidity following traditional surgery of the salivary glands is well documented and includes postsurgical complications such as the Frey's syndrome, complete or partial facial nerve damage, facial scarring, greater auricular nerve numbness, sialocoeles and salivary fistula. The avulsion of the salivary duct, secondary strictures, gland swelling, salivary fistulas and perforations (false rout), traumatic ranulas, and the lingual nerve paraesthesia are the main endoscopy-related complications. In general, the rate of postsurgical complications after modern advanced minimally invasive surgical interventions is significantly lower compared with traditional surgery of the salivary glands. However, such comparisons cannot be performed because up-to-date traditional and minimally invasive surgical techniques are applied to different salivary disorders. Combinations of various minimally invasive techniques are also possible. There is no clear borderline between "traditional" and "modern" surgery of the salivary glands. It is appropriate to write about gradual replacement of old techniques with newer ones, and this process has no traffic lights.
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Affiliation(s)
- O Nahlieli
- Oral and Maxillofacial Surgery Department Barzilai Medical Center, Ashkelon, Israel. Affiliated to the Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
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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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Foletti JM, Graillon N, Avignon S, Guyot L, Chossegros C. Salivary Calculi Removal by Minimally Invasive Techniques: A Decision Tree Based on the Diameter of the Calculi and Their Position in the Excretory Duct. J Oral Maxillofac Surg 2018; 76:112-118. [DOI: 10.1016/j.joms.2017.06.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
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Clinical efficacy of botulinum toxin in salivary duct stenosis: A preliminary study of six cases. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:349-352. [DOI: 10.1016/j.jormas.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/15/2017] [Accepted: 09/03/2017] [Indexed: 11/20/2022]
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Gardon MA, Foletti JM, Avignon S, Graillon N, Chossegros C. CT scan assessment in salivary gland lithiasis diagnosis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 119:110-112. [PMID: 29175510 DOI: 10.1016/j.jormas.2017.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/22/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of the study was to assess computed tomography (CT) scan efficiency for the diagnosis of salivary lithiasis. METHODS Patients who were included were all the patients who consulted in our department for main salivary gland (submandibular and parotid) obstruction symptoms between June 2014 and December 2016. A CT scan without injection was prescribed for all of them. The 163 patients were divided into two groups after the CT scan: patients with and without lithiasis. During surgery, we confirmed the presence or absence of the lithiasis previously diagnosed on the CT scan. The patients were divided in two groups: case and control groups. For statistical analysis, the sensitivity, specificity, and the negative and positive predictive values of the preoperative CT scan were calculated. RESULTS A total of 163 patients with a salivary obstructive syndrome were included. On the CT scans, we found lithiases (hyperdense images) in 157 glands ("CT scan⊕" group), and we found no lithiasis in 6 glands ("CT scan" group). In the "CT scan⊕" group, 203 lithiases were present. During surgery, we found and removed lithiases in 155 patients (case group), and 8 patients had no lithiases (control group). The overall sensitivity, specificity, positive predictive value, and negative predictive values of the CT scan for the detection of lithiasis were 100%, 75%, 99%, and 100%, respectively. The specificity of CT scans for the lithiasis located in the anterior and middle third of the duct was 100%. DISCUSSION According to our study, the CT scan is very efficient in diagnosing salivary main gland lithiases in patients with an obstructive syndrome.
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Affiliation(s)
- M A Gardon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France.
