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Salehzadeh F, Molatefi R, Mardi A, Nahanmoghaddam N. Juvenile idiopathic recurrent parotitis (JIRP) treated with short course steroids, a case series study and one decade follow up for potential autoimmune disorder. Pediatr Rheumatol Online J 2024; 22:8. [PMID: 38178123 PMCID: PMC10765850 DOI: 10.1186/s12969-023-00946-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Juvenile idiopathic recurrent parotitis (JIRP) in children is a condition characterized with recurrent episodes of idiopathic parotid gland inflammation. Since there are no definitive guidelines for diagnosis and management of this condition, we present a consecutive case series of patients with more than one decade follow up and their dramatic response to short course treatment by prednisolone. METHODS We conducted this study by retrospectively reviewed medical charts of children who were diagnosed with JIRP, from 1 January 2002 to 29 February 2023. We performed usual serological tests to exclude some possible background. We administered short course prednisolone on first day of episode as divided dosage (0.5 mg /kg). RESULTS In this case series of 10 patients (70%) were male, median age of onset was 5 years, duration of episodes 5 days, and the mean course of disease were 3.8 years. The average follows up of patients was near 10 years. In comparison with their natural course of disease all patients showed a dramatic response to treatment on the first day of administration of prednisolone (P Value 0.005). For ten years follow up there was not any additional accompanying autoimmune disorder. CONCLUSION Short course prednisolone on first day of each episode and its dramatic and meaningful response in our patients, introduce a new, effective, fast, and inexpensive regimen of therapy in patients with JIRP.
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Affiliation(s)
- Farhad Salehzadeh
- Pediatric Rheumatology, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Rasol Molatefi
- Pediatric Allergy and Immunology, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran.
| | - Ali Mardi
- Pediatric Gastroenterology, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Negin Nahanmoghaddam
- Pediatric Infectious Disease, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
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Ver Berne J, Brijs K, Coropciuc R, Politis C. Non-neoplastic salivary gland diseases in children: a 10-year review at a tertiary center. Oral Maxillofac Surg 2023; 27:693-697. [PMID: 35869350 DOI: 10.1007/s10006-022-01103-9] [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: 04/23/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Non-neoplastic salivary gland diseases are rare in children. This paper aims to present the spectrum of encountered non-neoplastic salivary gland diseases at a tertiary center by describing the demographics, clinical characteristics, and outcomes in this patient population. METHODS A review of electronic medical records was performed from 2010 until 2020. Relevant data were retrieved and charted according to the type of salivary gland disease. A comparison between diseases was made for demographics, presenting symptoms, treatment, and outcomes. RESULTS Fifty patients with 11 different non-neoplastic salivary gland diseases were identified. Sialolithiasis was the most prevalent condition (12/50), with 83% localized in the submandibular gland. In contrast to gender, age, and symptoms, the location of pathology was significantly associated with the diagnosis (p < 0.001). In patients with sialolithiasis, a hybrid procedure (combined endoscopy and lithotomy) resulted in 100% resolution of symptoms. For (plunging) ranula, marsupialisation had a relative risk of recurrence of 9.6 compared to (partial) extirpation of the sublingual gland. CONCLUSIONS Children with salivary gland diseases present with overlapping symptoms, making clinical diagnosis challenging. The present study may aid physicians and specialists in diagnosing the most prevalent conditions in children. Although no gold standards exist for their treatment, hybrid procedures (sialolithiasis) and subglingual gland extirpation (ranula) showed superior results over alternatives.
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Affiliation(s)
- Jonas Ver Berne
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Department of Imaging & Pathology, Group Biomedical Sciences, OMFS-IMPATH, Catholic University of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Katrien Brijs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
- Department of Imaging & Pathology, Group Biomedical Sciences, OMFS-IMPATH, Catholic University of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Ruxandra Coropciuc
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Department of Imaging & Pathology, Group Biomedical Sciences, OMFS-IMPATH, Catholic University of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Department of Imaging & Pathology, Group Biomedical Sciences, OMFS-IMPATH, Catholic University of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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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.
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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
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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.
