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Moe J, Helman JI. Surgical Techniques for the Management of Submandibular Salivary Duct Strictures. Atlas Oral Maxillofac Surg Clin North Am 2018; 26:99-103. [PMID: 30077328 DOI: 10.1016/j.cxom.2018.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Justine Moe
- Oral and Maxillofacial Surgery, Hospital Dentistry, University of Michigan, 1515 East Hospital Drive, Towsley Center, G1200, Ann Arbor, MI 48109, USA
| | - Joseph I Helman
- Oral and Maxillofacial Surgery, Hospital Dentistry, University of Michigan, 1515 East Hospital Drive, Towsley Center, G1200, Ann Arbor, MI 48109, USA.
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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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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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Desmots F, Chossegros C, Salles F, Gallucci A, Moulin G, Varoquaux A. Lithotripsy for salivary stones with prospective US assessment on our first 25 consecutive patients. J Craniomaxillofac Surg 2014; 42:577-82. [DOI: 10.1016/j.jcms.2013.07.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 04/09/2013] [Accepted: 07/17/2013] [Indexed: 11/29/2022] Open
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Guerre A, Katz P. Lithotripsie extracorporelle (LEC) salivaire : étude rétrospective sur 1571 patients. ACTA ACUST UNITED AC 2011; 112:75-9. [DOI: 10.1016/j.stomax.2011.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/19/2010] [Accepted: 01/10/2011] [Indexed: 11/24/2022]
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