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Karagozoglu KH, Mahraoui A, Bot JCJ, Cha S, Ho JPTF, Helder MN, Brand HS, Bartelink IH, Vissink A, Weisman GA, Jager DHJ. Intraoperative Visualization and Treatment of Salivary Gland Dysfunction in Sjögren's Syndrome Patients Using Contrast-Enhanced Ultrasound Sialendoscopy (CEUSS). J Clin Med 2023; 12:4152. [PMID: 37373845 DOI: 10.3390/jcm12124152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
In sialendoscopy, ducts are dilated and the salivary glands are irrigated with saline. Contrast-enhanced ultrasound sialendoscopy (CEUSS), using microbubbles, may facilitate the monitoring of irrigation solution penetration in the ductal system and parenchyma. It is imperative to test CEUSS for its safety and feasibility in Sjögren's syndrome (SS) patients. CEUSS was performed on 10 SS patients. The primary outcomes were safety, determined by the occurrence of (serious) adverse events ((S)AEs), and feasibility. The secondary outcomes were unstimulated and stimulated whole saliva (UWS and SWS) flow rates, xerostomia inventory (XI), clinical oral dryness score, pain, EULAR Sjögren's syndrome patient reported index (ESSPRI), and gland topographical alterations. CEUSS was technically feasible in all patients. Neither SAEs nor systemic reactions related to the procedure were observed. The main AEs were postoperative pain (two patients) and swelling (two patients). Eight weeks after CEUSS, the median UWS and SWS flow had increased significantly from 0.10 to 0.22 mL/min (p = 0.028) and 0.41 to 0.61 mL/min (p = 0.047), respectively. Sixteen weeks after CEUSS, the mean XI was reduced from 45.2 to 34.2 (p = 0.02). We conclude that CEUSS is a safe and feasible treatment for SS patients. It has the potential to increase salivary secretion and reduce xerostomia, but this needs further investigation.
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Affiliation(s)
- K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HV Amsterdam, Noord-Holland, The Netherlands
| | - Anissa Mahraoui
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HV Amsterdam, Noord-Holland, The Netherlands
| | - Joseph C J Bot
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, Noord-Holland, The Netherlands
| | - Seunghee Cha
- Department of Oral and Maxillofacial Diagnostic Sciences, Center for Orphaned Autoimmune Disorders, University of Florida, 1395 Center Drive, Gainesville, FL 32610, USA
| | - Jean-Pierre T F Ho
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HV Amsterdam, Noord-Holland, The Netherlands
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HV Amsterdam, Noord-Holland, The Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academisch Centrum Tandheelkunde Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, Noord-Holland, The Netherlands
| | - Imke H Bartelink
- Department of Pharmacy, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1018 HV Amsterdam, Noord-Holland, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, Groningen, The Netherlands
| | - Gary A Weisman
- Department of Biochemistry, Christopher S. Bond Life Sciences Center, University of Missouri, 1201 Rollins St, Columbia, MO 65211, USA
| | - Derk Hendrik Jan Jager
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HV Amsterdam, Noord-Holland, The Netherlands
- Amsterdam Institute for Infection and Immunity, Inflammatory Diseases, De Boelelaan 1118, 1081 HV Amsterdam, Noord-Holland, The Netherlands
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Koch M, Schapher M, Sievert M, Mantsopoulos K, Iro H. Intraductal Fragmentation in Sialolithiasis Using Pneumatic Lithotripsy: Initial Experience and Results. Otolaryngol Head Neck Surg 2021; 167:457-464. [PMID: 34637368 PMCID: PMC9442634 DOI: 10.1177/01945998211051296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report initial experience in using a pneumatic lithotripter to treat salivary stones. STUDY DESIGN Level IV retrospective study. SETTING University hospital and tertiary referral center. METHODS A pneumatic lithotripter was used to treat salivary stones after these were diagnosed. Probes with diameters of 0.7 mm were used. Total fragmentation was intended in all stones. Stone fragments were removed using several instruments in serial sialendoscopies to achieve complete stone clearance. RESULTS A total of 62 patients with 77 stones were treated. Forty-three submandibular stones were treated in 34 patients, and 34 parotid stones were treated in 28 patients. An operating pressure of 2.5 bar and a single frequency mode were used. Complete fragmentation was achieved in all but one of the treated stones in both glands (98.7%). Among the patients, 90.32% became stone free and 100% symptom free. Multiple stones were treated in 24.19% of the patients, and multimodal therapy was also carried out in 24.19%. All of the glands were preserved. CONCLUSIONS The pneumatic lithotripter proved to be effective in the treatment of sialolithiasis. Stone size, location, and the gland involved were important clinical factors. The device was sufficient to achieve success without any increased risk for complications in the patients or damage to the sialendoscopes.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Geisthoff U, Al-Nawas B, Beutner D, Günzel T, Iro H, Koch M, Lell M, Luers JC, Schröder U, Sproll C, Teymoortash A, Ußmüller J, Vogl T, Wittekindt C, Zengel P, Zenk J, Guntinas-Lichius O. [Updated S2k AWMF guideline on obstructive sialadenitis]. Laryngorhinootologie 2021; 100:793-798. [PMID: 34614527 DOI: 10.1055/a-1298-4241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The update of this guideline was an important step to define standards for the use of sialendoscopy and other emerging minimally invasive techniques for the therapy of sialolithiasis and other obstructive salivary gland diseases. The current actualization was necessary to adapt the diagnostic and therapeutic algorithms to the current scientific knowledge. In this article they are presented in a shortened version with a focus on conservative therapeutic measures which are especially relevant for daily practice.
