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Lakshmi Nair S, Faizal B, Hari H. A Prospective Study of Recovery of Salivary Gland Function After Calculus Removal by Sialendoscopy. Indian J Otolaryngol Head Neck Surg 2023; 75:88-93. [PMID: 37007899 PMCID: PMC10050491 DOI: 10.1007/s12070-023-03526-6] [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: 12/02/2022] [Accepted: 01/21/2023] [Indexed: 02/12/2023] Open
Abstract
Sialendoscopy is gaining popularity in treating obstructive sialolithiasis as a gland preserving procedure. The study aimed to determine if the salivary glands recovered apart from symptomatic improvement after interventional sialendoscopy for calculus removal. A prospective comparative study was conducted in a tertiary care center on 24 patients diagnosed with sialolithiasis. The eligibility criterion was patients who underwent calculus removal through interventional sialendoscopy. All patients underwent objective and subjective methods of assessments of function of the salivary glands with the help of salivary Technetium (Tc) 99 Scintigraphy, measurement of salivary flow rate, Chronic obstructive sialadenitis symptoms (COSS), and xerostomia index (XI) questionnaires. Assessments were done before the procedure and repeated after 3 months. Categorical variables were expressed using frequency and percentage. Numerical variables were represented using mean and standard deviation. To test the statistical significance of the difference in the mean of the four parameters Wilcoxen sign ranked test was used. According to our study improvement in functionality was noted in all of the subjective and objective parameters assessed namely Tc scintigraphy, salivary flow rate, COSS questionnaire, and XI questionnaire, with a statistically significant p value (< 0.001). Functionality of salivary gland showed improvement within 3 months of calculus removal through sialendoscopy. There was a marked improvement in the symptoms after sialendoscopy. This study demonstrates that removal of obstructing calculus results in rapid recovery of glandular function thereby emphasizing the need for salivary gland preservation. Level of evidence: Level III.
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Affiliation(s)
- S. Lakshmi Nair
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham University, Kochi, India
| | - Bini Faizal
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham University, Kochi, India
| | - Harsha Hari
- Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham University, Kochi, India
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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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Grillo R, Al-Moraissi E, Balel Y, Eshghpour M, Samieirad S, Teixeira RG. Oral and maxillofacial literature from Middle East: a bibliometric analysis and list of top-100 most cited articles. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101293. [PMID: 36152971 DOI: 10.1016/j.jormas.2022.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this work is to perform a bibliometric analysis on Middle Eastern oral and maxillofacial surgery through years and to compare the data with previous studies. A list of the top 100 most cited articles was generated. METHODS A Pubmed bibliographic search for literature journals specialized in oral and maxillofacial surgery in the Middle East was performed. A graphic representation of authorship and keywords was created with VOSviewer. Mendeley and Microsoft Excel were used for tabulation and data visualization. A list of the top 100 most cited articles was created using Web of Science. Some statistical tests were performed with a 95% confidence interval, which was considered significant. RESULTS A total of 6,536 articles were retrieved in fifteen selected oral and maxillofacial journals. A moderate correlation between number of publications and total population (R = 0.6052), low correlation with area (R = 0.302291), and a negligible correlation with the Human Development Index (HDI) were found (R = 0.1747). A disparity can be seen in the number of publications by country, leaded by Turkey (46.30%), Israel and Iran (13.68% each). The more common studied topic was oral surgery (25.77%), maxillofacial trauma (16.13%) and oral pathology (10.25%). CONCLUSIONS A useful list of the top 100 most cited articles on oral and maxillofacial surgery from Middle East has been created. Middle East publications on oral and maxillofacial surgery can be considered high quality (IF = 1.879). Some issues on performing an adequate selecting of MeSH keywords were discussed.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil; Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil; Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo, Brazil.
| | - Essam Al-Moraissi
- Department of Oral & Maxillofacial Surgery, Thamar University, Dhamar, Yemen
| | - Yunus Balel
- Department of Oral & Maxillofacial Surgery, Gaziosmanpasa University, Tokat, Turkey
| | - Majid Eshghpour
- Department of Oral & Maxillofacial surgery, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahand Samieirad
- Department of Oral & Maxillofacial surgery, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Douglas JE, Wen CZ, Thomas WW, Elrakhawy M, Rassekh CH. Management of Chronic Sialadenitis due to Sjogren's Syndrome and Radioactive Iodine Therapy Using Sialendoscopy. ORL J Otorhinolaryngol Relat Spec 2023; 85:7-11. [PMID: 35817018 DOI: 10.1159/000525217] [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: 11/24/2021] [Accepted: 04/10/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Sialendoscopy is a minimally invasive technique for the management of salivary gland disease. This work characterizes its utility for treating chronic sialadenitis due to Sjogren's syndrome and radioactive iodine (RAI) therapy. METHODS A single-center, retrospective review of patients undergoing sialendoscopy between March 2013 and May 2019 for the treatment of chronic sialadenitis due to Sjogren's or prior RAI therapy was performed. RESULTS Thirty-four patients with Sjogren's and 25 patients who received RAI were identified, undergoing a total of 86 procedures. Median age at presentation was 53 years with mean follow-up time of 14.3 months. Seventy-two procedures were performed on the parotid gland, four on the submandibular gland, and ten on both glands. Corticosteroid injection and duct dilation were performed most commonly. Sixteen patients required repeat procedure. All patients were symptomatically improved at follow-up visit. DISCUSSION/CONCLUSION These results support the idea that sialendoscopy offers symptomatic benefit for patients with chronic sialadenitis due to Sjogren's or RAI.
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Affiliation(s)
- Jennifer E Douglas
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Christopher Z Wen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,
| | | | - Mohamed Elrakhawy
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Christopher H Rassekh
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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Avishai G, Younes M, Gilat H, Gillman L, Reiser V, Rosenfeld E, Chaushu G, Masri D. Anatomical Features of the Parotid Duct in Sialography as an Aid to Endoscopy—A Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12081868. [PMID: 36010218 PMCID: PMC9406592 DOI: 10.3390/diagnostics12081868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Sialography is used for diagnosis of obstructive salivary gland diseases and prior to sialendoscopy. Three-dimensional cone beam computerized tomography (CBCT) sialography allows imaging and measurement of salivary duct structures. Salivary gland endoscopy has a long learning curve. The aim of this retrospective study is to create an anatomical quantitative guide of different distances and angles significant for endoscopy. Twenty-six CBCT sialographies of healthy parotid ducts were included. Outcome parameters included diameters, distances, angles and number of minor tributaries. Results show the average distance from the papilla to the curvature of the gland was 41.5 mm (Q1 36.97 mm–Q3 45.32 mm), with an angle of 126.9° (Q1 107.58°–Q3 135.6°) of the curvature and a distance of 35.25 mm (±7.81 mm) between the curvature and the hilus. The mean width of the duct was 0.8 mm (Q1 0.7 mm–Q3 1.15 mm) at its narrowest and 2 mm (Q1 1.4 mm–Q3 2.2 mm) at its widest. This is the first anatomical quantitative study of the parotid duct in relation to sialendoscopy.