| | - J M Foletti
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial & plastic surg department, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - S Avignon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - N Graillon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - C Chossegros
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France; Laboratoire parole et langage, 5, rue Pasteur, 13100 Aix-en-Provence, France
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Singh PP, Goyal M, Goyal A. Sialendoscopic Approach in Management of Juvenile Recurrent Parotitis. Indian J Otolaryngol Head Neck Surg 2017; 69:453-458. [PMID: 29238673 DOI: 10.1007/s12070-017-1223-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/06/2017] [Indexed: 11/29/2022] Open
Abstract
To assess the role of sialendoscopy as a diagnostic and therapeutic modality in juvenile recurrent parotitis. Juvenile recurrent parotitis (JRP) is the second most frequent salivary gland disease in childhood and is characterized by recurrent non suppurative and non obstructive parotid inflammation. These attacks influence the quality of life and can even lead to gland destruction, and there are no definitive treatment to avoid them. Sialendoscopic dilatation is emerging as the new treatment modality in this aspect. STUDY DESIGN retrospective study. STUDY SETTING Department of Otorhinolaryngology in tertiary care hospital. 17 cases of juvenile recurrent parotitis (i.e. children of age group 3-11 years presenting with complaints of recurrent parotid region swelling and pain, sometimes associated with fever) were included in the study during October 2012-September 2015. All cases underwent sialendoscopy under general anaesthesia. Diagnostic (classifying the ductal lesion) and interventional sialendoscopic procedure (dilatation with instillation of steroid) were carried out in single sitting. Follow up was done for a minimum of 6 months (range 6-36 months). 17 patients with mean age of 5.6 years and gender distribution of 47:53 (boys:girls) underwent sialendoscopy for JRP. 8 patients presented with unilateral parotitis and 9 with bilateral. The mean number of attacks in previous 1 year were 9.2. Average time for procedure was 20 min. All cases had ductal stenosis and ductal mucosa was pale in 15 cases on endoscopy. 1 patient underwent repeat endoscopy after 2 years. 50% had complete resolution of symptoms and 6 patients had one mild (swelling not associated with fever which subsided on its own) attack after treatment. Follow up period ranged from 6 months to 3 years. No complications were observed. Sialendoscopy has emerged as a viable option for assessment and treatment of JRP. Dilatation of the parotid duct and steroid instillation has significantly reduced the morbidity of this condition.
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Affiliation(s)
- P P Singh
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - M Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Sialoendoscopy combined with an internal stent and postoperative massage as a comprehensive treatment of delayed I 131-induced parotitis. Br J Oral Maxillofac Surg 2017; 55:674-678. [PMID: 28697989 DOI: 10.1016/j.bjoms.2017.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 01/30/2017] [Indexed: 11/20/2022]
Abstract
A common complication of radioiodine (I131) treatment of thyroid cancer is parotitis. Here we describe our clinical experience in treating delayed I131-induced parotitis using sialoendoscopy together with an internal stent and postoperative massage. In this retrospective cohort study we reviewed 32 patients who were treated in that way under general anaesthesia between July 2010 and March 2015. Their age, sex, and the time to development of the parotitis were collected from the hospital's database. All patients were evaluated using a visual analogue scale (VAS), sialography, and computed tomography preoperatively. The analyses of VAS scores were made during postoperative follow-up visits. We used the paired Student's t test and one-way ANOVA to assess the significance of differences, and probabilities of < 0.05 were accepted as significant. The mean (SD) age of the 32 patients was 50 (11) years, and they developed symptoms of delayed parotitis after a mean (SD) of 12 (11) months. The mean time between treatment with I131 and sialoendoscopy was 26 (10) months. Ductal stenosis was the most common sialoendoscopic feature, together with mucous plugs and fibrosis. Fifty of the 56 ducts were successfully dilated by sialoendoscopy, and VAS scores significantly decreased from a preoperative 7.3 (1.1) to a postoperative 3.3 (2.1) (p=0.000) during follow-up of 3 - 41 months. Sialoendoscopic interventions combined with an internal stent and postoperative massage may be optimal comprehensive treatment for delayed I131-induced parotitis.
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Serbetci E, Sengor GA. Sialendoscopy: Experience with the First 60 Glands in Turkey and a Literature Review. Ann Otol Rhinol Laryngol 2017; 119:155-64. [DOI: 10.1177/000348941011900303] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives We performed a retrospective analysis to contribute to the increasing number of reports on sialendoscopy in the literature and give basic concepts for beginners at the same time. Methods Between 2004 and 2009, 83 patients with symptoms of ductal obstruction of the major salivary glands were admitted to our clinic. Diagnostic and/or interventional sialendoscopy was applied to 60 glands (33 submandibular and 27 parotid) of 54 patients. A holmium:yttrium-aluminum-garnet laser or a pneumatic lithotripter was used for intraductal stone fragmentation. Results Sialendoscopy revealed no disorder in 2 cases, and in 38 glands (28 submandibular and 10 parotid) sialolithiasis was the underlying disease. Fifteen glands (5 submandibular and 10 parotid) were found to have other main disorders such as stenosis, synechia, or kink formation. Other findings included sialodochitis in 6 glands (2 submandibular and 4 parotid), a polyp in 1 parotid gland, mucus plugs in 21 glands (6 submandibular and 15 parotid), ductal ectasia in 4 glands (2 submandibular and 2 parotid), and ductal collapse in 1 parotid gland. The overall interventional success rate was 83% of all cases, and no complications occurred. Conclusions The success rate of the interventional sialendoscopy performed in the current study shows consistency with the results given in the related medical literature. In the age of sialendoscopy, the adjunctive intraoral surgeries can be argued to be safer, easier, and more successful than before. Sialendoscopy may be considered to be the best practice not only in sialolithiasis, but also in other treatments of obstructive ductal disorders.
