1
|
Soriano-Martín D, García-Consuegra L, Junquera L, Reda S, Junquera S. Juvenile Recurrent Parotitis: Video-Documented Sialendoscopy. J Clin Med 2023; 12:6842. [PMID: 37959307 PMCID: PMC10649241 DOI: 10.3390/jcm12216842] [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: 08/14/2023] [Revised: 10/01/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Juvenile recurrent parotitis (JRP) is characterised by recurrent episodes of painful parotid swelling in children. JRP is the second most common cause of parotitis in childhood, behind only paramyxovirus. The prevention of recurrent attacks represents the most dramatic and serious aspect of this pathology. Since 2004, different authors have evaluated sialendoscopy for the diagnostic and therapeutic management of JRP. In this paper, we share our clinical experience of the use of sialendoscopy for the treatment of JRP. We document with video sialendoscopy the glandular pathology in four children with a mean age of 11.5 years, who had suffered from 3-6 episodes/year of inflammation prior to treatment. The use of sialendoscopy in our patients was effective in preventing recurrences. For the first time, the videosialendoscopy of a series of children diagnosed with JRP is documented in the literature.
Collapse
Affiliation(s)
- David Soriano-Martín
- Department of Oral and Maxillofacial Surgery, Central University Hospital of Asturias, 33011 Oviedo, Spain
| | - Luis García-Consuegra
- Department of Oral and Maxillofacial Surgery, Central University Hospital of Asturias, 33011 Oviedo, Spain
| | - Luis Junquera
- Department of Oral and Maxillofacial Surgery, Central University Hospital of Asturias, 33011 Oviedo, Spain
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine and Health Sciences, University of Oviedo, C/. Catedrático Serrano s/n., 33006 Oviedo, Spain
| | - Sara Reda
- Department of Otolaringology, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Sonsoles Junquera
- Department of Radiology, San Agustín University Hospital, 33401 Avilés, Spain
| |
Collapse
|
2
|
Soriano-Martín D, García-Consuegra L, Junquera L, Rodríguez-Santamarta T, Olay S, Junquera-Olay S. Sialendoscopy approach in treating juvenile recurrent parotitis: a systematic review. J Otolaryngol Head Neck Surg 2023; 52:53. [PMID: 37598195 PMCID: PMC10440031 DOI: 10.1186/s40463-023-00658-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/12/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling in children. The purpose of this systematic review was to determine the diagnostic and therapeutic effectiveness of sialendoscopy in children affected by JRP. METHODS A systematic literature search was performed in PubMed, EMBASE, Scopus and the Cochrane Library until April 2022, without language restrictions or specified start date. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS). RESULTS Our review included 524 patients and 646 sialendoscopies. The sample sizes of the different studies ranged from 3 to 77 subjects. Most authors performed sialendoscopy under general anesthesia. The mean percentage of recurrences observed was 25.1% (95% confidence intervals) (CI 23.6-26.6). There was a statistically significant relationship between the number of attacks/year and recurrences (p < 0.05). The percentage of recurrences according to the type of irrigation/flushing used ranged from 22.2% to 25.2%, with no significant differences between the use of corticosteroids alone (25.2% of recurrences), corticosteroids plus antibiotics (25% of recurrences) or saline alone (22.2% of recurrences). Sialoendoscopy has proved in all cases to be a valid method for the diagnosis of JRP, but it does not allow a reliable differential diagnosis with other autoimmune parotitis such as Sjögren's syndrome. CONCLUSION According to our results, parotid sialoendoscopy was 74.9% effective as a primary treatment in the prevention of recurrent symptoms in JRP. The type of ductal irrigation used did not significantly influence the prognostic outcome.