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Affiliation(s)
- Gal Avishai
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
- Correspondence:
| | - Muhammad Younes
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Hanna Gilat
- Rabin Medical Center, Department of Otolaryngology-Head and Neck Surgery, Beilinson Hospital, Petach Tikva 49414, Israel;
| | - Leon Gillman
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Vadim Reiser
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Eli Rosenfeld
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Gavriel Chaushu
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Daya Masri
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
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Bannikova KA, Bosykh YY, Gaitova VG, Sysolyatin PG, Sysolyatin SP. Indications for the Use of Sialoendoscopy in Sialolithiasis. Sovrem Tekhnologii Med 2021; 12:41-45. [PMID: 34795978 PMCID: PMC8596244 DOI: 10.17691/stm2020.12.3.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Indexed: 11/14/2022] Open
Abstract
The aim of the study is to determine indications for the use of sialoendoscopy in the diagnosis and treatment of sialolithiasis. Materials and Methods The study involved 115 patients with sialolithiasis, who underwent cone beam computed tomography, ultrasound diagnosis of the salivary glands, and sialoendoscopy, in addition to the standard general clinical examination. Results Sialoendoscopy makes it possible to detect a stone, determine its shape, relative size, mobility, and assess the condition of the salivary ducts. It is impossible to obtain this information by other methods, though it is very important for treatment decision making. The design of the sialoscope and its special instruments make it possible to proceed with sialolith extraction immediately after detecting it. Conclusion The absolute indication for the use of sialoendoscopy is mobile calculi less than 5 mm in diameter (L1 according to F. Marchal's LSD classification). In case of immobile sialoliths less than 4-8 mm in size, located in the main duct (L2), endoscopy should be used as a method supplementary to ductotomy. When sialoliths are located in the distal parts behind the areas of bending or stricture (L3a and L3b), the use of endoscopy is not indicated.
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Affiliation(s)
- K A Bannikova
- PhD Student, Department of Surgical Dentistry and Maxillofacial Surgery; Peoples' Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow, 117198; Dental Surgeon; Center for Endoscopic Dentistry and Maxillofacial Surgery "Endostom", 12 Proyezd Berezovoy Roshchi, Moscow, 125252
| | - Yu Yu Bosykh
- Assistant, Department of Anatomy; I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Malaya Trubetskaya St., Moscow, 119991
| | - V G Gaitova
- Dental Surgeon; Center for Endoscopic Dentistry and Maxillofacial Surgery "Endostom", 12 Proyezd Berezovoy Roshchi, Moscow, 125252
| | - P G Sysolyatin
- Professor, Department of Hospital Surgical Dentistry and Maxillofacial Surgery; Novosibirsk State Medical University, 52 Krasny Prospect, Novosibirsk, 630091
| | - S P Sysolyatin
- Professor, Department of Surgical Dentistry and Maxillofacial Surgery; Peoples' Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow, 117198; Director; Center for Endoscopic Dentistry and Maxillofacial Surgery "Endostom", 12 Proyezd Berezovoy Roshchi, Moscow, 125252
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A conservative treatment for chronic obstructive sialoadenitis by intraductal instillation of mucolytic, steroids and antibiotic solution. Eur Arch Otorhinolaryngol 2021; 279:501-506. [PMID: 34110456 PMCID: PMC8739163 DOI: 10.1007/s00405-021-06930-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/03/2021] [Indexed: 11/11/2022]
Abstract
Purposes Reporting our experience in treating chronic obstructive sialadenitis with a protocol consisting of sialoendoscopy and intraductal instillation of antibiotics, steroids and n-acetyl-cysteine (NAC) solution. Methods Prospective study of patients with chronic obstructive sialadenitis with no apparent lithiasic obstructions, with recurrent non-lithiasic sialoadenitis and patients with lithiasic sialoadenitis not solved with sialoendoscopy. In all cases, a sialoendoscopy was performed. All the patients affected by lithiasic sialoadenitis where the chronic inflammation was resolved with sialoendoscopy were excluded from the study. The mid-term follow-up was performed at 12 months via phone interview, to understand whether patients had developed any further symptoms after the treatment. Results This study included 26 patients. All the patient without sialolithiasis have not reported any symptoms during the follow-up period. Two of those with sialolithiasis have not shown any signs of recurrence. The remaining three patients with non-resolved sialolithiasis had a recurrence of symptoms which were treated again with 1 intraductal administration of betamethasone, gentamicine and NAC, showing immediately a regression of the symptoms. Conclusions Intraductal administration of gentamicin + NAC + betamethasone seemed effective for the therapy of chronic obstructive sialoadenitis. Our protocol seemed effective also in that cases where it was not possible to remove or detect endoscopically an obstruction. In all these cases we have noticed an increase in the symptom-free time even in cases where it was not possible to remove the stones.
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Moorthy A, Bachalli PS, Krishna S, Murthy S. Sialendoscopic Management of Obstructive Salivary Gland Pathology: A Retrospective Analysis of 236 Cases. J Oral Maxillofac Surg 2020; 79:1474-1481. [PMID: 33359107 DOI: 10.1016/j.joms.2020.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To analyze and assess the results of treating obstructive salivary gland pathology by sialendoscopy or sialendoscopic-assisted surgery and analyze the difference in submandibular and parotid gland pathology. PATIENTS AND METHODS Between December 2012 and March 2020, 211 patients (236 procedures) underwent sialendoscopy/sialendoscopic-assisted surgery for treatment of obstructive salivary gland pathology. The cases were retrospectively analyzed for type of pathology, symptomatic relief, type of intervention (endoscopy alone or combined with open surgery), recurrence of symptoms, number of gland excisions, and complications encountered. Sialolith cases (n = 117) were treated by sialendoscopic/sialendoscopy-assisted surgical sialolithotomy using basket or graspers. Strictures (n = 69) were treated by serial dilatation or balloon dilatation with or without intraductal steroid. Mucous plugs (n = 26) were managed by sialendoscopic lavage and occasional retrieval using wire baskets. RESULTS There were 123 submandibular sialendoscopies in 118 patients and 113 parotid sialendoscopies in 95 patients. Of the 123 submandibular sialendoscopies, 99 were treated for sialolithiasis, 14 for strictures, 3 for mucous plugs, and 2 for foreign bodies. Of the 95 parotid sialendoscopies, 18 were treated for sialolithiasis, 55 for strictures, 23 for mucous plugs, and 1 for foreign body. The success rate was 85.3% for submandibular gland treatment and 92% for parotid gland treatment. About 62.7% of cases were treated by combined method (sialendoscopy with open approach) in submandibular gland and 50% in parotid gland. The number of gland excisions performed was 5 (2.1%). CONCLUSIONS Sialendoscopy although associated with a gradual learning curve can be used for all cases of obstructive salivary gland pathology with excellent success rate and minimum morbidity. Parotid gland obstructive pathology is distinct from that seen in the submandibular gland, with strictures and mucous plugs contributing to most cases. Diagnosing and treatment planning for strictures and mucous plugs should therefore be as seamless as that for sialoliths.