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Affiliation(s)
- Erhun Serbetci
- Otorhinolaryngology Group, Nisantasi ENT Group, Istanbul, Turkey
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Bignet C, Carvalho J, Lemaire E, Charpiot A. Acute submaxillitis: Etiological data and etiological management. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:315-319. [PMID: 28359731 DOI: 10.1016/j.anorl.2017.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objective of the present study was to test the hypothesis that acute submaxillitis involves salivary duct obstruction. Obstacle characteristics and treatment were analyzed. MATERIAL AND METHODS Patients presenting with an episode of acute submaxillitis between 2009 and 2015 were retrospectively included. All underwent salivary duct imaging and/or sialendoscopy, with pathologic examination if the salivary gland was removed for etiologic diagnosis. For etiological treatment, if the causal lesion could not be treated by isolated sialendoscopy, surgery used a direct approach assisted by sialendoscope. In case of failure of these procedures, submaxillectomy was indicated. RESULTS Twenty-nine patients were included, 28 of whom showed salivary duct abnormality. At least 1 calculus was found in 27 patients; calculi were usually single (n=20), situated in the mid-third (n=21), and large (mean 7.7mm). Ten patients showed stenosis, associated with salivary calculus in 9 cases. Twenty-five patients with salivary duct obstruction underwent sialendoscopy. Isolated sialendoscopy was used in 5 cases, and a combined approach in 13 cases. CONCLUSION An episode of submaxillitis requires salivary duct exploration by sialendoscopy, to enable early treatment given the prevalence of associated calculi and high success rate of conservative management by sialendoscopy.
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Affiliation(s)
- C Bignet
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - J Carvalho
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - E Lemaire
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Charpiot
- Service d'ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
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Vatin L, Foletti JM, Collet C, Varoquaux A, Chossegros C. A case of bilateral megaducts: Diagnostic and treatment methods. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:125-128. [PMID: 28345516 DOI: 10.1016/j.jormas.2017.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/20/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The pathology of the saliva glands comprises both tumoral and obstructive disorders. The latter include lithiasis, stenosis and megaduct. In this paper, we describe a clinical case of bilateral megaduct, a rare pathology, using sialo-MRI imaging and a conservative diagnostic-cum-therapeutic technique, sialendoscopy with dilation followed by catheterization. CLINICAL CASE Our female patient presented oversized parotids with an unsightly deformation of the face (parotid ducts visible beneath the skin) and itchy cheeks, from which she had suffered for several years. Sialo-MRI revealed bilateral hypertrophied parotid saliva glands. We opted to perform diagnostic sialendoscopy to explore the branches of the salivary gland system and found ducts shaped like strings of sausages associated with mucous plugs. The treatment procedure was combined with rinsing of both parotid ducts in physiological serum followed by initiation of antibiotic-corticotherapy within the saliva ducts and, lastly, by placement of transpapillary drains, which were left in place for 10 days. Immediately following the procedure, the patient felt a considerable improvement regarding both local discomfort and her cheek deformation. Postoperative control at 10 weeks by sialo-MRI confirmed the reduction of the dilation of the salivary ducts. At 3 months, the patient continued to display a marked clinical improvement despite her saliva retaining a thick consistency. She no longer suffered from pruritis or deformation of the cheeks. DISCUSSION Sialendoscopy could become the reference treatment tool since it is both efficient and conservative. Duration of her postoperative catheterization remains to be defined.