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Affiliation(s)
- Urban Geisthoff
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Gießen und Marburg - Standort Marburg, Germany
| | - Bilal Al-Nawas
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Plastische Operationen, Universitätsmedizin Mainz, Germany
| | - Dirk Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen Universitätsmedizin, Göttingen, Germany
| | - Thomas Günzel
- Belegabteilung Borromäus-Hospital Leer, HNO-Praxis Leer, Germany
| | - Heinrich Iro
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Koch
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Lell
- Institut für Radiologie und Nuklearmedizin, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - Jan Christoffer Luers
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie, Uniklinik Köln, Germany
| | - Ursula Schröder
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany
| | - Christoph Sproll
- Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum Düsseldorf, Germany
| | | | | | - Thomas Vogl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt, Germany
| | - Claus Wittekindt
- Hals-Nasen-Ohrenklinik, Städtisches Klinikum Dortmund gGmbH, Dortmund, Germany
| | | | - Johannes Zenk
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Augsburg, Germany
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Donaldson G, de Paiva Leite S, Hardcastle T, Ahmad Z, Morton RP. The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review. Ann Otol Rhinol Laryngol 2021; 131:805-811. [PMID: 34493105 DOI: 10.1177/00034894211045262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis. DESIGN Qualitative systematic review. METHODS A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced peer-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility. RESULTS About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management of ductal stenoses. CONCLUSION This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up.
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Affiliation(s)
| | - Sandro de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Middlemore Clinical Trials, Auckland, New Zealand
| | - Tim Hardcastle
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Zahoor Ahmad
- University of Auckland, Auckland, New Zealand.,Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Randall P Morton
- University of Auckland, Auckland, New Zealand.,Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
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Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
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Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
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6
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Shin GC, Kim J, Lee SJ, Kang MS, Ahn SJ, Lim JY. Sialendoscopy combined with transoral sialodochoplasty for treatment of parotid duct stenosis with megaduct. Clin Exp Otorhinolaryngol 2021; 14:431-434. [PMID: 33541036 PMCID: PMC8606292 DOI: 10.21053/ceo.2020.02285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/11/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Geun Cheol Shin
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jungghi Kim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Jin Lee
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Jun Ahn
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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7
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Stenosis and stenosis-like lesions in the submandibular duct: Detailed clinical and sialendoscopy-based analysis and proposal for a classification. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:486-495. [DOI: 10.1016/j.oooo.2020.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/08/2020] [Accepted: 05/25/2020] [Indexed: 11/20/2022]
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Karagozoglu KH, Helder M, Bot J, Kamp O, Forouzanfar T, Brand HS, Cha S, Weisman G, Bartelink I, Vissink A, Jager DHJ. Intraoperative visualisation and treatment of salivary glands in Sjögren's syndrome by contrast-enhanced ultrasound sialendoscopy (CEUSS): protocol for a phase I single-centre, single-arm, exploratory study. BMJ Open 2020; 10:e033542. [PMID: 32998913 PMCID: PMC7528357 DOI: 10.1136/bmjopen-2019-033542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION We established a promising sialendoscopic treatment for in vivo enhancement of salivation in salivary glands affected by Sjögren's syndrome (SS). In this technique, the ducts of the salivary glands are irrigated with saline and steroids. This allows for dilatation of ductal strictures and removal of debris. Unfortunately, it is not possible to assess the delivery and penetration of saline or medications in the ductal system and parenchyma. To address this problem, we will conduct contrast-enhanced ultrasound sialendoscopy (CEUSS) using sulphur hexafluoride microbubbles. To the best of our knowledge, microbubbles have never been used for the treatment of salivary glands in SS. It is, therefore, imperative to test this application for its safety and feasibility. METHODS AND ANALYSIS A single-arm phase I study will be performed in 10 SS patients. Under local anaesthesia, ultrasound (US) guided infusion of the parotid and submandibular glands with microbubbles will be performed. Continuous US imaging will be used to visualise the glands, including the location of strictures and occlusions. Main outcomes will be the evaluation of safety and technical feasibility of the experimental treatment. Secondary outcomes will consist of determinations of unstimulated whole mouth saliva flow, stimulated whole mouth saliva flow, stimulated parotid saliva flow, clinical oral dryness, reported pain, xerostomia, disease activity, salivary cytokine profiles and clinical SS symptoms. Finally, salivary gland topographical alterations will be evaluated by US. ETHICS AND DISSEMINATION Ethical approval for this study was obtained from the Medical Ethics Committee of the Amsterdam University Medical Centre, Amsterdam, The Netherlands (NL68283.029.19). data will be presented at national and international conferences and published in a peer-reviewed journal. The study will be implemented and reported in line with the Standard Protocol Items: Recommendations for Interventional Trials' statement. TRIAL REGISTRATION NUMBERS The Netherlands Trial Register: NL7731, MREC Trial Register: NL68283.029.19; Pre-results.