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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
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Wilson J, Gorelik M, Gulliver J, Jaju A, Bhushan B, Rastatter J, Johnston D, Maddalozzo J. Superficial Parotidectomy for Juvenile Recurrent Parotitis. Laryngoscope 2023; 133:1495-1500. [PMID: 37158262 DOI: 10.1002/lary.30349] [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: 05/11/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To investigate long-term outcomes, imaging, and pathologic findings in pediatric patients who underwent superficial parotidectomy for recalcitrant juvenile recurrent parotitis (JRP). METHODS Records for 20 children (23 parotidectomies; 9 females, 11 males; age at surgery of 8.6 ± 3.7 years) collected over a 10-year period (2012-2021) were reviewed. Parents were contacted via telephone to obtain extended follow-up. A simplified scoring system was used to assess imaging findings and an additional pathologic review was conducted to further clarify the underlying disease process. RESULTS All but one patient experienced resolution of their recurrent symptoms after superficial parotidectomy. Three of the patients studied required surgery on the contralateral side, and this could be predicted based on their imaging at the time of the initial surgery. Pathologic findings included ductal fibrosis, metaplasia, and dilatation as well as parenchymal atrophy and fatty deposition. There were no major surgical complications, however, the incidence of Frey's syndrome in this sample was 43.5% of surgical sites. CONCLUSION For patients with frequent recalcitrant symptoms or significant quality of life impairment related to JRP, superficial parotidectomy represents a potential treatment option with the noted reduction in symptom burden following surgery. Further longitudinal studies are needed. LEVEL OF EVIDENCE 4 Laryngoscope, 133:1495-1500, 2023.
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Affiliation(s)
- John Wilson
- Division of Otorhinolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Michael Gorelik
- Division of Otorhinolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Jessica Gulliver
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Alok Jaju
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Bharat Bhushan
- Division of Otorhinolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Jeffrey Rastatter
- Division of Otorhinolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - Douglas Johnston
- Division of Otorhinolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
| | - John Maddalozzo
- Division of Otorhinolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A
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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.
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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
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Sialendoscopy in Management of Juvenile Recurrent Parotitis-A Single Centre Experience. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111632. [PMID: 36360360 PMCID: PMC9688286 DOI: 10.3390/children9111632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
Juvenile recurrent parotitis is a rare inflammatory disease of the parotid gland that shares diverse therapeutic management between institutions. Sialendoscopy has been demonstrated as an efficient diagnostics and therapeutic method with minimal complications; however, due to the rarity of the disease and limited data, there is a lack of universal guidelines on its optimal management. Herein, we retrospectively analysed patients with juvenile recurrent parotitis who had the sialendoscopy performed at our tertiary centre. Descriptive data were retrieved along with the number of swelling episodes one year before and after the sialendoscopy intervention. In the last decade, twenty-nine sialendoscopic procedures were performed at our clinics on twenty-one patients diagnosed with juvenile recurrent parotitis. Most of them underwent the procedure under general anaesthesia (86%). In the year before and after the sialendoscopic procedure, the patients had 3.9 ± 2.7 and 0.2 ± 0.4 episodes of swelling per year, respectively. The difference proved to be statistically significant (p < 0.0001). The complete resolution was noted in sixteen patients (76%); however, the procedure was not repeated on the same side of any patient. Solely one patient had a relapse of the disease reported more than twelve months after the sialendoscopy, nonetheless, one of his exacerbation episodes was already reported in the first year after the sialendoscopy. The mean follow-up period of patients was 48.6 months (range, 13−116 months). All things considered, this study emphasises sialendoscopy as an effective minimally invasive diagnostic and therapeutic tool for the management of juvenile recurrent parotitis.
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Goyal M, Singh PP, Batra A. Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population. J Maxillofac Oral Surg 2022; 21:715-724. [DOI: 10.1007/s12663-020-01472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022] Open
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Grande-Moreillo C, Margarit-Mallol J, Fuentes-Carretero S, Torolla A, Martí-Camps M, Rodríguez-Molinero A. Parotid irrigation: A promising option for juvenile recurrent parotitis. Am J Otolaryngol 2022; 43:103398. [PMID: 35256205 DOI: 10.1016/j.amjoto.2022.103398] [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: 12/15/2021] [Revised: 02/06/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To study whether irrigating the parotid gland with saline solution through the parotid duct reduces the number of inflammatory episodes in patients with juvenile recurrent parotitis (JRP) over a 1-year period. METHODS This was a retrospective cohort study using the electronic clinical history data of patients with JRP that were treated with parotid irrigation under general anaesthesia at the Paediatric Surgery units of Consorci Sanitari Alt Penedès-Garraf and Hospital Universitari Mútua de Terrassa. The number of inflammation episodes in the year before and the year after treatment was analysed. RESULTS A total of 15 patients with JRP were evaluated, of whom 10 met the criteria for irrigation. Data from 9 patients were available. The procedure was performed without incident in all of the patients. There was no difficulty with probing the duct and no need for orifice dilation. No post-lavage complications were observed. Four patients had complete resolution of inflammation events (44.4%), and the remaining 5 patients had a decrease in the number of events. The Wilcoxon signed-rank test showed a statistically significant difference between the number of inflammation events before and after the intervention (p = 0.009). CONCLUSIONS Parotid irrigation with saline solution could be a safe and effective first-line technique for the treatment of JRP. LEVEL-OF-EVIDENCE IV.