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Affiliation(s)
- L Vatin
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - J M Foletti
- Oral, Maxillo-Facial & Plastic Surgery Department, Hospital Nord, chemin des Bourrelys, 13015 Marseille, France; Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France
| | - C Collet
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - A Varoquaux
- Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Parole et Langage Laboratory (LPL), UMR 6057, Pr N.N'Guyen, 13100 Aix-en-Provence, France
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Foletti JM, Wajszczak L, Gormezano M, Guyot L, Zwetyenga N, Chossegros C. Transoral Stensen's Duct Approach: A 22-case retrospective study. J Craniomaxillofac Surg 2016; 44:1796-1799. [DOI: 10.1016/j.jcms.2016.07.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 06/27/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022] Open
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Su CH, Lee KS, Hsu JH, Lee FP, Lin HY, Lin SP, Hung SH. Pediatric sialendoscopy in Asians: A preliminary report. J Pediatr Surg 2016; 51:1684-7. [PMID: 27325357 DOI: 10.1016/j.jpedsurg.2016.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 05/22/2016] [Accepted: 05/30/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE The sialendoscopic approach in treating pediatric salivary gland disorders has been reported with great success through the years. Whereas this success has been widely reported in Caucasian populations, relatively little has been reported regarding the use of this procedure in pediatric patients in Asian countries. The purpose of this study is to report our preliminary experience in pediatric sialendoscopy. METHODS The data from 20 patients (<18years old), who underwent sialendoscopy for obstructive sialoadenitis in the Department of Otorhinolaryngology of Mackay Memorial Hospital between October 2013 and November 2015, were reviewed. RESULTS Twelve of our 20 patients (60%) were diagnosed with sialolithiasis and 8 of our 20 patients (40%) presented with non-lithiasis obstructive sialoadenitis. Ductal stenosis was found in 13 patients, and 18 patients had debris/mucous plug formation. The overall success rate was 95% (19/20) in our series, and 85% (17/20) of the patients had achieved a complete remission after a single sialendoscopy procedure. CONCLUSIONS Sialendoscopy is an ideal treatment in the management of obstructive sialoadenitis in Asian pediatric patients. If necessary, Holmium:YAG laser lithotripsy and sialostent placement could be applied, and both procedures are well tolerated in pediatric patients.
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Affiliation(s)
- Chin-Hui Su
- Department of Otorhinolaryngology, Mackay Memorial Hospital; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Sheng Lee
- Department of Otorhinolaryngology, Mackay Memorial Hospital
| | - Jui-Hsien Hsu
- Department of Otorhinolaryngology, Mackay Memorial Hospital
| | - Fei-Peng Lee
- Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Otolaryngology, Shuang-Ho Hospital, Taipei Medical University
| | - Hsiang-Yu Lin
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Shuan-Pei Lin
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Shih-Han Hung
- Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Otolaryngology, Taipei Medical University Hospital.
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Koch M, Iro H. Extended and treatment-oriented classification of parotid duct stenosis. Laryngoscope 2016; 127:366-371. [PMID: 27346484 DOI: 10.1002/lary.26079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To provide an extended and treatment-oriented classification of parotid duct stenosis that might be useful in the management of this condition. STUDY DESIGN Retrospective study in a tertiary referral center. METHODS A total of 550 symptomatic stenoses of the parotid gland excretory duct in 445 patients were analyzed. Sialendoscopy was performed with semirigid endoscopes. The tissue quality, location, grade of luminal narrowing, and length and number of the stenoses were assessed. RESULTS Inflammation-dominant stenosis (type 1) was found in 8.9% of the patients, web-associated fibrous stenosis (type 2) in 19.5%, and fibrous (type 3) in 71.6%. Multiple stenoses (≥3) were found in 2.8% of patients, and bilateral stenoses in 11.9%. Type 1 stenoses differed significantly from type 3 stenoses, with lower grades. Type 3 stenoses showed significantly higher grades of luminal narrowing than the other two types (P = .0001). Type 2 stenoses were significantly shorter in comparison with the other two types (P = .0001). Multiple stenoses were observed significantly more often in type 2 than in type 3 stenoses (P = .0001). Due to these differences, the type of stenosis appears to be the most important criterion in the treatment-oriented classification. CONCLUSIONS Significant differences between the different stenoses were observed. Type 1 stenosis may be considered as a precursor of type 3 stenosis, but type 2 stenosis showed significantly different characteristics. The differences prescribed in this classification may be helpful in the management of parotid duct stenoses. LEVEL OF EVIDENCE 4. Laryngoscope, 2016 127:366-371, 2017.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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Pezier TF, Prasad S, Marchal F. Towards an international database of benign salivary disease: RE: Management of obstructive salivary disorders by sialendoscopy: a systematic review. Br J Oral Maxillofac Surg 2016; 54:968-969. [PMID: 26994565 DOI: 10.1016/j.bjoms.2016.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 01/13/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Thomas F Pezier
- European Sialendoscopy Training Center, 16 Cours de Rive, 1204 Geneva, Switzerland.
| | - Shashi Prasad
- European Sialendoscopy Training Center, 16 Cours de Rive, 1204 Geneva, Switzerland
| | - Francis Marchal
- European Sialendoscopy Training Center, 16 Cours de Rive, 1204 Geneva, Switzerland.