Collapse
Affiliation(s)
- D Soriano-Martín
- Department Maxillofacial Surgery, Central University Hospital of Asturias, Avenida de Roma, 33011, Oviedo, Spain.
| | - L García-Consuegra
- Department Maxillofacial Surgery, Central University Hospital of Asturias, Avenida de Roma, 33011, Oviedo, Spain
| | - L Junquera
- Department of Surgery, Oviedo University, Julian Clavería, 33009, Oviedo, Spain
| | - T Rodríguez-Santamarta
- Department Maxillofacial Surgery, Central University Hospital of Asturias, Avenida de Roma, 33011, Oviedo, Spain
| | - S Olay
- Department of Surgery, Oviedo University, Julian Clavería, 33009, Oviedo, Spain
| | - S Junquera-Olay
- Department of Radiology, San Agustin University Hospital, 33410, Heros Avilés, Spain
| |
Collapse
|
3
|
Liljekvist MS, Foghsgaard J, Howitz MF. Sialendoscopy for pediatric salivary gland disorders: a study of safety and effect. Eur Arch Otorhinolaryngol 2023; 280:1927-1937. [PMID: 36478117 DOI: 10.1007/s00405-022-07747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Sialendoscopy has become the preferred modality for managing pediatric salivary gland disorders (PSGD) including juvenile recurrent parotitis (JRP) and sialolithiasis. The literature remains sparse, but several case series have reported good outcomes and few complications. The aim of this study was to investigate the safety and efficacy of sialendoscopy for PSGD in a Danish setting. METHODS From a national sialendoscopy database, we included records of children who had undergone sialendoscopy for PSGD at our clinic over a 6-year period. Clinical and intraoperative data, follow-up and e-mail surveys after 1, 3 and 5 years were retrieved for analysis. RESULTS We included 52 procedures on 50 glands (32 parotid, 18 submandibular) in 49 children. Of eligible patients, 90% attended clinical follow-up, 80% answered the survey after 1 year, 80% after 3 years and 60% after 5 years. JRP was diagnosed in 33 cases, obstructive causes in 18 cases. Complications noted were ductal perforation (2%), transient lingual nerve affection (4%) and infection (2%). For JRP patients, overall symptoms had improved for 96% after 3 months, 81% after 1 year and 83% after 3 years. For patients suffering from obstruction, overall symptoms were improved for 93% after 3 months and for 100% after 1 year. CONCLUSION Sialendoscopy is a safe procedure for PSGD, and effective for sialolithiasis and symptom reduction in JRP.
Collapse
Affiliation(s)
- Mads S Liljekvist
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark.
| | - Jakob Foghsgaard
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
| | - Michael F Howitz
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
| |
Collapse
|
4
|
Pediatric Sialendoscopy. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00415-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Abstract
Purpose of Review
To describe the pathophysiology, evaluation, and management of sialadenitis as well as the indications for and outcomes of sialendoscopy in the pediatric population.
Recent Findings
Pediatric sialadenitis makes up a small proportion of all salivary gland disease. Acute viral sialadenitis and juvenile recurrent parotitis are the most common forms of the condition. Juvenile recurrent parotitis is thought to be multifactorial in etiology with infectious, behavioral, autoimmune, and structural contributions. Review of the current literature supports a potential benefit from sialendoscopy for children with recurrent acute or chronic sialadenitis. Sialendoscopy can provide both diagnostic and therapeutic benefits with very low associated risks. The most common sialendoscopy findings include intraductal sludge or debris, sialoliths, and ductal strictures.
Summary
In the select pediatric population, sialendoscopy is a safe and effective procedure with associated decreased rates of recurrent acute sialadenitis including juvenile recurrent parotitis.