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Affiliation(s)
- Aditya Moorthy
- Consultant, Department of Oral and Maxillofacial Surgery- Rangadore Memorial Hospital, Trust-Well Hospital, Apollo Hospitals, Bangalore, India
| | - Prithvi S Bachalli
- Consultant, Department of Oral and Maxillofacial Surgery- Rangadore Memorial Hospital, Trust-Well Hospital, Apollo Hospitals, Bangalore, India
| | - Shreya Krishna
- Associate Consultant, Department of Oral and Maxillofacial Surgery- Rangadore Memorial Hospital, Bangalore, India.
| | - Sreenivasa Murthy
- Consultant, Department of ENT, Columbia Asia Hospitals, Bangalore, India
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Badger CD, Patel S, Romero NJ, Fuson A, Joshi AS. In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi. Otolaryngol Head Neck Surg 2020; 164:124-130. [PMID: 32600219 DOI: 10.1177/0194599820937676] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The present study was developed to evaluate the accuracy of in vivo ultrasound sizing for parotid and submandibular salivary gland calculi, as compared with ex vivo pathology sizing with a standard plastic ruler after extraction. STUDY DESIGN Retrospective chart review. SETTING Ultrasound is frequently used to size salivary calculi and make treatment decisions, but the accuracy of measurements from this modality has not been validated. SUBJECTS AND METHODS We evaluated and reviewed the charts and ultrasound examinations of 167 patients who underwent procedures for the treatment of sialolithiasis involving the parotid and submandibular glands. US examinations were performed between 2009 and 2016 in a tertiary-level hospital setting by the senior author. Measurements were collected from ultrasound evaluation before sialolithotomy, and pathology measurements were taken after removal. Ultrasound measurements in millimeters were compared with the measurements collected with a ruler. The differences were calculated and compared. RESULTS A total of 167 calculi measurements were compared. Good concurrent validity between pathology and ultrasound measurements was suggested by a Pearson correlation of 0.92 (95% CI, 0.887-0.937). On Bland-Altman plot, correlation of the difference between US and pathology measurements showed a mean difference of 0.095 mm (95% CI, -0.19 to 0.38 mm) with a limit of agreement ranging from -3.59 mm (95% CI, -3.84 to -3.34 mm) to +3.78 mm (95% CI, +3.53 to +4.03 mm). CONCLUSIONS Ultrasound is an accurate, relatively precise, and minimally invasive imaging tool for salivary gland sialolithiasis. Preoperative size of calculi can be used to guide management and clinical decision making. LEVEL OF EVIDENCE 2C.
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Affiliation(s)
- Christopher D Badger
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Sahil Patel
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Nahir J Romero
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Andrew Fuson
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Arjun S Joshi
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
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Wu CB, Sun HJ, Li FL, Qiao QH, Zhou Q. Sialendoscopy-Assisted Treatment of Stensen's Duct Injury: A Case Series. J Oral Maxillofac Surg 2020; 78:1595.e1-1595.e5. [PMID: 32417320 DOI: 10.1016/j.joms.2020.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the clinical value of sialendoscopy in the treatment of Stensen's duct injury. PATIENTS AND METHODS A total of 5 patients with Stensen's duct injuries who had been treated from December 2017 to April 2019 were included in the present study. The operations were performed with the help of a sialendoscope. All patients were followed for 6 months. RESULTS The distal end of the ductal system was found precisely with the use of the sialendoscope, and the proximal end was identified by the location of the distal end. The end-to-end anastomosis was performed successfully. None of the patients complained of salivary gland fistula at the 6-month follow-up examination. CONCLUSIONS The stumps of the ductal system could be precisely and effectively located with the help of a sialendoscope.
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Affiliation(s)
- Chuan-Bin Wu
- Attending Doctor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang, People's Republic of China
| | - Hai-Jiang Sun
- Physician, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang, People's Republic of China
| | - Fu-Long Li
- Physician, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang, People's Republic of China
| | - Qi-Hui Qiao
- Physician, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang, People's Republic of China
| | - Qing Zhou
- Professor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang, People's Republic of China.
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Pachisia S, Mandal G, Sahu S, Ghosh S. Submandibular sialolithiasis: A series of three case reports with review of literature. Clin Pract 2019; 9:1119. [PMID: 30996853 PMCID: PMC6444375 DOI: 10.4081/cp.2019.1119] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/20/2019] [Indexed: 11/22/2022] Open
Abstract
One of the most common disorders of the salivary glands is sialolithiasis. A history of pain or/and swelling in the salivary glands, especially during meal suggests this diagnosis. For small and accessible stones conservative therapies like milking of ducts with palliative therapy can produce satisfactory results. Surgical management should be considered when the stone/stones are inaccessible or large in size as conservative therapies turned out to be unsatisfactory. In this paper, we present three cases of sialolithiasis in the submandibular gland along with a review of existing literature. The purpose of this paper is to add three more cases to the literature and review the theories of etiology, clinical features, available diagnostic and treatment procedures.
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Affiliation(s)
- Sandeep Pachisia
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
| | - Gaurav Mandal
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
| | - Sudipto Sahu
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
| | - Sucharu Ghosh
- Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal, India
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12
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Kondo N, Yoshihara T, Yamamura Y, Kusama K, Sakitani E, Seo Y, Tachikawa M, Kujirai K, Ono E, Maeda Y, Nojima T, Tamiya A, Sato E, Nonaka M. Treatment outcomes of sialendoscopy for submandibular gland sialolithiasis: The minor axis of the sialolith is a regulative factor for the removal of sialoliths in the hilum of the submandibular gland using sialendoscopy alone. Auris Nasus Larynx 2018; 45:772-776. [DOI: 10.1016/j.anl.2017.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 08/06/2017] [Accepted: 09/05/2017] [Indexed: 11/25/2022]
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13
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Jokela J, Tapiovaara L, Lundberg M, Haapaniemi A, Bäck L, Saarinen R. A Prospective Observational Study of Complications in 140 Sialendoscopies. Otolaryngol Head Neck Surg 2018; 159:650-655. [DOI: 10.1177/0194599818782418] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Johanna Jokela
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura Tapiovaara
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marie Lundberg
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leif Bäck
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Riitta Saarinen
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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14
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Kondo N, Yoshihara T, Yamamura Y, Kusama K, Sakitani E, Seo Y, Tachikawa M, Kujirai K, Ono E, Maeda Y, Nojima T, Tamiya A, Sato E, Nonaka M. Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography. Auris Nasus Larynx 2017; 45:880-884. [PMID: 29217121 DOI: 10.1016/j.anl.2017.11.004] [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] [Received: 05/05/2017] [Revised: 11/02/2017] [Accepted: 11/06/2017] [Indexed: 11/16/2022]
Abstract
Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjögren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen's duct stenosis and may similarly have limitation in the treatment of Sjögren's syndrome and recurrent parotitis.
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Affiliation(s)
- Norio Kondo
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
| | - Toshio Yoshihara
- Department of Otolaryngology, Tohto Bunkyo Hospital, 3-5-7, Yushima, Bunkyo-ku, Tokyo 113-0034, Japan; Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 164-0023, Japan
| | - Yukie Yamamura
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kaoru Kusama
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Eri Sakitani
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yukako Seo
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Mayako Tachikawa
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Keiko Kujirai
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Erika Ono
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yasuyo Maeda
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Tomohito Nojima
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Akiko Tamiya
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Emiri Sato
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Manabu Nonaka
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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15
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Farneti P, Macrì G, Gramellini G, Ghirelli M, Tesei F, Pasquini E. Learning curve in diagnostic and interventional sialendoscopy for obstructive salivary diseases. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 35:325-31. [PMID: 26824914 PMCID: PMC4720929 DOI: 10.14639/0392-100x-352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Sialendoscopy is a new diagnostic and surgical tool for management of salivary gland diseases that offers the opportunity to treat selected pathologies less invasively and with better results compared to previous techniques. As with any new technique, an adequate training programme involving a gradual learning curve is mandatory to quickly obtain results similar to those reported in the literature. This includes an appropriate diagnostic programme, correct patient selection and knowledge of possible pitfalls. In this retrospective study, the outcomes of the first 141 procedures (74 on the parotid gland and 67 on the submandibular gland) performed with this technique in our Department from 2009 to 2013 were compared with those reported in the literature. Patients were divided into three groups: Group A (the first 49 procedures performed), Group B (the next 50 procedures), and Group C (the last 42 procedures). There were no statistically significant differences relative to mean procedure times, recurrence of symptomatology after treatment, need for further treatments and rates of minor complications between groups. No major complications were seen. The increase in experience resulted in an increased number of interventional sialendoscopies performed under local anaesthesia instead of general anaesthesia (51% vs 18% vs 14%). In only three of 130 glands treated (2.3%) was gland resection required. We also evaluated which technique had been used for stone removal and rate of failure, which was similar in all groups (13.6% vs 15% vs 15%). Our results do not substantially differ from those reported in the literature. Initial difficulties in catheterising the papilla could be overcome with practise on fresh human specimens or fresh pig heads. Lack of precision regarding diagnostic imaging techniques was remedied by improving the competence of the surgeon in performing pre- and postoperative ultrasound. The creation of specialised centres capable of treating up to 1 to 2 million people would be desirable in order to better stratify pathologies, validate the investment in equipment and gain the necessary experience in the various surgical techniques.