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Affiliation(s)
- Carme Grande-Moreillo
- Pediatric Surgery Unit, Consorci Sanitari Alt Penedés i Garraf, Ronda Sant Camil s/n, 08810 Barcelona, Spain; Department of Pediatric Surgery, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Plaça Doctor Robert 5, 08221 Terrassa, Spain.
| | - Jaume Margarit-Mallol
- Department of Pediatric Surgery, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Plaça Doctor Robert 5, 08221 Terrassa, Spain
| | - Sara Fuentes-Carretero
- Department of Pediatric Surgery, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Plaça Doctor Robert 5, 08221 Terrassa, Spain
| | - Alina Torolla
- Department of Anesthesiology, Consorci Sanitari Alt Penedés i Garraf, Ronda Sant Camil s/n, 08810 Barcelona, Spain
| | - Montse Martí-Camps
- Department of Pediatric Surgery, Consorci Sanitari de Terrassa, Carretera Torrebonica 1, 08227 Terrassa, Spain
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Dammak N, Berrezouga L, Raadani I, Selmi W, Khelifa MB. Juvenile recurrent parotitis in a 4-year-old patient: a case report. Pan Afr Med J 2021; 40:86. [PMID: 34909075 PMCID: PMC8607950 DOI: 10.11604/pamj.2021.40.86.27001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 09/01/2021] [Indexed: 11/11/2022] Open
Abstract
Juvenile recurrent parotitis (JRP) is a rare disease. It is most commonly occurring between the ages of 3 and 5 years, that classically resolves at adolescence. It is characterized by recurrent non-suppurative parotitis, with several acute inflammatory episodes per year. The parotid´s swelling tends to be unilateral, but it can occur bilaterally, with a more predominant side. The aim of this work was to present a case report that highlights signs and symptoms of this unusual condition and to stress on the value of ultrasonography as an aid to diagnosis.
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Affiliation(s)
- Nouha Dammak
- Department of Medicine and Oral Surgery, University Dental Clinic of Monastir, Monastir, Tunisia
| | - Latifa Berrezouga
- Department of Dental Medicine, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| | - Imen Raadani
- Department of Dental Medicine, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| | - Wissal Selmi
- Department of Dental Medicine, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| | - Mohamed Ben Khelifa
- Department of Dental Medicine, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
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Ultrasound in Inflammatory and Obstructive Salivary Gland Diseases: Own Experiences and a Review of the Literature. J Clin Med 2021; 10:jcm10163547. [PMID: 34441850 PMCID: PMC8397054 DOI: 10.3390/jcm10163547] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Ultrasound is established as a diagnostic tool in salivary glands for obstructive diseases such as sialolithiasis and tumors. Concerning inflammatory diseases and in non-sialolithiasis-caused obstruction, much fewer data are available. In recent years, technical development has allowed a better assessment of the gland parenchyma, and knowledge about intraductal pathologies has increased considerably, which has provided new insights and a new interpretation of ultrasound findings. Objectives: To provide a comprehensive review of the literature that includes our own experiences and to point out the state of the art in ultrasound in the diagnostics of inflammatory and obstructive salivary gland diseases, taking adequate techniques and recent technical developments into consideration. Data sources and study eligibility criteria: A systematic literature search was performed in Pubmed using various specific key words. Results: According to the literature results, including our own experiences, ultrasound is of value in up to >90% of cases presenting with inflammatory and/or obstructive diseases. Technical developments (e.g., elastography) and the application of modified ultrasound techniques (e.g., transoral ultrasound) have contributed to these results. Today, ultrasound is considered a first-line diagnostic tool in these diseases. However, in some inflammatory diseases, the final diagnosis can be made only after inclusion of the anamnesis, clinical symptoms, serologic blood tests, or histopathologic investigation. Conclusions: Ultrasound can be considered as a first-line diagnostic tool in obstructive and inflammatory salivary gland diseases. In obstructive diseases, it may be sufficient for diagnostics in >90% of cases. In inflammatory diseases, ultrasound is at least an excellent screening method and can be used to establish the diagnosis in cases of an early suspicion. In all diseases ultrasound can contribute to better management and can be used for monitoring during follow-up.