Collapse
|
5
|
Chen T, Szwimer R, Daniel SJ. The changing landscape of pediatric salivary gland stones: A half-century systematic review. Int J Pediatr Otorhinolaryngol 2022; 159:111216. [PMID: 35777140 DOI: 10.1016/j.ijporl.2022.111216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/06/2022] [Accepted: 06/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the evidence for pediatric sialolithiasis, including its demographic characteristics, diagnosis, and demonstrate the shift in its treatment paradigm. DESIGN A systematic review of sources from the Medline and Embase databases was conducted from inception to Dec 4, 2020. Two researchers independently extracted data and assessed quality. PATIENTS Patients under the age of 18 with sialolithiasis were included. MAIN OUTCOME MEASURES Study design, cohort size, age, sex, symptoms, stone characteristics, diagnostic modality and intervention were collected data points. RESULTS Forty-one studies with 243 patients were included in the review, of which 40 were case reports or series. Most stones were found in the submandibular gland (n = 210, 85.4%) and were single stones (n = 101, 71.1%). Average stone size was 7.7 mm. The most common diagnostic imaging modality used was ultrasound (n = 73, 47.4%), shifting from plain radiograph which was favoured in earlier years. Similarly, open gland excision was historically preferred, but since 2000, sialoendoscopy comprised 40.5% of all treatment modalities and continues to increase in prevalence, up to 52.1% by 2020. Extracorporeal shock wave lithotripsy was associated with the highest complication rate of 54.2%. CONCLUSIONS The pediatric sialolithiasis diagnostic and therapeutic landscape has changed with ultrasound replacing plain radiographs, and sialoendoscopy replacing submandibular gland excision. Further high-level quality evidence research is required to refine the indications, effectiveness, and safety of sialoendoscopy in pediatric sialolithiasis.
Collapse
Affiliation(s)
- Tanya Chen
- Department of Otolaryngology Head & Neck Surgery, University of Toronto, Toronto, Canada
| | - Rachel Szwimer
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Sam J Daniel
- Department of Otolaryngology Head & Neck Surgery, Montreal Children's Hospital, Montreal, Canada.
| |
Collapse
|
6
|
Geisthoff UW, Droege F, Schulze C, Birk R, Rudhart S, Maune S, Stuck BA, Hoch S. Treatment of juvenile recurrent parotitis with irrigation therapy without anesthesia. Eur Arch Otorhinolaryngol 2021; 279:493-499. [PMID: 34117898 PMCID: PMC8739303 DOI: 10.1007/s00405-021-06928-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
Purpose No standardized treatment regimen exists for juvenile recurrent parotitis (JRP). The investigators hypothesized that irrigation with saline only without local anesthesia will be an effective and beneficial option.
Methods Using a retrospective study design, a series of children with typical symptoms of JRP who were treated with at least one irrigation therapy were evaluated. This treatment consisted of irrigation of the affected gland with 3–10 ml saline solution without any type of anesthesia. The outcome variables were patient/parent satisfaction, frequency and duration of acute JRP episodes, and the need for antibiotics before and after irrigation therapy. Results The case series was composed of six boys aged 3.3–7.7 years who experienced one to eight sessions of irrigation therapy. The period of follow-up was 9–64 months. We observed a total resolution of symptoms in two children and an improvement in the other four. No relevant side effects were seen. Conclusion Our results suggest that irrigation therapy is a reasonable, simple, and minimally invasive treatment alternative for JRP. In contrast to sialendoscopy or sialography, there is no need for general anesthesia or radiation exposure.
Collapse
Affiliation(s)
- Urban W Geisthoff
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, 35043, Baldingerstraße, Germany
| | - Freya Droege
- Department of Otorhinolaryngology, Essen University Hospital, Essen, Germany
| | - Cathrin Schulze
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, 35043, Baldingerstraße, Germany
| | - Richard Birk
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, 35043, Baldingerstraße, Germany
| | - Stefan Rudhart
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, 35043, Baldingerstraße, Germany
| | - Steffen Maune
- Department of Otorhinolaryngology, Hospitals of the City of Cologne, Cologne, Germany
| | - Boris A Stuck
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, 35043, Baldingerstraße, Germany
| | - Stephan Hoch
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, 35043, Baldingerstraße, Germany.