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Affiliation(s)
- P Farneti
- Department of Experimental, Diagnostic and Specialty Medicine, Dimes, Bologna University Medical School, Ear, Nose and Throat Unit of "Sant'Orsola-Malpighi" Hospital, Bologna, Italy
| | - G Macrì
- Ear, Nose and Throat Unit of "Sant'Orsola-Malpighi" Hospital, Bologna, Italy
| | - G Gramellini
- Ear, Nose and Throat Unit of "Sant'Orsola-Malpighi" Hospital, Bologna, Italy
| | - M Ghirelli
- Ear, Nose and Throat Metropolitan Unit, Surgical Department, AUSL Bologna, Italy
| | - F Tesei
- Ear, Nose and Throat Metropolitan Unit, Surgical Department, AUSL Bologna, Italy
| | - E Pasquini
- Ear, Nose and Throat Metropolitan Unit, Surgical Department, AUSL Bologna, Italy
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16
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Delagnes EA, Zheng M, Aubin-Pouliot A, Chang JL, Ryan WR. Salivary duct stenosis: Short-term symptom outcomes after sialendoscopy-assisted salivary duct surgery. Laryngoscope 2017; 127:2770-2776. [DOI: 10.1002/lary.26665] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/02/2017] [Accepted: 04/12/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Elise A. Delagnes
- School of Medicine; University of California-San Francisco; San Francisco California U.S.A
| | - Melissa Zheng
- School of Medicine; University of California-San Francisco; San Francisco California U.S.A
| | - Annick Aubin-Pouliot
- Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Surgery Center; University of California-San Francisco; San Francisco California U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Surgery Center; University of California-San Francisco; San Francisco California U.S.A
| | - William R. Ryan
- Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Oncologic and Endocrine Surgery, Salivary Gland Surgery Center; University of California-San Francisco; San Francisco California U.S.A
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17
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Kondo N, Yoshihara T, Yamamura Y, Kusama K, Sakitani E, Seo Y, Tachikawa M, Kujirai K, Ono E, Maeda Y, Nojima T, Tamiya A, Sato E, Nonaka M. The landmark for removal of sialoliths using sialendoscopy alone in parotid gland sialolithiasis. Auris Nasus Larynx 2017; 45:306-310. [PMID: 28651858 DOI: 10.1016/j.anl.2017.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/02/2017] [Accepted: 05/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the general guidelines for removal of sialoliths in parotid gland sialolithiasis using sialendoscopy alone. METHODS We analyzed 34 sialoliths treated using sialendoscopy in 26 patients with parotid gland sialolithiasis. We divided the Stensen's duct and parotid gland into for parts using computed tomography findings: (A) front of the masseter, (B) anterior and lateral to the center (anterolateral) of the masseter, (C) posterior and lateral to the center (posterolateral) of the masseter, (D) behind of the masseter. The location and size of each sialolith was assessed. RESULTS The removal rates of sialoliths in the different locations by sialendoscopy alone were as follows: front of the masseter, 68.8%; anterolateral of the masseter, 60.0%; posterolateral of the masseter, 0%; and behind of the masseter, 33.3%. The removal rate using sialendoscopy alone was significantly higher in the sections anterior to the center of the masseter than in those posterior to the center of the masseter (66.7% [14/21] vs. 20.0% [2/10]; P=0.019). The size of the sialolith was not correlated to the removal rate by sialendoscopy alone. CONCLUSION Sialoliths of the parotid gland located in positions anterior to the center of the masseter are significantly easier to remove by sialendoscopy alone. The center of the masseter is a general landmark for removal of sialoliths from the parotid gland using sialendoscopy alone. The size of the sialolith is not correlated with removal, except rare huge sialoliths.
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Affiliation(s)
- Norio Kondo
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
| | - Toshio Yoshihara
- Department of Otolaryngology, Tohto Bunkyo Hospital, 3-5-7, Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Yukie Yamamura
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kaoru Kusama
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Eri Sakitani
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yukako Seo
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Mayako Tachikawa
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Keiko Kujirai
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Erika Ono
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yasuyo Maeda
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Tomohito Nojima
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Akiko Tamiya
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Emiri Sato
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Manabu Nonaka
- Department of Otolaryngology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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18
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Capaccio P, Torretta S, Pignataro L, Koch M. Salivary lithotripsy in the era of sialendoscopy. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2017; 37:113-121. [PMID: 28516973 PMCID: PMC5463518 DOI: 10.14639/0392-100x-1600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 01/17/2023]
Abstract
The traditional management of obstructive salivary disorders has been replaced by minimally-invasive gland-preserving techniques including shock-wave lithotripsy, sialendoscopy, interventional radiology and endoscopically video-assisted trans-oral and cervical stone retrieval, of which sialendoscopy is considered to be the method of first choice. Primary endoscopically controlled stone extraction without prior fragmentation is only possible in 15-20% of cases; in more than 80%, fragmentation is necessary because of the size, impactation and location of the stone, or an alternative treatment such as transoral duct surgery or combined approaches are required. Moreover, about 10-20% of all stones cannot be adequately accessed by means of a sialendoscope or any alternative surgical method and, in such cases, extra-corporeal shock wave lithotripsy (ESWL) is the treatment of choice. However, in endoscopically accessible stones, ESWL is being gradually replaced by endoscopically assisted intra-corporeal techniques, including endoscopically guided laser and pneumatic intracorporeal lithotripsy. We describe the currently most widely used techniques for salivary lithotripsy, including ESWL, and endoscopically guided laser, electrohydraulic, electrokinetic and pneumatic intra-corporeal lithotripsy, and discuss their indications given the widespread use of advanced rehabilitative sialendoscopy and combined therapeutic approaches.
