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Sonar PR, Panchbhai A, Dhole P. Sialolithiasis in the Left Submandibular Gland: A Case. Cureus 2023; 15:e48999. [PMID: 38111416 PMCID: PMC10726080 DOI: 10.7759/cureus.48999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/18/2023] [Indexed: 12/20/2023] Open
Abstract
The most common illness affecting the salivary glands is submandibular gland sialoliths. The size of the sialolith and the patient's clinical history mainly influence how this salivary system abnormality is treated. This diagnosis is suggested by a history of salivary gland pain or swelling, particularly during mastication. Palliative therapy combined with conservative therapies, such as the milking of the ducts, can effectively treat small and accessible stones. When a stone or stones are large and inaccessible, surgical therapy should be considered if conservative approaches have not proven to be effective. A case of sialolithiasis affecting the left submandibular salivary gland is described in this article. Under local anesthesia, sialolith was removed following the opening of the duct. The wound was closed with sutures, and the patient was advised to practice tongue exercises and to maintain good oral hygiene.
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Affiliation(s)
- Prasanna R Sonar
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aarati Panchbhai
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pooja Dhole
- Oral Medicine and Radiology, Vidarbha Youth Welfare Society Dental College and Hospital, Amravati, IND
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Filipov I, Cristache CM, Săndulescu M. Minimally-invasive definitive treatment of recurrent sialadenitis due to obstructive sialolithiasis - a case report. Germs 2023; 13:288-291. [PMID: 38146381 PMCID: PMC10748844 DOI: 10.18683/germs.2023.1397] [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: 07/22/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 12/27/2023]
Abstract
Introduction Salivary gland lithiasis is one of the most frequent causes of sialadenitis. We report the case of a patient who presented multiple episodes of subangulomandibular tumefaction, until salivary lithiasis was finally identified as the underlying condition and resolved through a minimally invasive approach. Case report A 43-year-old male patient presented with a history of 12 episodes of recurring one-sided subangulomandibular tumefaction over the course of the past 3 years. A computed tomography of the head and neck revealed a large calculus on Wharton's duct and right lithiasic submaxillitis. Non-steroidal anti-inflammatory treatment and antibiotic treatment was administered, and after the complete resolution of the acute process, we performed a sialendoscopically-assisted sialolithotomy with complete removal of the calculus. Following the procedure, the patient was discharged on the same day, clinically well, and displayed no further recurrences over a follow-up duration of 12 months. Conclusions The case we have reported highlights the importance of performing a correct differential diagnosis and of determining the underlying cause of recurrent sialadenitis, in order to ensure the most adequate therapeutic and, when warranted, minimally-invasive surgical management for definitive treatment.
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Affiliation(s)
- Iulian Filipov
- DDS, PhDc, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest, Romania
| | - Corina Marilena Cristache
- DDS, PhD, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, 8 Eroilor Sanitari, Bucharest, Romania
| | - Mihai Săndulescu
- DDS, PhD, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest, Romania
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Borner U, Caversaccio M, Wagner F, Marchal F, Anschuetz L. First evaluation of an ovine training model for sialendoscopy. Laryngoscope Investig Otolaryngol 2023; 8:903-911. [PMID: 37621264 PMCID: PMC10446307 DOI: 10.1002/lio2.1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/08/2023] [Accepted: 07/03/2023] [Indexed: 08/26/2023] Open
Abstract
Objective Sialendoscopy is a minimally invasive diagnostic and therapeutic technique used in the treatment of various salivary gland diseases. To date, there are very few suitable training models other than the pig's head, which has been used at the European Sialendoscopy Training Center for 22 years. The goal of this study was to describe an ovine model for sialendoscopy training and compare the ovine model's to the human anatomy. We propose a step-by-step approach for sialendoscopy training using this ex-vivo model. Methods The anatomy of the ovine salivary ducts and glands was assessed by magnetic resonance imaging using one fresh ovine head. Thereafter, the model was designed during dissection by an experienced sialendoscopist. The various steps were then validated during consecutive dissections using a Likert-scale questionnaire. Results The full model was described in the form of a dissection guide and allowed reliable diagnostic sialendoscopy in 10/10 Stenson's and in 5/10 Wharton's ducts. Moreover, interventional sialendoscopy was simulated to provide a training model for the removal of sialoliths in the Stenson's duct. The human and ovine anatomy are quite similar allowing a training experience close to reality. Conclusion We developed and evaluated an ovine model with the goal of improving training in diagnostic and interventional sialendoscopy. In particular, the Stenson's duct can be successfully prepared, probed and subjected to sialendoscopy. The realistic anatomical environment and excellent tissue quality created a life-like training experience for an experienced sialendoscopist. Further studies with beginners are necessary to validate this model as a training model. Level of Evidence 4.