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Affiliation(s)
- K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc) and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marco Helder
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc) and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Joseph Bot
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Otto Kamp
- Department of Cardiology, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc), Amsterdam, The Netherlands
| | - Tim Forouzanfar
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc) and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Seunghee Cha
- Department of Oral and Maxillofacial Diagnostic Sciences, Division of Oral Medicine, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Gary Weisman
- Department of Biochemistry, MU Bond Life Sciences Center, University of Missouri, Columbia, Missouri, USA
| | - Imke Bartelink
- Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc), Amsterdam, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Derk Hendrik Jan Jager
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam University Medical Center (Amsterdam UMC, Location VUmc) and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Plonowska KA, Ochoa E, Ryan WR, Chang JL. Sialendoscopy in Chronic Obstructive Sialadenitis Without Sialolithiasis: A Prospective Cohort Study. Otolaryngol Head Neck Surg 2020; 164:595-601. [PMID: 32988282 DOI: 10.1177/0194599820957256] [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: 01/12/2023]
Abstract
OBJECTIVES To evaluate long-term chronic sialadenitis symptoms in patients without sialolithiasis following sialendoscopy-assisted salivary duct surgery (SASDS) compared to a control group managed conservatively. STUDY DESIGN Prospective cohort study. SETTING Tertiary care center. METHODS Thirty-six patients (52 glands) with chronic sialadenitis without sialolithiasis completed the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire at presentation and at 3-month time intervals thereafter for 1 year. Lower COSS scores represent lower symptom severity. We compared 27 patients who underwent SASDS to 9 control patients who elected conservative management. RESULTS COSS gland-specific scores from 38 SASDS-treated glands (cases) and 14 control glands were similar at baseline. At 6 to 12 months (mean, 8.4 months), the surgically treated group had significantly lower scores and a greater score reduction from baseline compared to controls (mean score change [95% confidence interval] cases: 20.7 points [15.7-25.8]; controls: 11.7 points [4.9-18.4]; P = .04). There was a significant difference in scores between the 2 groups over time (P < .001). A greater proportion (72%) of cases reported partial or complete resolution of overall sialadenitis symptoms at 6 to 12 months compared to the controls (22%, P < .05). CONCLUSION Compared to patients electing for conservative management, patients with sialadenitis without sialolithasis treated with SASDS had improved symptom scores and a greater reduction of symptom severity after 6 months. With SASDS, patients had higher rates of significant overall symptom improvement. In evaluating chronic sialadenitis, assessment at multiple time points is necessary to capture the intermittent and cyclical pattern of obstructive symptoms.
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Affiliation(s)
- Karolina A Plonowska
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| | - Edgar Ochoa
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| | - William R Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
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10
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Koch M, Schapher M, Mantsopoulos K, Iro H. Intraductal Lithotripsy in Sialolithiasis Using the Calculase III™ Ho:YAG Laser: First Experiences. Lasers Surg Med 2020; 53:488-498. [PMID: 32997838 DOI: 10.1002/lsm.23325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/24/2020] [Accepted: 09/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES To report the first experiences with a newly available Ho:YAG laser system for the treatment of salivary stones. STUDY DESIGN/MATERIALS AND METHODS A retrospective study in a tertiary referral center was conducted. Patients diagnosed with sialolithiasis were treated in Erlangen using the Calculase III™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany). Preset parameters had a frequency of 4 Hz and energy of 0.8-1.2 J, resulting in 3.2-4.8 W. Following total fragmentation, one to two serial sialendoscopies were performed to achieve complete fragment clearance. RESULTS A total of 55 stones in 49 patients were treated; 17 stones in 15 submandibular glands and 38 in 34 parotids. In total, 61 laser lithotripsies (range 1-3 per stone) were performed using various modes (long, short, and burst) and with preset parameters of 4 Hz and energy of 0.8-1.2 J, resulting in effective power of 3.2-4.8 W. Complete fragmentation was achieved in all the accessible stones. Sialendoscopes, fibers, or the mode used had no significant influence on success rates. A multimodal therapy concept was employed to treat stones in 12.24% of the cases; 95.92% of the patients were ultimately stone-free, and all became symptom-free. All glands were preserved. CONCLUSIONS The new Calculase III™ Ho:YAG laser was effective in the treatment of sialolithiasis with no increased risk of complications in the patients or damage to the sialendoscopes. Clinical factors such as the type of gland involved, or the location and size of stones had a greater impact on success rates than the technical or preset parameters. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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11
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Marcus KS, Zhu VL, Eigsti RL, Hoffman HT. Fibrous Salivary Ductal Stricture: A Novel Histopathologic Correlate. EAR, NOSE & THROAT JOURNAL 2020; 100:NP429-NP431. [PMID: 32453645 DOI: 10.1177/0145561320927553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Vivian L Zhu
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, IA, USA
| | - Renee L Eigsti
- Department of Pathology, University of Iowa Hospitals and Clinics, IA, USA
| | - Henry T Hoffman
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, IA, USA
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12
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Wang C, Wu H, Ding X, Ji H, Jiao P, Song H, Li S, Du H. Does infection of 2019 novel coronavirus cause acute and/or chronic sialadenitis? Med Hypotheses 2020; 140:109789. [PMID: 32361098 PMCID: PMC7194735 DOI: 10.1016/j.mehy.2020.109789] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/23/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022]
Abstract
2019 novel coronavirus (2019-nCoV) is widespread in China and other countries. The target of 2019-nCoV and severe acute respiratory syndrome coronavirus (SARS-CoV) is angiotensin-converting enzyme 2 (ACE2) positive cells. ACE2 is present in the salivary gland duct epithelium, and thus it could be the target of 2019-nCoV and SARS-CoV. SARS-CoV-related animal model experiments show that it can infect the epithelial cells on the salivary gland duct in Chinese rhesus macaques by targeting ACE2. Clinical studies confirmed that 2019-nCoV and SARS-CoV could be detected in saliva of human patients. We hypothesize that the infection of 2019-nCoV and SARS-CoV will lead to inflammatory pathological lesions in patients' target organs, and possibly inflammatory lesions in salivary glands. 2019-nCoV may cause acute sialoadenitis in the acute phase of infection. After the acute phase, chronic sialoadenitis may be caused by fibrosis repairment. Although there was no direct evidence to prove this, the available indirect evidence indicates a high probability of our hypothesis.