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Affiliation(s)
- P. Capaccio
- Department of Biomedical, Surgical and Dental Sciences
| | - S. Torretta
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - L. Pignataro
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - M. Koch
- Department of Otorhinolaryngology, Head and Neck Surgery; Friedrich Alexander University of Erlangen Nuremberg, Germany
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Thomas WW, Douglas JE, Rassekh CH. Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis. Otolaryngol Head Neck Surg 2017; 156:834-839. [DOI: 10.1177/0194599817696308] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To determine the accuracy of the 2 most utilized imaging modalities in obstructive sialadenitis secondary to sialolithiasis—computed tomography (CT) and ultrasonography (US)—using sialendoscopic findings as a comparison standard. To review the impact of CT and US on the management of sialolithiasis managed with sialendoscopy alone and through combined approaches. Study Design Retrospective cohort study. Setting Quaternary academic referral center. Subjects and Methods All cases of patients undergoing sialendoscopy by a single surgeon for suspected parotid and submandibular gland pathology between the October 2013 and April 2016 were reviewed. Results Sixty-eight patients were in this cohort, of whom 44 underwent US, CT, and sialendoscopy; 20 underwent CT and sialendoscopy only; and 4 underwent US and sialendoscopy only. The sensitivity and specificity were 65% and 80% for US and 98% and 88% for CT, respectively. These 68 patients had 84 total stones addressed, with 79 being removed and 5 remaining in situ. The methods of stone removal were sialendoscopy alone (34 stones), open transoral approaches (36 stones), and an external approach: transcervical for submandibular and transfacial for parotid (11 stones). Conclusion US had a lower sensitivity (65%) than what has been reported in the literature (70%-94%), and the majority of missed stones were anterior Wharton’s duct stones. These sialoliths were likely missed due to an incomplete examination. US and CT were complementary in this study, and the findings suggest that both modalities can be utilized to optimize the outcome of sialendoscopy and combined approaches.
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Affiliation(s)
- W. Walsh Thomas
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer E. Douglas
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christopher H. Rassekh
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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20
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Modayil PC, Jacob V, Manjaly G, Watson G. Intracorporeal electrokinetic lithotripsy: an advancement in minimally invasive management of parotid duct calculus. The Journal of Laryngology & Otology 2017; 122:428-31. [PMID: 17498338 DOI: 10.1017/s0022215107008304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Symptomatic salivary stones in the middle or proximal parotid duct have previously been treated by gland excision, which is associated with a 3–7 per cent risk to the facial nerve. Minimally invasive approaches to the management of salivary duct calculi have been devised over the past decade. Fluoroscopically guided basket retrieval, lithotripsy and intra-oral stone removal under general anaesthesia have found favour with most surgeons. Endoscopically controlled intracorporeal shock wave lithotripsy using the pneumoblastic lithotripter has been replaced by electrohydraulic lithotripsy (used in sialolith treatment).Method:The electrokinetic lithotripter is normally used for the treatment of lower ureteric stones, and has the benefit of minimal concomitant tissue damage. We have extended its use to the treatment of parotid duct calculi. We present initial results for its use in the treatment of a proximal parotid duct stone.Result:Application of the shock wave to the stone under direct vision avoided injury to the duct or to any local structure. The patient made an uneventful recovery and was asymptomatic after 18 months' follow up.Conclusion:Continuous, endoscopically monitored electrokinetic lithotripsy with good irrigation gives a well illuminated field and absolute delivery of energy to the target. It avoids the side effects caused by impact of the shock wave on the parotid duct and adjacent anatomical structures, thereby making it a safer procedure.
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Affiliation(s)
- P C Modayil
- Department of Otorhinolaryngology, Eastbourne District General Hospital, East Grinstead, UK.
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21
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Xiao JQ, Sun HJ, Qiao QH, Bao X, Wu CB, Zhou Q. Evaluation of Sialendoscopy-Assisted Treatment of Submandibular Gland Stones. J Oral Maxillofac Surg 2017; 75:309-316. [DOI: 10.1016/j.joms.2016.08.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/10/2016] [Accepted: 08/14/2016] [Indexed: 11/16/2022]
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Pniak T, Štrympl P, Staníková L, Zeleník K, Matoušek P, Komínek P. Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods. Open Med (Wars) 2016; 11:461-464. [PMID: 28352836 PMCID: PMC5329868 DOI: 10.1515/med-2016-0081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 10/03/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the accuracy of ultrasound, sialography, and sialendoscopy for examining benign salivary gland obstructions. METHODS In this prospective study, patients with symptoms of obstruction of the major salivary gland duct system presenting at the ENT Clinic University Hospital, Ostrava, from June 2010 to December 2013 were included. All patients (n=76) underwent ultrasound, sialography, and sialoendoscopy. The signs of sialolithiasis, ductal stenosis, or normal findings were recorded after the examinations. Statistical analysis of the sensitivity and specificity of all the methods was performed, as well as a comparison of the accuracy of each method for different kinds of pathology (sialolithiasis or stenosis). RESULTS The sensitivity of ultrasound, sialography, and sialoendoscopy for sialolithiasis findings were 71.9%, 86.7 %, and 100%, respectively. The sensitivity of sialography and sialoendoscopy for stenosis of the duct was 69.0%, and 100%, respectively. The study showed impossibility of ultrasonic diagnostics of ductal stenosis. The sensitivity of sialoendoscopy for both pathologies was significantly higher than that from ultrasound or sialography (p<0.05). The specificity of sialoendoscopy was significantly higher than that from by ultrasound or sialography (p<0.05). CONCLUSION Sialoendoscopy was the most accurate method for examination ductal pathology, with significantly higher sensitivity and specificity than by ultrasound or sialography.
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Affiliation(s)
- Tomáš Pniak
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Pavel Štrympl
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Lucia Staníková
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Karol Zeleník
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Petr Matoušek
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otolaryngology, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic, Tel. 00420597375801
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23
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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, Zenk J, Bozzato A, Bumm K, Iro H. Sialoscopy in Cases of Unclear Swelling of the Major Salivary Glands. Otolaryngol Head Neck Surg 2016; 133:863-8. [PMID: 16360504 DOI: 10.1016/j.otohns.2005.08.005] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2005] [Indexed: 11/25/2022]
Abstract
OBJECTIVE: Sialoscopy has developed into an important diagnostic and therapeutic tool for diseases of the major salivary glands. STUDY DESIGN AND SETTING: We evaluated 103 patients with chronic swelling of the major salivary glands. Routine diagnostic measures revealed no clear diagnosis. The findings of 109 sialoscopies are described. A semi-rigid endoscope (with a diameter of 1.1 mm and 2 integrated working channels) was used for sialoscopy, 51.5% of the cases in Warthon's duct and 48.5% in Stensen's duct. RESULTS: Pathologic findings resulted in 83.0% of the submandibular and in 96% of the parotid ducts. Obstruction neither due to sialolithiasis nor stenosis was observed in 56.3%, whereas sialolithiasis was observed in 20.3% of the patients. In 36 (35%) patients, an interventional sialoscopy was performed. CONCLUSIONS: In cases of invisible salivary duct obstruction, especially in those with low mineralized calculi, strictures, stenoses, or postinflammatory changes, sialoscopy gives immediate and direct information about causal pathologies. Moreover, further therapy can be planned within the same procedure. EBM RATING: C
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany
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Samani M, Hills AJ, Holden AM, Man CB, McGurk M. Minimally-invasive surgery in the management of symptomatic parotid stones. Br J Oral Maxillofac Surg 2016; 54:438-42. [DOI: 10.1016/j.bjoms.2016.01.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 01/29/2016] [Indexed: 10/22/2022]
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Koch M, Mantsopoulos K, Schapher M, von Scotti F, Iro H. Intraductal pneumatic lithotripsy for salivary stones with the StoneBreaker: Preliminary experience. Laryngoscope 2016; 126:1545-50. [DOI: 10.1002/lary.25849] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Felix von Scotti