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Affiliation(s)
- Urs Borner
- Department of Otorhinolaryngology – Head and Neck Surgery, InselspitalBern University Hospital and University of BernBernSwitzerland
- European Sialendoscoy Training CenterGenevaSwitzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology – Head and Neck Surgery, InselspitalBern University Hospital and University of BernBernSwitzerland
| | - Franca Wagner
- Department of Diagnostic and Interventional Neuroradiology, InselspitalUniversity Hospital Bern and University of BernBernSwitzerland
| | - Francis Marchal
- European Sialendoscoy Training CenterGenevaSwitzerland
- Department of Otolaryngology – Head and Neck SurgeryUniversity Hospitals of GenevaGenevaSwitzerland
| | - Lukas Anschuetz
- Department of Otorhinolaryngology – Head and Neck Surgery, InselspitalBern University Hospital and University of BernBernSwitzerland
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Thyrion FZ, Farneti P, Pasquini E. Sialendoscopy in Pediatric Sialolithiasis: Two Cases of Salivary Stones in the Parotid Gland and Review of the Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:857-863. [PMID: 37274989 PMCID: PMC10235292 DOI: 10.1007/s12070-023-03508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023] Open
Abstract
Sialolithiasis is one of the most common diseases of the salivary glands and the most common cause of chronic obstructive sialadenitis. Whereas salivary stones are responsible for most of the cases of obstructive sialadenitis in the adult population, sialolithiasis in children is considered relatively rare. We describe two cases of a 9 and a 4-year-old male respectively, with parotid sialolithiasis treated with sialendoscopy. A systematic review of the current literature was also completed in order to evaluate all described cases of parotid sialolithiasis in the pediatric population. We found 25 articles eligible for a total of 42 cases of pediatric parotid sialolithiasis. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03508-8.
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Affiliation(s)
| | - Paolo Farneti
- ENT Department Bologna, Azienda USL di Bologna, Via Altura 3, 40139, Bologna, Italy
| | - Ernesto Pasquini
- ENT Department Bologna, Azienda USL di Bologna, Via Altura 3, 40139, Bologna, Italy
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柳 登, 郑 丹, 赵 雅, 张 亚, 叶 欣, 张 丽, 谢 晓, 张 雷, 张 祖, 俞 光. [Recent progress in the treatment of intractable sialolithiasis]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:8-12. [PMID: 36718683 PMCID: PMC9894789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Indexed: 02/01/2023]
Abstract
Sialolithiasis occurs in approximately 0.45% to 1.20% of the general population. The typical clinical symptom manifests as a painful swelling of the affected glands after a meal or upon salivary stimulation, which extremely affects the life quality of the patients. With the development of sialendoscopy and lithotripsy, most sialoliths can be successfully removed with preservation of the gland. However, sialoliths in the deep hilar-parenchymal submandibular ducts and impacted parotid stones located in the proximal ducts continue to pose great challenges. Our research center for salivary gland diseases (in Peking University School and Hospital of Stomatology) has used sialendoscopy for 17 years and treated >2 000 patients with salivary gland calculi. The success rate was approximately 92% for submandibular gland calculi and 95% for parotid calculi. A variety of minimally invasive surgical techniques have been applied and developed, which add substantial improvements in the treatment of refractory sialolithiasis. Further, the radiographic positioning criteria and treatment strategy are proposed for these intractable stones. Most of the hilar-parenchymal submandibular stones are successfully removed by a transoral approach, including transoral duct slitting and intraductal basket grasping, while a small portion of superficial stones can be removed by a mini-incision in submandibular area. Impacted stones located in the distal third of parotid gland ducts are removed via "peri-ostium incision", which is applied to avoid a cicatricial stenosis from a direct ostium incision. Impacted parotid stones located in the middle and proximal third of the Stensen's duct are removed via a direct mini-incision or a peri-auricular flap. A direct transcutaneous mini-incision is commonly performed under local anesthesia with an imperceptible scar, and is indicated for most of impacted stones located in the middle third, hilum and intraglandular ducts. By contrast, a peri-auricular flap is performed under general anesthesia with relatively larger operational injury of the gland parenchyma, and should be best reserved for deeper intraglandular stones. Laser lithotripsy has been applied in the treatment of sialolithiasis in the past decade, and holmium ∶YAG laser is reported to have the best therapeutic effects. During the past 3 years, our research group has performed laser lithotripsy for a few cases with intractable salivary stones. From our experiences, withdrawal of the endoscopic tip 0.5-1.0 cm away from the extremity of the laser fiber, consistent saline irrigation, and careful monitoring of gland swelling are of vital importance for avoidance of injuries of the ductal wall and the vulnerable endoscope lens during lithotripsy. Larger calculi require multiple treatment procedures. The risk of ductal stenosis can be alleviated by endoscopic dilation. In summary, appropriate use of various endoscopy-assisted lithotomy helps preserve the gland function in most of the patients with refractory sialolithiasis. Further studies are needed in the following aspects: Transcervical removal of intraglandular submandibular stones, intraductal laser lithotripsy of impacted parotid stones and deep submandibular stones, evaluation of long-term postoperative function of the affected gland, et al.