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Affiliation(s)
- Chenxing Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Heming Wu
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Xu Ding
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Huan Ji
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Pengfei Jiao
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Haiyang Song
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Sheng Li
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China
| | - Hongming Du
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province 210029, PR China.
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Barakat KI, Elborolosy SA. Does diabetes mellitus affect the parotid ductal system? A sialendoscopic evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:e243-e248. [PMID: 32111580 DOI: 10.1016/j.oooo.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/02/2019] [Accepted: 09/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess the existence of ductal changes in diabetics using sialendoscopy. STUDY DESIGN Twenty patients and 10 volunteers received bilateral parotid diagnostic sialendoscopy. Group I included 10 patients with uncontrolled diabetes (UCD); group II, 10 patients with controlled diabetes (CD); and group III, 10 nondiabetic controls (CG). Expected ductal changes were examined in 3 proposed distinct zones. A χ2 test was used to compare groups. RESULTS Ductal pathologic conditions were significantly higher in diabetic patients in all zones. Abnormalities were classified as stenosis, hyperemia, or others. In UCD, stenosis percentage was 55%, 90%, and 100% in zones 1, 2, and 3, respectively, compared with 30%, 40%, and 55% in CD and 5%, 5%, and 0% in CG (P < .01). Hyperemic changes in UCD were 90%, 90%, and 40% compared with 50%, 50%, and 20% in CD (P < .01) and 0% in CG. Comparing zones in UCD and CD indicated that stenosis increased significantly toward the proximal end, whereas hyperemia prevailed toward the distal end. CONCLUSIONS Significant ductal abnormalities were detected in the parotids of UCD and CD patients compared with CG. Ductal changes were higher in UCD compared with CD.
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Affiliation(s)
- Khaled Ibrahim Barakat
- Professor and Head of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Minia University, Minia, Egypt; General Manager of Cranio-Maxillofacial Surgery Unit, Faculty of Dentistry, Minia University, Minia, Egypt; Director of Shifa Oral and Maxillofacial Surgery Center, Cairo, Egypt.
| | - Samir Ali Elborolosy
- Lecturer, Oral and Maxillofacial Surgery Department Faculty of Dentistry, Beni Suef University, Beni Suef, Egypt
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Jackson EM, Walvekar RR. Surgical Techniques for the Management of Parotid Salivary Duct Strictures. Atlas Oral Maxillofac Surg Clin North Am 2018; 26:93-98. [PMID: 30077327 DOI: 10.1016/j.cxom.2018.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Erica M Jackson
- Department of Otolaryngology Head and Neck Surgery, LSU Health Sciences Center, 533 Bolivar Street, Suite 566, New Orleans, LA 70112, USA
| | - Rohan R Walvekar
- Department of Otolaryngology Head and Neck Surgery, LSU Health Sciences Center, 533 Bolivar Street, Suite 566, New Orleans, LA 70112, USA.
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Koch M, Iro H. Salivary duct stenosis: diagnosis and treatment. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:132-141. [PMID: 28516976 PMCID: PMC5463521 DOI: 10.14639/0392-100x-1603] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022]
Abstract
The management of stenoses of the major salivary glands had undergone a significant change during the last 15-20 years. Accurate diagnosis forms the basis of adapted minimal invasive therapy. Conventional sialography and MR-sialography are useful examination tools, and ultrasound seems to be a first-line investigational tool if salivary duct stenosis is suspected as cause of gland obstruction. Sialendoscopy is the best choice to establish final diagnosis and characterise the stenosis in order to plan accurate treatment. In all major salivary glands, inflammatory stenosis can be distinguished from fibrotic stenosis. In the parotid duct system, an additional stenosis associated with various abnormalities of the duct system has been reported. Conservative therapy is not sufficient in the majority of cases. The development of a minimally invasive treatment regime, in which sialendoscopy plays a major role, has made the preservation of the gland and its function possible in over 90% of cases. Ductal incision procedures are the most important measure in submandibular duct stenoses, but sialendoscopy becomes more important in the more centrally located stenoses. Sialendoscopic controlled opening and dilation is the dominating method in parotid duct stenoses. In 10-15% of cases, success can be achieved after a combined treatment regime had been applied. This review article aims to give an overview on the epidemiology, diagnostics and current state of the art of the treatment of salivary duct stenoses.