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
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Proot JLJ, Nelissen P, Ladlow JF, Bowlt Blacklock K, Kulendra N, de la Puerta B, Sheahan DE. Parotidectomy for the treatment of parotid sialocoele in 14 dogs. J Small Anim Pract 2015; 57:79-83. [DOI: 10.1111/jsap.12429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 09/13/2015] [Accepted: 10/27/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | - P. Nelissen
- Department of Surgery; Dick White Referrals; Newmarket Suffolk CB8 0UH
| | - J. F. Ladlow
- Queen's Veterinary School Hospital; The University of Cambridge Veterinary School; Cambridge CB3 0ES
| | - K. Bowlt Blacklock
- Department of Small Animal Surgery; Animal Health Trust; Newmarket Suffolk CB8 7UU
| | - N. Kulendra
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; North Mymms Herts AL9 7TA
| | - B. de la Puerta
- Department of Small Animal Surgery; North Downs Specialist Referrals; Redhill Surrey RH1 4QP
| | - D. E. Sheahan
- Department of Small Animal Surgery; Dogwood Vets; Sale Manchester M33 6JN
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Atienza G, López-Cedrún J. Management of obstructive salivary disorders by sialendoscopy: a systematic review. Br J Oral Maxillofac Surg 2015; 53:507-19. [DOI: 10.1016/j.bjoms.2015.02.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
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Kalia V, Kalra G, Kaur S, Kapoor R. CT Scan as an Essential Tool in Diagnosis of Non-radiopaque Sialoliths. J Maxillofac Oral Surg 2015; 14:240-4. [PMID: 25838703 DOI: 10.1007/s12663-012-0461-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Accepted: 11/16/2012] [Indexed: 11/26/2022] Open
Abstract
Sialolithiasis is the second most common disease of the salivary glands and the main cause of salivary gland obstruction. Diagnosis of calculi/sialoliths can be made by means of an elaborate history, precise clinical examination and radiographic support. But all sialoliths do not present with predictable signs and symptoms and radiographic appearance. Sialoliths have a variety of manifestations and they may or may not be radiopaque. Non-radiopaque sialoliths are difficult to diagnose radiographically. Although newer techniques like CBCT, CT virtual sialandoscopy and established techniques like sialography, xeroradiography can be useful in selected cases. A regular CT scan is an excellent tool in the diagnosis of a non-radiopaque sialolith and associated salivary gland changes. CT scan should be considered as an important tool of imaging for diagnosis, treatment planning and follow-up of all cases of sialoliths and associated pathologies of the salivary gland.
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Affiliation(s)
- Vimal Kalia
- Department of Oral and Maxillofacial Surgery, BRS Dental College and Hospital, Panchkula, India ; Dantantra, House no 731, Sector 2, Panchkula, India
| | - Geeta Kalra
- Department of Oral and Maxillofacial Surgery, BRS Dental College and Hospital, Panchkula, India
| | | | - Rajeev Kapoor
- Department of Radiology, General Hospital, Sector-6, Panchkula, India
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Wu CB, Xue L, Zhang B, Sun NN, Zhou Q. Sialendoscopy-Assisted Treatment for Chronic Obstructive Parotitis—Our Treatment Strategy with 31 Patients. J Oral Maxillofac Surg 2015; 73:1524-31. [PMID: 25970512 DOI: 10.1016/j.joms.2015.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE Chronic obstructive parotitis (COP) is the most common non-neoplastic salivary disorder. The aim of this study was to describe the authors' experience using sialendoscopy for diagnosing and treating COP. MATERIALS AND METHODS Thirty-one patients with COP who were treated with sialendoscopy from January 2013 through June 2014 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University (Shenyang, China) were retrospectively reviewed. The cohort underwent ultrasonography and salivary gland scintigraphy examinations before sialendoscopy. Patients without stones underwent sialography before surgery. All patients were asked to report visual analog scale (VAS) scores before and 6 months after surgery to evaluate their condition. A paired t test was conducted and differences with a P value less than .05 were considered statistically significant. RESULTS Thirty patients (44 parotid glands) successfully underwent interventional sialendoscopy under local anesthesia; 1 patient (1 parotid gland) received general anesthesia. The mean preoperative VAS score was 6, and the mean VAS score 6 months after sialendoscopy was 4.9. The postoperative VAS score was significantly lower than the preoperative VAS score (P < .05). CONCLUSIONS Interventional sialendoscopy plays an important role in the treatment of COP.
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Affiliation(s)
- Chuan-Bin Wu
- Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China
| | - Lei Xue
- Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China
| | - Bin Zhang
- Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China
| | - Ning-Ning Sun
- Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China
| | - Qing Zhou
- Professor, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
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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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Pace CG, Hwang KG, Papadaki M, Troulis MJ. Interventional Sialoendoscopy for Treatment of Obstructive Sialadenitis. J Oral Maxillofac Surg 2014; 72:2157-66. [DOI: 10.1016/j.joms.2014.06.438] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/12/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022]
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Konstantinidis I, Chatziavramidis A, Constantinidis J. Conservative management of bilateral pneumoparotitis with sialendoscopy and steroid irrigation. BMJ Case Rep 2014; 2014:bcr-2013-201429. [PMID: 25355739 DOI: 10.1136/bcr-2013-201429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pneumoparotitis is a rare condition related to retrograde airflow into the ductal system of the gland and secondary infections. Although counselling is enough in the majority of cases, persistent problems require surgery. Sialendoscopy and ductal irrigation with steroids have never been described as a treatment option. We present the case of a 61-year-old man with recurrent bilateral parotid swellings who had three episodes of sialadenitis on the right side within 2 years. Massage of the glands revealed air bubbles coming out from both papillae. A previous CT scan confirmed the presence of air in both parotid glands. The patient underwent sialendoscopy and irrigation of the ductal system with prednisolone. Ductal irrigation with steroids in three additional sessions led to a significant improvement of symptoms 6 months later. Sialendoscopy and irrigation with steroids could be another treatment modality in cases of recurrent pneumoparotitis avoiding major surgery.
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Affiliation(s)
- Iordanis Konstantinidis
- 2nd Academic ENT Department, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Angelos Chatziavramidis
- 2nd Academic ENT Department, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Jannis Constantinidis
- 2nd Academic ENT Department, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
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Wu CB, Xi H, Zhou Q, Zhang LM. Sialendoscopy-assisted treatment for radioiodine-induced sialadenitis. J Oral Maxillofac Surg 2014; 73:475-81. [PMID: 25544300 DOI: 10.1016/j.joms.2014.09.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/23/2014] [Accepted: 09/27/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE Chronic sialadenitis is a common complication of radioactive iodine for the treatment of thyroid disease. The aim of this study was to describe the authors' experience with interventional sialendoscopy for the management of radioiodine-induced sialadenitis. MATERIALS AND METHODS Twelve patients with radioiodine-induced sialadenitis treated with sialendoscopy from January 2013 through December 2013 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University were retrospectively reviewed. Age, gender, and time to development of radioiodine-induced sialadenitis were obtained from the hospital database. All patients were asked to undergo visual analog scale (VAS) and salivary gland scintigraphy (SGS) examinations before and 6 months after surgery. A paired t test was conducted, and a P value less than .05 was considered statistically significant. RESULTS Twelve patients (15 parotid glands and 4 submandibular glands) successfully underwent interventional sialendoscopy under local anesthesia. Ductal stenosis was the most common feature identified by endoscopy. Among the 12 patients, swelling occurred in 91.7%. Compared with the preoperative score of 6, the mean VAS score 6 months after sialendoscopy was 3; 15 glands (78.9%) showed improved uptake and excretion by SGS. The postoperative VAS score was significantly lower than the preoperative VAS score (P < .05), and the postoperative SGS result was significantly higher than the preoperative SGS result (P < .05). CONCLUSIONS Interventional sialendoscopy could be an effective technique for the treatment of sialadenitis caused by radioactive iodine.