| |
Collapse
|
7
|
Iordanis K, Panagiotis D, Angelos C, Antonios M, Alexander D, Sofia A, Efimia PA. Unilateral Sialendoscopy for Juvenile Recurrent Parotitis: What Happens to the Other Side? Laryngoscope 2020; 131:1404-1409. [PMID: 33098313 DOI: 10.1002/lary.29187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/02/2020] [Accepted: 10/02/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE/HYPOTHESIS Current literature has confirmed the benefits of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). However, this procedure is often performed unilaterally, although the disease can affect both sides. This article investigated the clinical course of the contralateral parotid (CL) gland in children requiring unilateral sialendoscopy with the goal of clarifying the necessity of primary bilateral sialendoscopy. STUDY DESIGN Prospective cohort study in a tertiary center. METHODS Over an eight-year period, 77 children with JRP underwent unilateral sialendoscopy. We observed the clinical course of the CL parotid over a minimum follow-up period of 24 months. New episodes of sialadenitis were recorded on both sides along with the need for a second sialendoscopy. These data were correlated with the preoperative symptoms of the contralateral side as well as ultrasound (U/S) findings at baseline assessment. RESULTS In total, six children required sialendoscopy on the CL side (7.8%), 62 children remained asymptomatic or with scarce swellings (80.5%), and nine children improved (11.7%). The preoperative U/S findings on the CL side positively correlated with the number of postoperative swellings. The proportion of children needing CL sialendoscopy was higher (21.4%) among children needing a second sialendoscopy on the operated side. CONCLUSIONS In the long term, the vast majority of children needing unilateral sialendoscopy do not require similar treatment of the CL parotid gland. However, a history of bilateral swellings along with U/S findings of parenchymal disorganization on the CL side significantly increases the risk of needing further sialendoscopy at a later time. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1404-1409, 2021.
Collapse
Affiliation(s)
- Konstantinidis Iordanis
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, School of Medicine, Thessaloniki, Greece
| | - Dogantzis Panagiotis
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, School of Medicine, Thessaloniki, Greece
| | - Chatziavramidis Angelos
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, School of Medicine, Thessaloniki, Greece
| | - Metzikofis Antonios
- 4th Department of Pediatrics, Aristotle University, School of Medicine, Papageorgiou Hospital, Thessaloniki, Greece
| | - Delides Alexander
- 2nd Academic ORL Department, Attikon Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece
| | - Alataki Sofia
- 4th Department of Pediatrics, Aristotle University, School of Medicine, Papageorgiou Hospital, Thessaloniki, Greece
| | - Papadopoulou-Alataki Efimia
- 4th Department of Pediatrics, Aristotle University, School of Medicine, Papageorgiou Hospital, Thessaloniki, Greece
| |
Collapse
|
8
|
Kanerva M, Tapiovaara L, Aro K, Saarinen R. Pediatric sialendoscopy: An 11-year study from a single tertiary care center. Int J Pediatr Otorhinolaryngol 2020; 131:109869. [PMID: 31972384 DOI: 10.1016/j.ijporl.2020.109869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate the suitability, benefits, and limitations of sialendoscopy for pediatric patients. METHODS We performed a retrospective analysis of all pediatric sialendoscopy patients (aged 16 years or younger) in our tertiary care institution between September 2007 and October 2018. We characterized patient data, procedure-related factors, complications, and outcomes. RESULTS In total, 55 sialendoscopies were performed on 42 patients. Among these, 36 were diagnostic endoscopies and 19 were interventional. Five endoscopies were performed under local anesthesia. We identified 16 sialolithiasis patients, where removal of a sialolith was possible in 11 (69%) cases; one case required a second endoscopy. We removed two sialoliths under local anesthesia. Among recurrent juvenile parotitis (RJP) patients, 18/20 (90%) were symptom-free after a single sialendoscopy, and all after a second endoscopy. The median follow-up time was 70 months. We achieved a 95% success rate in sialendoscopies, with a failure-to-treat rate of 15%. The complication rate for the study cohort was 2%, with prolonged parotid swelling the only complication encountered. CONCLUSIONS Sialendoscopy represented a safe and effective method to treat pediatric patients. Local anesthesia was successful in selected cases, even for sialolith removal. Sialendoscopy had a soothing effect on RJP and the majority of sialoliths were suitable for endoscopic removal.
Collapse
Affiliation(s)
- Mervi Kanerva
- 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
| | - Katri Aro
- 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
| |
Collapse
|