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Affiliation(s)
- M Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
| | - H Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
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16
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Clinical efficacy of botulinum toxin in salivary duct stenosis: A preliminary study of six cases. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:349-352. [DOI: 10.1016/j.jormas.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/15/2017] [Accepted: 09/03/2017] [Indexed: 11/20/2022]
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Choi JS, Choi YG, Kim YM, Lim JY. Clinical outcomes and prognostic factors of sialendoscopy in salivary duct stenosis. Laryngoscope 2017; 128:878-884. [PMID: 28988448 DOI: 10.1002/lary.26897] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/13/2017] [Accepted: 08/11/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study aimed to analyze the clinical outcomes of sialendoscopy in patients with salivary duct stenosis and to investigate factors associated therewith. STUDY DESIGN Retrospective case series. METHODS This study included 47 patients with salivary stenosis who underwent sialendoscopy between January 2014 and December 2015. Subjective symptom, salivary flow rate, salivary scintigraphy, and radiologic evaluation using magnetic resonance (MR) sialography were performed preoperatively; direct ductal findings were evaluated during sialendoscopy. Univariate and multivariate analyses of factors influencing the patient-reported outcomes (complete, partial, or no improvement at 3 months after sialendoscopy) were conducted. RESULTS Stenosis severity was graded according to sialendoscopic findings. Seventeen patients were classified with grade I stenosis, 18 patients with grade II stenosis, and 12 patients with grade III stenosis. Symptoms completely disappeared in 21 patients (44.7%) after sialendoscopic procedures. In 19 patients (40.4%), symptoms were partially improved. Seven patients (14.9%) showed no improvement or worsening of symptoms. In univariate analysis, symptom score, stimulatory salivary flow rate, Tmin (time interval from stimulation to minimal count on salivary scintigraphy), type of stenosis on MR sialography, and sialendoscopic grade were found to be significantly associated with treatment outcomes. In multivariate analysis, Tmin , stenosis type of MR sialography, and sialendoscopic grade remained significantly associated with outcomes after sialendoscopy. CONCLUSIONS Sialendoscopic procedures were found to be clinically satisfactory for relieving the symptoms of patients with salivary stenosis. Factors related to the severity of ductal stenosis such as Tmin , stenosis type of MR sialography, and sialendoscopic grade were significantly associated with the success of sialendoscopic treatment for salivary duct stenosis. LEVEL OF EVIDENCE 4. Laryngoscope, 128:878-884, 2018.
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Affiliation(s)
- Jeong-Seok Choi
- Department of Otorhinolaryngology, Inha University College of Medicine, Incheon, South Korea
| | - Yoon-Gi Choi
- Department of Otorhinolaryngology, Inha University College of Medicine, Incheon, South Korea
| | - Young-Mo Kim
- Department of Otorhinolaryngology, Inha University College of Medicine, Incheon, South Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
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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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Ng SK, Chan JYK, Wong EWY, Vlantis AC. Diagnostic accuracy of sialendoscopy referenced to current imaging modalities. SURGICAL PRACTICE 2017. [DOI: 10.1111/1744-1633.12239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Siu-Kwan Ng
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Jason Ying-Kuen Chan
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Eddy Wai-Yeung Wong
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Alexander Chris Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
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Diggelmann HR, Hoffman HT. Intraductal infusion of steroids in patients with Sjögren syndrome to treat painful salivary swelling: Report of 2 cases. EAR, NOSE & THROAT JOURNAL 2016; 94:238-9. [PMID: 26053983 DOI: 10.1177/014556131509400611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Painful salivary swelling in patients with Sjögren syndrome presents the clinician with a difficult-to-manage condition, and treatment options are limited. We report 2 cases that demonstrate the utility of a clinic-based intraductal corticosteroid infusion for the treatment of painful salivary swelling associated with Sjögren syndrome. Steroid infusion is a cost-effective, simple-to-perform, well-tolerated gland-sparing procedure that may yield good clinical results in selected patients.
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Affiliation(s)
- Henry R Diggelmann
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., 21264 PFP, Iowa City, IA, 52242-1078, USA
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Bathala S, Makura ZG. Duplication of the right internal jugular vein: A case report. EAR, NOSE & THROAT JOURNAL 2016; 94:236-7. [PMID: 26053982 DOI: 10.1177/014556131509400610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We present a case of duplication of the right internal jugular vein (IJV) in a patient who underwent neck dissection as part of the management of carcinoma of the larynx. The patient was a 63-year-old man who presented to the otolaryngology department with a 7-month history of hoarseness and a 3-week history of noisy breathing. Flexible endoscopy detected a transglottic tumor that had extended beyond the vocal folds. The patient underwent a total laryngectomy and bilateral selective neck dissection at levels II-VI. Intraoperatively, the right IJV was noted to be duplicated. The duplicate segment was approximately 10 cm in length, and it rejoined the normal vein before the normal vein joined the subclavian vein.
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Affiliation(s)
- Srinivasalu Bathala
- ENT Department, Royal Liverpool and Broadgreen University Hospitals, Kent Lodge, Thomas Dr., Liverpool, UK L14 3LB.