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Ortillés Á, Leiva M, Allgoewer I, Peña MT. Intracanalicular injection of N-acetylcysteine as adjunctive treatment for sialoceles in dogs: 25 cases (2000-2017). J Am Vet Med Assoc 2021; 257:826-832. [PMID: 33021449 DOI: 10.2460/javma.257.8.826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe intracanalicular injection of 10% N-acetylcysteine (IINAC) as adjunctive treatment for sialoceles in dogs. ANIMALS 25 client-owned dogs. PROCEDURES Hard copy medical records at 2 veterinary ophthalmology practices were searched to identify dogs that underwent IINAC for treatment of sialoceles from January 2000 to December 2017. Signalment, affected salivary gland, clinical signs, duration of signs, other treatments administered, diagnostic tests performed, anesthetic approach, N-acetylcysteine volume administered, complications, follow-up time, and recurrence of sialoceles were recorded. Descriptive statistics were reported. RESULTS Boxers and mixed-breed dogs were most commonly represented. Subjectively decreased globe retropulsion and conjunctival or periorbital swelling (23/25 [92%] dogs each) were the most common clinical signs, with no vision deficits in any patient. The zygomatic gland was mainly affected (23/25 [92%] dogs), followed by parotid and mandibular glands (1 [4%] dog each). The condition was unilateral in 22 (88%) dogs. Ultrasonography (19/25 [76%] dogs), MRI (14 [56%]), fine-needle aspiration (20 [80%]), and biopsy (4 [16%]) were performed; however, the condition was deemed idiopathic in 22 (88%) dogs. Most IINACs were performed with local anesthesia (median volume, 5 mL/gland; range, 1.5 to 9 mL). No complications were identified. Other treatments included antimicrobials and anti-inflammatories. Mean follow-up time was 18.8 months. All recurrences (5/23 [22%] dogs) were controlled with medical management. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested noninvasive IINAC may be a useful adjunctive treatment for sialoceles in dogs. The procedure was easily and safely performed with local anesthesia (or general anesthesia with concurrent diagnostic imaging) in these dogs.
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Juvenile recurrent parotitis: Review and proposed management algorithm. Int J Pediatr Otorhinolaryngol 2021; 142:110617. [PMID: 33421670 DOI: 10.1016/j.ijporl.2021.110617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/31/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Despite being the second most common salivary disease in childhood, the aetiology and appropriate management of juvenile recurrent parotitis (JRP) remains uncertain. Consequently patients may be misdiagnosed, or even undergo indeterminate or potentially invasive procedures without benefit. This article reviews the current understanding of the epidemiology and pathophysiology of JRP, and to appraise the management options available. METHODS AND RESULTS Medline and Google Scholar databases were searched and peer reviewed journal articles assessed. The epidemiology of JRP remains uncertain, and the clinical presentation of JRP can vary widely in frequency and severity. Diagnosis is still largely based on clinical signs and symptoms including parotid swelling, pain and fever. Investigation typically focuses on the exclusion of other diseases and immunodeficiencies, however there are noted typical radiological findings on both ultrasound and magnetic resonance imaging. The ideal management of this condition still remains unclear, however symptoms typically resolve by puberty. Treatment focuses on minimally invasive procedures such as sialography and sialendoscopy to reduce the frequency and severity of acute episodes. CONCLUSIONS Acute episodes of JRP can occur up to 30 times per year and have a significant impact on the quality of life of an affected child. Consequently a management algorithm is proposed based on the exclusion of other pathology. There is increasing evidence for non-ablative, minimally invasive approaches such as sialography and sialendoscopy to reduce the impact of this disease.
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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.
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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
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Gellrich D, Bichler M, Reichel CA, Schrötzlmair F, Zengel P. Salivary Gland Disorders in Children and Adolescents: A 15-year Experience. Int Arch Otorhinolaryngol 2020; 24:e31-e37. [PMID: 31929831 PMCID: PMC6952288 DOI: 10.1055/s-0039-1697993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 08/04/2019] [Indexed: 11/07/2022] Open
Abstract
Introduction
Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections.
Objective
To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years.
Methods
A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016.
Results
Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolaryngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties – resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improvements in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis.
Conclusions
Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unnecessarily long period of suffering despite a favorable outcome following the correct treatment.