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Affiliation(s)
- 登高 柳
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 丹妮 郑
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 雅宁 赵
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 亚琼 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 欣 叶
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 丽琪 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 晓艳 谢
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 雷 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 祖燕 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 光岩 俞
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification. J Clin Med 2023; 12:jcm12031129. [PMID: 36769777 PMCID: PMC9917658 DOI: 10.3390/jcm12031129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Identifying a submandibular (Wharton's) duct punctum often hinders sialendoscopy; however, there is a paucity of evidence on whether the appearance of Wharton's duct papilla impacts the sialendoscopic procedure. A classification of Wharton's duct papillae based on the macroscopic appearance, size of dilatation probes, and sialendoscopic approach was proposed herein. The classification describing four main types of papillae, A, B, C, and D, was prospectively evaluated on 351 Wharton's duct papillae in 315 patients. For each papillae type, the demographic/clinical data, intraoperative complications, and time required for sialendoscope introduction were analyzed. Estuary-like papilla (type A) was commonly seen after spontaneous stone extrusion, had no intraoperative complications noted, and had the shortest time required for the sialendoscope introduction. Normal papilla (type B) was the most frequently observed papilla (48.1%), reflecting diverse underlying pathology, while difficult papilla (type C) was often associated with unfavorable anatomical variations of the mandible or floor of the mouth. Substantially closed papilla (type D) had the highest rate of intraoperative complications, namely, perforation with a false passage, and required the longest time for the sialendoscope introduction. In seven patients (2.0%), the entrance into the duct was feasible only through the fistula, while the sialendoscope introduction failed in eight patients (2.3%). In conclusion, the appearance of Wharton's duct papillae may be influenced by the underlying pathology. Based on the proposed classification, papilla typology affects the duration of sialendoscope introduction and may influence the frequency of intraoperative complications.
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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.
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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.
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Ramazani F, Hamour A, Jeffery CC, Biron V, Alrajhi Y, O'Connell D, Côté DWJ. Development of a patient reported outcome instrument for chronic sialadenitis. J Otolaryngol Head Neck Surg 2022; 51:4. [PMID: 35120574 PMCID: PMC8815140 DOI: 10.1186/s40463-022-00555-z] [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: 05/27/2021] [Accepted: 01/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sialendoscopy assisted treatments are a minimally invasive management modality for chronic sialadenitis. Clinicians report improved patient quality of life (QoL) following sialendoscopy assisted treatments, but there exist gaps in current literature about patient reported outcomes (PROs). PROs are outcome measures developed based on patient perceptions. OBJECTIVE The objective of this study was to create a PRO instrument for chronic sialadenitis, to assess the efficacy of sialendoscopy assisted treatments in improve patients' QoL. DESIGN This four-phase qualitative study employed grounded theory methodology and a modified Delphi technique. In Phase I, ten patients were interviewed to identify the QoL domains impacted by chronic sialadenitis. In Phase II, these QoL domains were presented to a focus group of different chronic sialadenitis patients, who were asked to rank them by order of importance. A conceptual framework of QoL domains impacted by chronic sialadenitis was created based on patient consensus. Itemization of the PRO questionnaire was done by a focus group of four Otolaryngologists in phase III. Lastly, the questionnaire was completed in Phase IV by cognitive interviewing of five new chronic sialadenitis patients; ensuring ease of understanding and clarity. RESULTS Patients identified 15 domains of QoL impacted by chronic sialadenitis, divided into three sub-scales: physical symptoms, psychosocial symptoms, and activity restriction. These domains provided the basis for creation of a 22-item PRO questionnaire, with a Likert-type response scale. CONCLUSION Clinical application of the novel questionnaire produced by this study will allow for a patient-centered assessment of the patient reported effectiveness of sialendoscopy assisted therapies for management of chronic sialadenitis. Level of evidence Level V.