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22
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Koch M, Iro H. Extended and treatment-oriented classification of parotid duct stenosis. Laryngoscope 2016; 127:366-371. [PMID: 27346484 DOI: 10.1002/lary.26079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To provide an extended and treatment-oriented classification of parotid duct stenosis that might be useful in the management of this condition. STUDY DESIGN Retrospective study in a tertiary referral center. METHODS A total of 550 symptomatic stenoses of the parotid gland excretory duct in 445 patients were analyzed. Sialendoscopy was performed with semirigid endoscopes. The tissue quality, location, grade of luminal narrowing, and length and number of the stenoses were assessed. RESULTS Inflammation-dominant stenosis (type 1) was found in 8.9% of the patients, web-associated fibrous stenosis (type 2) in 19.5%, and fibrous (type 3) in 71.6%. Multiple stenoses (≥3) were found in 2.8% of patients, and bilateral stenoses in 11.9%. Type 1 stenoses differed significantly from type 3 stenoses, with lower grades. Type 3 stenoses showed significantly higher grades of luminal narrowing than the other two types (P = .0001). Type 2 stenoses were significantly shorter in comparison with the other two types (P = .0001). Multiple stenoses were observed significantly more often in type 2 than in type 3 stenoses (P = .0001). Due to these differences, the type of stenosis appears to be the most important criterion in the treatment-oriented classification. CONCLUSIONS Significant differences between the different stenoses were observed. Type 1 stenosis may be considered as a precursor of type 3 stenosis, but type 2 stenosis showed significantly different characteristics. The differences prescribed in this classification may be helpful in the management of parotid duct stenoses. LEVEL OF EVIDENCE 4. Laryngoscope, 2016 127:366-371, 2017.
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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Kandl JA, Ong AA, Gillespie MB. Pull-through sialodochoplasty for Stensen's megaduct. Laryngoscope 2016; 126:2003-5. [DOI: 10.1002/lary.25983] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/14/2016] [Accepted: 02/25/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Jessica A. Kandl
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
| | - Adrian A. Ong
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
| | - M. Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
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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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Koch M, Künzel J, Iro H, Psychogios G, Zenk J. Long-term results and subjective outcome after gland-preserving treatment in parotid duct stenosis. Laryngoscope 2014; 124:1813-8. [DOI: 10.1002/lary.24534] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/18/2013] [Accepted: 11/18/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Julian Künzel
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Georgios Psychogios
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology and Head and Neck Surgery; University of Erlangen-Nuremberg; Germany
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Ianovski I, Morton RP, Ahmad Z. Patient-perceived outcome after sialendoscopy using the glasgow benefit inventory. Laryngoscope 2014; 124:869-74. [DOI: 10.1002/lary.24343] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/15/2013] [Accepted: 07/15/2013] [Indexed: 12/15/2022]
Affiliation(s)
- Ilia Ianovski
- Department of Otolaryngology-Head and Neck Surgery; Counties Manukau District Health Board; Auckland New Zealand
| | - Randall P. Morton
- Department of Otolaryngology-Head and Neck Surgery; Counties Manukau District Health Board; Auckland New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery; Counties Manukau District Health Board; Auckland New Zealand
- Department of Surgery; University of Auckland; Auckland New Zealand
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27
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Koch M, Iro H, Bozzato A, Zenk J. Sialendoscopy-assisted microsurgical repair of traumatic transection of Stensen's duct. Laryngoscope 2013; 123:3074-7. [DOI: 10.1002/lary.23412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 04/05/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
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Kopeć T, Szyfter W, Wierzbicka M, Nealis J. Stenoses of the salivary ducts-sialendoscopy based diagnosis and treatment. Br J Oral Maxillofac Surg 2013; 51:e174-7. [DOI: 10.1016/j.bjoms.2012.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 08/09/2012] [Indexed: 10/27/2022]
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Tran SD, Liu Y, Xia D, Maria OM, Khalili S, Wang RWJ, Quan VH, Hu S, Seuntjens J. Paracrine effects of bone marrow soup restore organ function, regeneration, and repair in salivary glands damaged by irradiation. PLoS One 2013; 8:e61632. [PMID: 23637870 PMCID: PMC3634855 DOI: 10.1371/journal.pone.0061632] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 03/11/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There are reports that bone marrow cell (BM) transplants repaired irradiated salivary glands (SGs) and re-established saliva secretion. However, the mechanisms of action behind these reports have not been elucidated. METHODS To test if a paracrine mechanism was the main effect behind this reported improvement in salivary organ function, whole BM cells were lysed and its soluble intracellular contents (termed as "BM Soup") injected into mice with irradiation-injured SGs. The hypothesis was that BM Soup would protect salivary cells, increase tissue neovascularization, function, and regeneration. Two minor aims were also tested a) comparing two routes of delivering BM Soup, intravenous (I.V.) versus intra-glandular injections, and b) comparing the age of the BM Soup's donors. The treatment-comparison group consisted of irradiated mice receiving injections of living whole BM cells. Control mice received irradiation and injections of saline or sham-irradiation. All mice were followed for 8 weeks post-irradiation. RESULTS BM Soup restored salivary flow rates to normal levels, protected salivary acinar, ductal, myoepithelial, and progenitor cells, increased cell proliferation and blood vessels, and up-regulated expression of tissue remodeling/repair/regenerative genes (MMP2, CyclinD1, BMP7, EGF, NGF). BM Soup was as an efficient therapeutic agent as injections of live BM cells. Both intra-glandular or I.V. injections of BM Soup, and from both young and older mouse donors were as effective in repairing irradiated SGs. The intra-glandular route reduced injection frequency/dosage by four-fold. CONCLUSION BM Soup, which contains only the cell by-products, can be advantageously used to repair irradiation-damaged SGs rather than transplanting whole live BM cells which carry the risk of differentiating into unwanted/tumorigenic cell types in SGs.