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Affiliation(s)
- Chuan-Bin Wu
- Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning Province, China
| | - Hong Xi
- Resident, Department of Pediatric Dentistry, School of Stomatology, Jilin University, Changchun, Jilin Province, China
| | - Qing Zhou
- Professor, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning Province, China.
| | - Liang-Mei Zhang
- Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning Province, China
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Sun YT, Lee KS, Hung SH, Su CH. Sialendoscopy with holmium:YAG laser treatment for multiple large sialolithiases of the Wharton duct: a case report and literature review. J Oral Maxillofac Surg 2014; 72:2491-6. [PMID: 25216563 DOI: 10.1016/j.joms.2014.06.448] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/24/2014] [Accepted: 06/24/2014] [Indexed: 11/27/2022]
Abstract
Sialolithiasis is defined as calcified stone(s) in the salivary duct or glands. Submandibular gland sialolithiasis is the most common (80 to 90%), followed by parotid gland sialolithiasis (5 to 15%). The typical clinical presentation is salivary gland swelling after eating. As the swelling persists, symptoms owing to local inflammation, such as pain and trismus, emerge. In severe cases, cellulitis and even abscess formation occur and subsequently lead to salivary gland atrophy or fistula formation if the sialolithiasis remains untreated. The most common treatment is complete excision of the affected gland together with the stone(s). In some cases, intraoral sialolithotomy is performed when the stone is solitary and easily palpable through the oral cavity. Sialendoscopy is increasingly performed because of its minimal invasiveness. The major limitation of endoscopic laser lithotripsy of the salivary glands is the size of the stone. Often, for a stone larger than 4 mm, multiple fragmentations of the stone into small pieces is necessary before the pieces can be removed by wire basket or grasping forceps. Recently, the holmium:YAG laser has been reported as quite effective in removing larger salivary gland stones. However, sialoendoscopic laser lithotripsy is a very time-consuming procedure and in most cases, when there are multiple large stones in a single gland, entire gland excision is recommended. This report describes a male patient diagnosed with multiple large stones in his left submandibular gland who was successfully treated under sialendoscopy with holmium:YAG laser lithotripsy.
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Affiliation(s)
- Yu-Ting Sun
- Senior Resident, Department of Otorhinolaryngology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Sheng Lee
- Department Head, Department of Otorhinolaryngology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shih-Han Hung
- Assistant Professor, Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chin-Hui Su
- Attending Physician, Department of Otorhinolaryngology, Mackay Memorial Hospital, Taipei; Assistant Professor, Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
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Kiringoda R, Eisele DW, Chang JL. A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders. Laryngoscope 2014; 124:2696-701. [DOI: 10.1002/lary.24787] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/28/2014] [Accepted: 05/22/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
| | - David W. Eisele
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
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Mikolajczak S, Meyer MF, Beutner D, Luers JC. Treatment of chronic recurrent juvenile parotitis using sialendoscopy. Acta Otolaryngol 2014; 134:531-5. [PMID: 24597494 DOI: 10.3109/00016489.2013.879738] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The combination of sialendoscopy and an intraductal application of corticosteroids can be recommended for children with chronic recurrent juvenile parotitis (CRJP) as there is growing evidence for a positive effect in the absence of side effects. OBJECTIVE CRJP is a disorder with painful, episodic swelling of the parotid gland in children. The majority of cases have a self-limiting character within 5-10 years, but the disease may also continue into adulthood. CRJP can occur on one or both sides and up to now the etiology has been unclear. The aim of this study was to analyze the therapeutic effect of a sialendoscopic application of corticosteroids on the clinical course of patients with CRJP. METHODS We retrospectively analyzed the clinical course of 9 children with 10 parotid glands affected by CRJP, who all underwent sialendoscopy and intraductal application of corticosteroids. In all cases the procedure was conducted under general anesthesia. The average follow-up period was 15 months. RESULTS There were no side effects associated with the sialendoscopy. All duct systems showed signs of chronic inflammation with an atrophic or thickened epithelium. At the follow-up visit, CRJP symptoms had completely resolved in eight children. One child still showed slight parotid swellings without the need for antibiotics. None of the parents reported that symptoms had continued at an equal level or worsened after sialendoscopy.
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Sionis S, Caria R, Trucas M, Brennan P, Puxeddu R. Sialoendoscopy with and without holmium:YAG laser-assisted lithotripsy in the management of obstructive sialadenitis of major salivary glands. Br J Oral Maxillofac Surg 2014; 52:58-62. [DOI: 10.1016/j.bjoms.2013.06.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/24/2013] [Indexed: 10/26/2022]
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Venetis G, Bourlidou E, Liokatis PG, Zouloumis L. Endoscopic assistance in the diagnosis and treatment of odontogenic maxillary sinus disease. Oral Maxillofac Surg 2013; 18:207-12. [PMID: 23508785 DOI: 10.1007/s10006-013-0413-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 03/06/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Endoscopic sinus surgery has become an increasingly popular treatment for most surgical cases of chronic sinusitis. However, in some cases, a modification of the classic Caldwell-Luc operation is unavoidable. The purpose of this paper is to present the outcome of 20 cases with pathology of the maxillary sinus which was approached endoscopically on diagnostic or interventional purpose. The primary indication for endoscopy for 11 cases was acute or chronic odontogenic sinusitis. For six cases, endoscopy was performed for removing a foreign body from the sinus cavity and for the remaining three cases, for diagnostic purpose only. METHODS A 4-mm rigid endoscope was used through the middle nasal meatus (eight cases) or via a puncture at the canine fossa (seven cases). A combined endoscopic approach was used in five cases. In three cases, endoscopy was combined with Caldwell-Luc technique. For the majority of the patients, the operation was performed under local anesthesia (16 cases). RESULTS The mean follow-up period was 9.1 months. No major complications were observed. One patient died 18 months after an endoscopically assisted detection of malignancy. Results were depended on the surgical procedure pursued and the underlying sinus pathology. Laborious surgery and chronic sinusitis gave the less satisfactory results. CONCLUSIONS Endoscopy of the maxillary sinus can be applied in a variety of indications. Alone or in combination with conventional surgery, it is a minimally invasive and highly diagnostic tool.
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Zheng LY, Kim E, Yu CQ, Yang C, Park J, Chen ZZ. A retrospective case series illustrating a possible association between a widened hilum and sialolith formation in the submandibular gland. J Craniomaxillofac Surg 2013; 41:648-51. [PMID: 23375532 DOI: 10.1016/j.jcms.2013.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 01/03/2013] [Accepted: 01/03/2013] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE The purpose of this study was to explore any association between anatomical variances in the ductal system and sialolith formation using sialoendoscopy and acrylic resin replication of the ductal system. METHODS A retrospective study of 372 submandibular gland sialoendoscopies was performed to review the findings of the submandibular gland duct anatomy. Using sialoendoscopy and replicated casts, a high rate of hilar widening was noted in patients with submandibular sialolithiasis. RESULTS Sialolithiasis was detected in 326 of the patients who presented with obstructive symptoms. Around 67% (285/426) of the stones were located in the distal third of the ducts or at the hilum of the submandibular gland. During the sialoendoscopic procedure, the anatomy of the ductal system was examined and 285/326 (87.4%) of the hilums were noted to be widened like a basin. The anatomy of the duct from the replicated casts demonstrated a treelike structure and the basin-like widening of the hilum was found in all the excised submandibular glands. CONCLUSION Using sialoendoscopy, a high number of patients presenting with sialolithiasis in the submandibular gland seem to have an anatomical variance in the hilar region. The reproduced ductal system from excised glands also demonstrated this abnormal widening of the hilum. Although further studies need to be performed, we try and explain why there is such a high prevalence of hilar widening in patients with submandibular sialolithiasis.