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Affiliation(s)
- Fatemeh Ramazani
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Amr Hamour
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Caroline C Jeffery
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Vincent Biron
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Yaser Alrajhi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Daniel O'Connell
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - David W J Côté
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 1E4 Walter C. MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2B7, Canada.
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9
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Vanden Daele A, Drubbel J, Van Lierde C, Meulemans J, Delaere P, Vander Poorten V. Long-term outcome of a cohort of 272 patients undergoing sialendoscopy. Clin Otolaryngol 2021; 47:138-145. [PMID: 34674373 DOI: 10.1111/coa.13882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/13/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the cohort of patients undergoing sialendoscopic intervention for improvement of symptoms and gland-related quality of life at long-term follow-up. DESIGN This is a retrospective review of medical records with a prospective follow-up by questionnaire. SETTING & PARTICIPANTS All patients undergoing sialendoscopy at the University Hospitals Leuven Department of Otorhinolaryngology, Head and Neck Surgery between March 2008 and June 2020. MAIN OUTCOME MEASURES The electronic files of the patients were searched for information about their sialendoscopic procedure and follow-up consultations. We also send the patients a questionnaire by mail to assess symptom control and gland-related quality of life at long-term follow-up. RESULTS Two hundred seventy-two sialendoscopies were performed in 221 patients. Median follow-up time was 37 months. The sialendoscopies were performed in 130 patients for lithiasis, in 66 for stenosis, in 14 for recurrent parotitis of childhood, in 8 for recurrent sialadenitis of unknown origin and in 3 for radioiodine-induced sialadenitis. Complications occurred in 11 of 272 sialendoscopies (4%). Those were iatrogenic perforations, temporary lingual nerve paresthesia and swelling of the floor of the mouth. 53% of patients returned the questionnaire, for a total of 146 evaluable sialendoscopies. The majority of the responders indicated that sialendoscopy had improved their symptoms (83.6%). Salivary glands could be preserved in 89% of the responder group. The highest percentage of patients reporting residual symptoms was found in the RPC group (81.3%) and the lowest in the lithiasis group (16.2%). Besides age, no statistical differences in demographic and pathological features between the responder and non-responder groups were found, supporting generalisation of the responders' results to the entire cohort. CONCLUSIONS This study confirms the good long-term outcomes of sialendoscopic interventions in patients with chronic sialadenitis of different aetiologies and a high rate of gland preservation.
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Affiliation(s)
- Arike Vanden Daele
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Joekio Drubbel
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Charlotte Van Lierde
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Jeroen Meulemans
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Pierre Delaere
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Vincent Vander Poorten
- Otorhinolaryngology and Head & Neck Surgery, University Hospital Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
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10
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Giotakis AI, Fischlechner R, Dejaco D, Gottfried T, Riechelmann H. [Prognostic factors for successful outcome in sialendoscopy for sialolithiasis]. Laryngorhinootologie 2021; 101:228-237. [PMID: 34058775 PMCID: PMC8885298 DOI: 10.1055/a-1510-9548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hintergrund
Der Erfolg der Sialendoskopie hängt von mehreren Faktoren ab. Im Jahr 2008 wurde die Lithiasis-Stenosis-Dilatation (LSD) -Klassifikation zur genaueren Beschreibung des Stein-Gang-Verhältnisses eingeführt. Neben dem Nutzen der LSD-Klassifikation untersuchten wir weitere prä- und intraoperativ erhobene Einflussfaktoren auf den Erfolg der Sialendoskopie bei Sialolithiasis.