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Affiliation(s)
- Simon D. Tran
- Faculty of Dentistry, McGill University, Montreal, Quebec City, Canada
- * E-mail:
| | - Younan Liu
- Faculty of Dentistry, McGill University, Montreal, Quebec City, Canada
| | - Dengsheng Xia
- Faculty of Dentistry, McGill University, Montreal, Quebec City, Canada
| | - Ola M. Maria
- Faculty of Dentistry, McGill University, Montreal, Quebec City, Canada
| | - Saeed Khalili
- Faculty of Dentistry, McGill University, Montreal, Quebec City, Canada
| | | | - Vu-Hung Quan
- Centre Hospitalier de l’Université de Montréal, Montreal, Quebec City, Canada
| | - Shen Hu
- School of Dentistry, University of California Los Angeles, Los Angeles, California, United States of America
| | - Jan Seuntjens
- Department of Oncology, Medical Physics Unit, McGill University, Montreal, Quebec City, Canada
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Combined endoscopic–transcutaneous surgery in parotid gland sialolithiasis and other ductal diseases: reporting medium- to long-term objective and patients′ subjective outcomes. Eur Arch Otorhinolaryngol 2012; 270:1933-40. [DOI: 10.1007/s00405-012-2286-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
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Gillespie MB, Intaphan J, Nguyen SA. Endoscopic-assisted management of chronic sialadenitis. Head Neck 2011; 33:1346-51. [DOI: 10.1002/hed.21620] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 08/03/2010] [Accepted: 08/12/2010] [Indexed: 01/18/2023] Open
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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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Koch M, Iro H, Zenk J. [Stenosis and other non-sialolithiasis-related obstructions of the major salivary gland ducts. Modern treatment concepts]. HNO 2010; 58:218-24. [PMID: 20213107 DOI: 10.1007/s00106-009-2076-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The treatment of stenoses and non-stone-related obstructive diseases of the major salivary glands has undergone significant changes due to the development of minimally invasive treatment modalities. Correct diagnosis can often not be established in detail with all diagnostic tools except sialendoscopy, which is necessary for gland-preserving therapy. Over the last 10 years a range of minimally invasive treatment approaches aimed at preserving gland function have been developed. In addition to sialography-controlled therapy, interventional sialendoscopy plays a central role, representing the treatment of first choice in all stenoses and non-stone-related obstructions of the salivary duct system and with a success rate of about 85%-90%. By combining sialendoscopy with other minimally invasive surgical procedures, the function of the gland can be preserved in more than 95%. Thus sialendoscopy plays a crucial role in the treatment of non-stone-related obstructive diseases of the major salivary glands. In stenoses of the salivary gland ducts extirpation of the gland should be considered only as a last step.
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Affiliation(s)
- M Koch
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen.
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Sialendoscopy in children. Int J Pediatr Otorhinolaryngol 2010; 74:347-50. [PMID: 20116866 DOI: 10.1016/j.ijporl.2009.12.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Revised: 12/17/2009] [Accepted: 12/18/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND The definitive cause of most cases of recurrent salivary gland inflammation in children remains unknown. Relatively little has been written about the use of sialendoscopy as a diagnostic and therapeutic tool in children. OBJECTIVE To evaluate the safety and efficacy of sialendoscopy as a diagnostic and therapeutic tool for recurrent salivary gland inflammation in children. STUDY DESIGN Retrospective case series. METHODS Medical records of all patients who underwent sialendoscopy for recurrent salivary gland inflammation from a single tertiary-care pediatric otolaryngology practice were reviewed. Comparison of pre-procedure vs. post-procedure frequency and severity of disease was reviewed. Operative reports, images, and video were analyzed for causes of inflammation. RESULTS Six patients (aged 3-16 years old) underwent sialendoscopy (3/6 bilateral parotid, 2/6 unilateral parotid, 1/6 unilateral submandibular). There were no complications. No post-operative recurrence was noted in 3/6 patients; decreased frequency of recurrence was noted in 2/6 patients; repeat sialendoscopy was required in 1/6. Operative findings from sialendoscopy from 10 parotid glands showed fibrinous debris (7/10), mucoid debris (1/10), purulent debris (1/10), or duct stenosis (1/10). No stones were noted. CONCLUSIONS Sialendoscopy is a safe, minimally invasive procedure that may decrease the frequency of recurrences for salivary gland inflammation in children. In contrast to previously published work, the most common cause of salivary gland obstruction in this series was debris, rather than stones. Increased use of sialendoscopy as a diagnostic and therapeutic tool will allow for improved understanding of the causes of and management for recurrent salivary gland inflammation in children.
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Abstract
When basic surgical principles are followed diagnostic salivary endoscopy is a relatively safe operative procedure. Therapeutic sialendoscopy uses such instrumentation as lasers, forceps, baskets, and balloons for endoductal fragmentation, retrieval, and dilatation. Based on experience acquired from more than 300 salivary endoscopy procedures and a review of the current literature, the most relevant operative techniques are presented.