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Affiliation(s)
- Ling Yan Zheng
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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Durbec M, Dinkel E, Vigier S, Disant F, Marchal F, Faure F. Thulium-YAG laser sialendoscopy for parotid and submandibular sialolithiasis. Lasers Surg Med 2012; 44:783-6. [DOI: 10.1002/lsm.22094] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2012] [Indexed: 11/11/2022]
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Luers JC, Stenner M, Schinke M, Helmstaedter V, Beutner D. Tolerability of sialendoscopy under local anesthesia. Ann Otol Rhinol Laryngol 2012; 121:269-74. [PMID: 22606931 DOI: 10.1177/000348941212100413] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We sought to investigate patients' tolerance of sialendoscopy of the parotid and submandibular glands with local anesthesia. METHODS In a retrospective case series of 84 adult patients who underwent sialendoscopy with local anesthesia at an academic tertiary referral hospital, we analyzed patients' demographic data, American Society of Anesthesiologists (ASA) status score, perioperative cardiovascular parameters, and results on a 2-question survey. RESULTS Of the 84 patients, 44 were female and 40 were male (mean age, 48.6 years). The patients had a mean ASA status score of 1.57. On average, 2.16 mL of local anesthetic was used. The mean systolic blood pressure was 137 mm Hg, and the mean diastolic blood pressure was 80 mm Hg. The duration of the procedure showed a significant correlation with the maximum systolic blood pressure (r = 0.35; p = 0.001), the mean systolic blood pressure (r = 0.25; p = 0.02), the maximum diastolic blood pressure (r = 0.37; p = 0.001), and the mean diastolic blood pressure (r = 0.31; p = 0.005). The mean heart rate was 77 beats per minute. The majority of patients considered the procedure to be tolerable. In this series, the indications for conducting sialendoscopy under general anesthesia were procedures of greater invasiveness and complex situations with multiple sialolithiases, difficult anatomic preconditions, or a very long expected operation time. CONCLUSIONS Sialendoscopy performed with local anesthesia is well tolerated, provided that the patient has a good general health status and the operative procedure is not expected to be complex or long-lasting.
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Affiliation(s)
- Jan Christoffer Luers
- Department of Otorhinolaryngology-Head and Neck Surgery University of Cologne, Köln, Germany
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Witt RL, Iro H, Koch M, McGurk M, Nahlieli O, Zenk J. Minimally invasive options for salivary calculi. Laryngoscope 2012; 122:1306-11. [DOI: 10.1002/lary.23272] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Revised: 01/06/2012] [Accepted: 02/07/2012] [Indexed: 01/04/2023]
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44
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Cheng Y, Long X, Li H. Poster 23: Evaluation of Endoscopy in the Diagnosis and Treatment of Obstructive Salivary Gland Diseases. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Luers JC, Grosheva M, Reifferscheid V, Stenner M, Beutner D. Sialendoscopy for sialolithiasis: Early treatment, better outcome. Head Neck 2011; 34:499-504. [DOI: 10.1002/hed.21762] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2011] [Indexed: 11/09/2022] Open
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Extra-oral approach to removal of parotid duct stones. The Journal of Laryngology & Otology 2010; 124:1100-2. [DOI: 10.1017/s0022215110000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThere are many different management strategies for salivary calculi within the parotid ducts. Commonly, the stones can be extracted via an intra-oral approach. Stones that are farther from the papillae require more complex management. This article describes a technique for extra-oral excision of palpable salivary calculi using known external facial landmarks and dissection. Two cases are discussed and illustrations shown, and a brief discussion of other techniques for the management of salivary stones is included.
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Yu C, Yang C, Zheng L, Wu D. Endoscopic Observation and Strategic Management of Obstructive Submandibular Sialadenitis. J Oral Maxillofac Surg 2010; 68:1770-5. [DOI: 10.1016/j.joms.2009.09.118] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2008] [Revised: 09/11/2009] [Accepted: 09/25/2009] [Indexed: 11/24/2022]
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Abstract
Minimally invasive, in particular endoscopic treatment modalities are an important topic in medicine today. Over the last 15 years mini-endoscopy (ME) has been introduced and established in different fields of the head and neck region. ME includes endoscopy of the Eustachian tube, middle ear, lacrimal duct system and duct system of the major salivary glands. Direct visualization by endoscopy enables rapid, efficient and accurate diagnosis and treatment planning according to the findings. In the majority of cases simultaneous interventional therapy is possible. This has lead to a fundamental change in treatment regimes which now aim to preserve the anatomic structure and function. In specialized centers the frequency of external dacryocystostomy could be reduced to less than 10% by means of endoscopic surgery of the lacrimal system, while the frequency of parotidectomy was reduced to below 5%. This development allows not only for medical advances, but also for the desired cost reduction on the part of the administrative organs responsible for providing medical care.
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Affiliation(s)
- M Koch
- Klinik für Hals-, Nasen-, Ohrenkranke, Kopf und Hals-Chirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen, Deutschland.
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Abstract
Technical developments have taken place since the first endoscopes suitable for sialendoscopy appeared. Now, a variety of endoscopes are available. Ranging from rigid to flexible, each type has its own properties. Light sources, imaging, recording instrumentation, and other equipment used with the endoscopes facilitate or extend the range of their use. Experiences using different endoscopes in more than 300 endoscopies are discussed.
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Su YX, Wang L, Liao GQ, Liu HC, Liang YJ, Zheng GS. Sialoendoscopic secondary intervention after failure of open sialolithectomy. J Oral Maxillofac Surg 2010; 68:313-8. [PMID: 20116701 DOI: 10.1016/j.joms.2009.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 04/14/2009] [Accepted: 07/25/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Traditionally, sialoadenectomy was always indicated when open sialolithectomy failed. The aim of the present study was to investigate the role of sialoendoscopy as the secondary intervention after failure of open sialolithectomy. PATIENTS AND METHODS A consecutive series of 15 patients with obstructive salivary gland disease with failure of open sialolithectomy were prospectively recruited for our study. All these patients underwent sialoendoscopy under local anesthesia. The reasons for the failure of open sialolithectomy were analyzed, and secondary interventions were performed using sialoendoscopy. RESULTS Failure of open sialolithectomy resulted from 4 main causes. Small stones could not be found after the duct was incised (n = 3); the stones were pushed posteriorly during open surgery (n = 4); the stones located in the anterior part of the duct were removed, but the hilar stones were left untouched (n = 5); and radiolucent stones were missed (n = 3). All the patients were treated successfully by sialoendoscopy. No symptoms or signs of recurrence developed during a median follow-up period of 16 months. CONCLUSIONS Sialoendoscopy can be recommended as an effective secondary intervention after failure of open sialolithectomy.
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Affiliation(s)
- Yu-xiong Su
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen University Guanghua School of Stomatology, Guangzhou, China
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