Methode
PatientInnen mit Sialolithiasis der Glandula submandibularis und Glandula parotis, die zwischen September 2018 und März 2020 eine primäre Sialendoskopie erhielten, wurden retrospektiv untersucht. Die Steingröße, Steinlokalisation und LSD-Klassifikation wurden unter anderem als prognostische Einflussfaktoren untersucht.
Ergebnisse
Insgesamt wurden 37 PatientInnen retrospektiv untersucht. Eine erfolgreiche Steinextraktion wurde bei 12/37 (32 %) PatientInnen durchgeführt. Bei Erfolg betrug die mediane Steingröße 3,7 mm, verglichen mit 10 mm bei Misserfolg (Mann-Whitney-Test; p < 0,0001). Bei Erfolg waren 11/12 Steine distal lokalisiert, verglichen mit 13/25 proximal lokalisierten Steinen bei Misserfolg (Pearson-Chi-Quadrat-Test; p = 0,010). Bei Erfolg wurden 10/12 Steine als L1S0D0 klassifiziert, während 15/25 bei Misserfolg als L3aS0D0-Steine klassifiziert wurden (Pearson-Chi-Quadrat-Test; p = 0,001). Für distal lokalisierte Steine, die kleiner als 5 mm waren, lag die Erfolgsrate bei 100 %. Für proximal lokalisierte Steine, die größer als 4 mm waren, lag die Erfolgsrate bei 0 %. Für die als L1S0D0 klassifizierten Steine betrug die Erfolgsrate 60–100 %.
Schlussfolgerung
Distal lokalisierte Steine und Steine kleiner als 5 mm in einem ansonsten unauffälligen Gangsystem können als prognostisch günstige Faktoren angesehen werden. Zukünftige Studien sollten anhand größerer Datenmengen die LSD-Klassifikation, das Volumen der Steine und deren Gangorientierung bzw. deren Abstand von der Papille untersuchen.
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Affiliation(s)
- Aris I Giotakis
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Rene Fischlechner
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Daniel Dejaco
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Timo Gottfried
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
| | - Herbert Riechelmann
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Austria
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11
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Nation J, Panuganti B, Manteghi A, Pransky S. Pediatric Sialendoscopy for Recurrent Salivary Gland Swelling: Workup, Findings, and Outcomes. Ann Otol Rhinol Laryngol 2019; 128:338-344. [DOI: 10.1177/0003489418823794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Introduction: Recurrent salivary gland swelling of the parotid and submandibular glands results in painful swelling in the pediatric population. There is no defined algorithm for workup and treatment of these disorders, resulting in wide heterogeneity and in some cases overuse of computed tomography (CT) imaging. Sialendoscopy (SE) is an interventional option for recurrent swelling of both glands; however, its effectiveness in the pediatric population is still being determined. Objectives: To assess preoperative imaging utilization and benefit in the workup of recurrent pediatric sialadenitis, intraoperative SE findings, and postoperative outcomes after intervention with SE. Methods: Case-series with a 5-year retrospective chart review on children undergoing SE for recurrent sialadenitis. Results: Forty-nine SE procedures were performed on 38 parotid glands (PG) and 11 submandibular glands (SMGs) in 29 children. CT imaging findings were useful for identifying a stone or stricture and guiding surgical management in 45.5% of SMGs versus 2.6% of PGs ( P < .001). A stone was found in 45.5% of SMGs and none in PG ( P < .001). SE intervention such as balloon dilation or stone removal was performed in 54.6% of SMGs and 5.3% of PGs ( P < .001). 74% of parotid patients undergoing SE responded to 1 intervention with a cessation of recurrent gland swelling, while 26% required additional interventions. One hundred percent of SMG patients responded to first intervention. There was no improvement in the beneficial effect of SE with steroid injection ( P = .897) regardless of steroid used ( P = .082). Conclusion: CT findings were found to be low yield for recurrent parotid swelling, and ultrasound is a recommended first-line step for PG pathology. SE is a recommended first-line intervention for SMG and parotid sialadenitis as demonstrated by 100% and 74% response rate to initial SE, respectively.