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Affiliation(s)
- Urban W Geisthoff
- University of the Saarland, Medical Faculty, Kirrberger Street, D-66421 Homburg/Saar, Germany
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Combined Endoscopic and Transcutaneous Approach for Parotid Gland Sialolithiasis: Indications, Technique, and Results. Otolaryngol Head Neck Surg 2010; 142:98-103. [DOI: 10.1016/j.otohns.2009.10.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 08/26/2009] [Accepted: 10/19/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE: Despite all the advances of minimally invasive surgery, refractory stones remain in 10 to 20 percent of all cases of parotid gland sialolithiasis, and persistence of the symptoms makes removal of the gland inevitable. In some of these cases, however, it may be possible to conserve the gland using a combination of endoscopic and transcutaneous procedures. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Nine patients treated with a combined endoscopic transcutaneous operation were evaluated. During this procedure, the stone is removed through a skin incision under endoscopic guidance. Indications were sialolithiasis refractory to treatment (n = 5), sialolithiasis with complications (n = 2), contraindications to primary minimally invasive surgery (n = 1), and primary treatment (n = 1). In seven cases, the stones were extracted. Simultaneous resection of a sialocele was carried out in one case, and simultaneous resection of a saliva-cutaneous fistula was carried out in another. A stent was inserted in 66.7 percent of the cases. RESULTS: Treatment was successful in 88.9 percent of the patients. All of these patients were free of stones and symptoms, and glandular function was maintained both clinically and on ultrasound assessment. Complete parotidectomy had to be carried out in one case because it was not possible to reconstruct the duct system. CONCLUSION: The combined operation offers a further option for gland-conserving treatment in cases with obstructive salivary gland disease, especially sialolithiasis. At present, it is indicated for cases that are resistant to treatment after sialendoscopy or extracorporeal shock wave lithotripsy. The gland resection rate can thus be further reduced.
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Ardekian L, Shamir D, Trabelsi M, Peled M. Chronic Obstructive Parotitis Due to Strictures of Stenson's Duct—Our Treatment Experience With Sialoendoscopy. J Oral Maxillofac Surg 2010; 68:83-7. [DOI: 10.1016/j.joms.2009.08.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 08/18/2009] [Indexed: 11/17/2022]
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Koch M, Zenk J, Iro H. Algorithms for Treatment of Salivary Gland Obstructions. Otolaryngol Clin North Am 2009; 42:1173-92, Table of Contents. [DOI: 10.1016/j.otc.2009.08.002] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Harrison JD. Causes, Natural History, and Incidence of Salivary Stones and Obstructions. Otolaryngol Clin North Am 2009; 42:927-47, Table of Contents. [DOI: 10.1016/j.otc.2009.08.012] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Capaccio P, Torretta S, Pignataro L. The Role of Adenectomy for Salivary Gland Obstructions in the Era of Sialendoscopy and Lithotripsy. Otolaryngol Clin North Am 2009; 42:1161-71, Table of Contents. [DOI: 10.1016/j.otc.2009.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zenk J, Iro H, Klintworth N, Lell M. Diagnostic Imaging in Sialadenitis. Oral Maxillofac Surg Clin North Am 2009; 21:275-92. [DOI: 10.1016/j.coms.2009.04.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Koch M, Iro H, Zenk J. Sialendoscopy-based diagnosis and classification of parotid duct stenoses. Laryngoscope 2009; 119:1696-703. [DOI: 10.1002/lary.20522] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kruegel J, Winterhoff J, Koehler S, Matthes P, Laskawi R. Botulinum toxin: A noninvasive option for the symptomatic treatment of salivary gland stenosis-A case report. Head Neck 2009; 32:959-63. [DOI: 10.1002/hed.21150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Marchal F, Chossegros C, Faure F, Delas B, Bizeau A, Mortensen B, Schaitkin B, Buchwald C, Cenjor C, Yu C, Campisi D, Eisele D, Greger D, Trikeriotis D, Pabst G, Kolenda J, Hagemann M, Tarabichi M, Guntinas-Lichius O, Homoe P, Carrau R, Irvine R, Studer R, Wang S, Fischer U, Van der Poorten V, Saban Y, Barki G. [Salivary stones and stenosis. A comprehensive classification]. ACTA ACUST UNITED AC 2008; 110:e1-4. [PMID: 19108856 DOI: 10.1016/j.stomax.2008.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Accepted: 07/23/2008] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Sialendoscopy and sialo-MRI enable diagnosis of salivary gland obstructive pathologies, such as lithiasis, stenosis and dilatations. Therefore, a classification of these pathologies is needed, allowing large series comparisons, for better diagnosis and treatment of salivary pathologies. MATERIAL AND METHODS With help from people from the European Sialendoscopy Training Center (ESTC), the results of sialographies, sialoMRI and sialendoscopies, a comprehensive classification of obstructive salivary pathologies is described, based on the absence or presence of lithiasis (L), stenosis (S) and dilatation (D) ("LSD" classification). DISCUSSION It appears that a classification of salivary gland obstructive pathologies should be described. We hope it will be widely used and of course criticized to be improved and to compare the results of salivary gland diagnostic methods, such as sialography and sialendoscopy and also the results and indications for salivary gland therapeutic methods, such as lithotripsy, sialendoscopy and/or open surgery.
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Affiliation(s)
- F Marchal
- Clinique Générale Beaulieu, 20, Chemin Beau-Soleil, 1206 Geneva, Switzerland
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Marchal F, Chossegros C, Faure F, Delas B, Bizeau A, Mortensen B, Schaitkin B, Buchwald C, Cenjor C, Yu C, Campisi D, Eisele D, Greger D, Trikeriotis D, Pabst G, Kolenda J, Hagemann M, Tarabichi M, Guntinas-Lichius O, Homoe P, Carrau R, Irvine R, Studer R, Wang S, Fischer U, Van der Poorten V, Saban Y, Barki G. Salivary stones and stenosis. A comprehensive classification. ACTA ACUST UNITED AC 2008; 109:233-6. [DOI: 10.1016/j.stomax.2008.07.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Accepted: 07/23/2008] [Indexed: 11/29/2022]
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