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Sialoendoscopy as a diagnostic and therapeutic option for obstructive diseases of the large salivary glands—a retrospective analysis. Clin Oral Investig 2015; 20:1065-70. [DOI: 10.1007/s00784-015-1588-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
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Sahin-Yilmaz A, Oysu C. A serious complication of laser lithotripsy. J Oral Maxillofac Surg 2015; 73:798-9. [PMID: 25882995 DOI: 10.1016/j.joms.2014.12.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 12/29/2014] [Indexed: 11/30/2022]
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Louvrier A, Foletti JM, Guyot L, Chossegros C. [Combined approach of parotid lithiasis. A technical note]. ACTA ACUST UNITED AC 2015; 116:139-42. [PMID: 25841269 DOI: 10.1016/j.revsto.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/18/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Sialendoscopy, extracorporeal lithotripsy and transoral removal are the usual treatments for parotid lithiasis. These techniques cannot treat all the patients. In fact, removal of lithiasis bigger than the ductal diameter and situated in the middle or posterior third of the duct may fail with such techniques. For this reason the combined approach has been developed. Our technical note describes this procedure. TECHNICAL NOTE Preoperative check-up needs an ultrasound or a CT scan of the parotid region. The procedure is conducted under general anesthesia. It begins with the localization of the lithiasis with help of the sialendoscope light visible through the skin. A face lift approach is performed giving access to the SMAS that is opened over the lithiasis and the transilluminated area. A window is opened on the duct and the lithiasis is removed. Proximal duct permeability is assessed with the sialendoscope. The different layers are sutured and a suction drainage is left in place. DISCUSSION Combined approach is indicated in case of failure of conservative techniques. It provides good results in removal of lithiasis located in the posterior or middle thirds of the duct. Its morbidity is low. It can avoid performing a parotidectomy and lowers the risk of facial palsy. In case of failure, botulinum toxin injection may be indicated.
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Affiliation(s)
- A Louvrier
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, 13284 Marseille, France
| | - L Guyot
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, 13284 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Aix-Marseille université, 13284 Marseille, France
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Nahlieli O. Complications of Sialendoscopy: Personal Experience, Literature Analysis, and Suggestions. J Oral Maxillofac Surg 2015; 73:75-80. [DOI: 10.1016/j.joms.2014.07.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/17/2014] [Accepted: 07/21/2014] [Indexed: 11/24/2022]
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Vaiman M. Comparative analysis of methods of endoscopic surgery of the submandibular gland: 114 surgeries. Clin Otolaryngol 2014; 40:162-6. [PMID: 25516236 DOI: 10.1111/coa.12357] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 01/16/2023]
Affiliation(s)
- M Vaiman
- Department of Otolaryngology - Head and Neck Surgery, Assaf Harofe Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Bat Yam, Israel
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[Parotid involvement in Churg-Strauss syndrome]. ACTA ACUST UNITED AC 2014; 115:188-91. [PMID: 24797730 DOI: 10.1016/j.revsto.2014.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 03/31/2014] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Churg-Strauss syndrome is a rare systemic vascularitis. This disease causes eosinophilic tissue infiltration. The most frequent manifestations are cortico-dependent asthma, mono- or polyneuropathy, paranasal sinus polyposis, and digestive and renal dysfunction. Salivary glands are very rarely involved. OBSERVATION We describe a case of CSS in a patient presenting with bilateral parotid swelling. The morphological study of salivary glands revealed an unusual thickening of the salivary duct walls. DISCUSSION Salivary gland involvement in Churg and Strauss syndrome can be difficult to demonstrate histologically; it does not usually present in the clinical foreground of the disease, and can be a source of misdiagnosis. The biopsy should be performed in the symptomatic gland, away from any previous corticoid treatment.
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Ardekian L, Klein HH, Araydy S, Marchal F. The Use of Sialendoscopy for the Treatment of Multiple Salivary Gland Stones. J Oral Maxillofac Surg 2014; 72:89-95. [DOI: 10.1016/j.joms.2013.06.206] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 06/05/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
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