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Affiliation(s)
- Javan Nation
- Division of Otolaryngology, University of California San Diego, San Diego, CA, USA
- Division of Pediatric Otolaryngology, Rady Children’s Hospital San Diego, San Diego, CA, USA
| | - Bharat Panuganti
- Division of Otolaryngology, University of California San Diego, San Diego, CA, USA
| | - Alexander Manteghi
- Division of Pediatric Otolaryngology, St. Christopher’s Hospital for Children, Philadelphia, PA, USA
| | - Seth Pransky
- Division of Pediatric Otolaryngology, Rady Children’s Hospital San Diego, San Diego, CA, USA
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Affiliation(s)
- Oded Nahlieli
- Department of Oral and Maxillofacial Surgery, The Barzilai Medical Center, Ha-Histadrut Street 2, Ashkelon 78306, Israel; Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel; Department of Oral and Maxillofacial Surgery, Eastman Institute for Oral Health University of Rochester, Rochester, NY, USA; Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, MI, USA.
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13
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Guastaldi FPS, da Silva JSP, Troulis MJ, Lahey E. Surgical Retrieval of Parotid Stones. Atlas Oral Maxillofac Surg Clin North Am 2018; 26:105-110. [PMID: 30077318 DOI: 10.1016/j.cxom.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Fernando Pozzi Semeghini Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA
| | - Jose Sandro Pereira da Silva
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA
| | - Maria J Troulis
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA.
| | - Edward Lahey
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02114, USA
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Yıldırım YSS, Kaygusuz I, Ozercan IH, Cetiner H, Sakallioglu O, Akyigit A, Duzer S. Histopathological changes in parotid gland following submandibular gland failure: an experimental animal study. Braz J Otorhinolaryngol 2018; 85:422-426. [PMID: 29754976 PMCID: PMC9443012 DOI: 10.1016/j.bjorl.2018.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/19/2018] [Indexed: 11/20/2022] Open
Abstract
Introduction Submandibular glands are exposed to many effects due to diseases and therapeutic interventions. A study evaluating the effect of submandibular gland dysfunction on the parotid gland has not been presented in the literature. Objective The aim of this study was to evaluate the histopathological changes in the parotid gland following submandibular gland failure. Methods Three groups of seven randomly selected female New Zealand rabbits weighing 2500–3000 g were studied. Unilateral and bilateral submandibular glands were removed in Groups 1 and 2, respectively. No procedure was performed in Group III, the control group. The parotid glands were removed 30 days later. Histological parameters were evaluated and graded between 0 (none) and 3 (severe). Differences between groups were compared using the Mann–Whitney U test. Results Mean mucus accumulation in acinar cells was 2.57 ± 0.53 and 1.71 ± 0.75 in Groups 1 and 2, respectively (p < 0.05). This value was 0.57 ± 0.53 in Group 3, which was significantly lower than in Groups 1 and 2 (p < 0.05). Mean dilatation of the intercalated ducts’ lumen was 1.28 ± 0.48 and 1.57 ± 0.53 in Groups 1 and 2, respectively (p > 0.05). This value was 0.28 ± 0.48 in Group 3, which was significantly lower than in Groups 1 and 2 (p < 0.05). Mean mucus accumulation in the intercalated ducts’ lumen was 2.00 ± 0.81 and 1.00 ± 0.57 in Groups 2 and 3, respectively (p < 0.05). Conclusion The findings of this study indicate that only 1 month after submandibular gland failure, the parotid glands exhibit significant changes.
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Affiliation(s)
| | - Irfan Kaygusuz
- University of Firat, School of Medicine, Department of Otorhinolaryngology, Elazig, Turkey
| | - Ibrahim Hanifi Ozercan
- University of Firat, School of Medicine, Department of Otorhinolaryngology, Elazig, Turkey
| | - Hasan Cetiner
- Elazig Education and Research Hospital, Department of Otorhinolaryngology, Elazig, Turkey.
| | - Oner Sakallioglu
- Elazig Education and Research Hospital, Department of Otorhinolaryngology, Elazig, Turkey
| | - Abdulvahap Akyigit
- Elazig Education and Research Hospital, Department of Otorhinolaryngology, Elazig, Turkey
| | - Sertac Duzer
- Elazig Education and Research Hospital, Department of Otorhinolaryngology, Elazig, Turkey
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