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Affiliation(s)
- Donata Gellrich
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Moritz Bichler
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christoph A Reichel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Florian Schrötzlmair
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Pamela Zengel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
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16
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Juvenile Recurrent Parotitis: The Role of Sialendoscopy. Int J Inflam 2019; 2019:7278907. [PMID: 31662845 PMCID: PMC6791204 DOI: 10.1155/2019/7278907] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/02/2019] [Indexed: 01/12/2023] Open
Abstract
Juvenile recurrent parotitis (JRP) is a recurrent parotid inflammation of nonobstructive, nonsuppurative nature. It manifests in childhood and usually resolves after puberty but may also persist into adulthood. JRP is characterized by recurrent episodes of unilateral or/and bilateral parotid swelling with pain, reduction of salivary secretion, swallowing difficulty, fever, and malaise. The cause of this condition remains obscure. Throughout the last two decades, many therapeutic methods have been used in order to reduce the frequency and severity of JRP. During the acute episodes, conservative approaches (antibiotics, analgesics, sialogogues, massage of the parotid gland, and mouth rinses) are used. Parotidectomy has been suggested in rare selective occasions. Recently, a promising concept of sialendoscopy, which is a minimal invasive endoscopic technique, has been applied. This review outlines the literature on JRP focusing on methods and challenges in diagnosing JRP along with the differential diagnosis of JRP and the function of the parotid during JRP. In addition, we describe the treatment options for JRP, pointing out the importance of sialendoscopy as a diagnostic and treatment procedure that offers improvement in patients' daily life.
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17
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Tucci FM, Roma R, Bianchi A, De Vincentiis GC, Bianchi PM. Juvenile recurrent parotitis: Diagnostic and therapeutic effectiveness of sialography. Retrospective study on 110 children. Int J Pediatr Otorhinolaryngol 2019; 124:179-184. [PMID: 31202035 DOI: 10.1016/j.ijporl.2019.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/19/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling, generally associated with non-obstructive sialectasia of the parotid gland. The aim of this study was to evaluate the diagnostic and therapeutic effectiveness of sialography in children affected by JRP. METHODS Clinical records of 110 outpatients with a diagnosis of JRP followed up from 2008 to 2017 at the Unit of Paediatric Otorhinolaryngology, Surgery Department of the Bambino Gesù Children's Hospital of Rome, were retrospectively reviewed. Data on demographics, number of acute episodes/year, course of disease, site of symptoms and duration of follow up were collected. The inclusion criteria were: at least two or more episodes of intermittent swelling of the parotid glands on one side or both sides during the last 6 months, age <16 years. Exclusion criteria were: obstructive lesions, dental malocclusion, Sjogren syndrome, congenital IgA immunodeficiency, and relevant systemic diseases. Outcome of the procedure was measured by evaluating number and degree of episodes of parotid swelling before and after sialography. RESULTS Sialography has been shown in all cases to be a valid method in the diagnosis of JRP. Following the execution of the sialography, in 98 patients (89% of cases) there was a statistically significant improvement of disease with a mean reduction of 67.4% of episodes of parotid swelling (p < 0.05). In 75 patients there was marked improvement of the symptomatology (p < 0.05). In 23 patients partial resolution occurred (p < 0.05); in 12 patients there was no resolution or a reduction less than 30% of episodes (p > 0.05). There was a statistically significant relationship between the number of attacks/year and the degree of glandular function, pre and post-sialography in 2-way ANOVA test (p < 0.05). CONCLUSION Sialography is effective method not only as a diagnostic procedure but also as a therapeutic procedure in treatment of JRP. It is a method that can be carried out in ambulatory setting, without anaesthesia, with a minimum cost and with a very low rate of complications. In a disease with tendency to spontaneous resolution like JRP, sialography represent a therapeutic option alternative to more invasive treatment.
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Affiliation(s)
- Filippo Maria Tucci
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy.
| | - Rocco Roma
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
| | - Alessandra Bianchi
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
| | - Giovanni Carlo De Vincentiis
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
| | - Pier Marco Bianchi
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
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18
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Lau RK, Turner MD. Viral mumps: Increasing occurrences in the vaccinated population. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:386-392. [PMID: 31326348 DOI: 10.1016/j.oooo.2019.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/23/2019] [Indexed: 11/17/2022]
Abstract
Before the introduction of the vaccine, mumps was the most common salivary gland disease and was one of the most common infectious diseases in children globally. Following the introduction of the mumps vaccine in 1967, the disease was almost nonexistent in the United States and was only found to occur in nonvaccinated patients, and even then, it did not present in epidemic portions because of the extent of vaccination in the population at large. Beginning in the early 2000s, viral mumps began to present itself in vaccinated populations, and currently, outbreaks are continuing to increase in number. This article presents information on the various outbreaks, a review of the virus and the disease, including symptoms and comorbidities, and new recommendations for management. Dental practitioners should be aware of the increasing incidence and prevalence of this disease, be able to recognize it, and make appropriate referrals for management.
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Affiliation(s)
- Roger K Lau
- Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburg, PA, USA
| | - Michael D Turner
- Division of Oral and Maxillofacial Surgery, Icahn Mount Sinai School of Medicine, New York, NY, USA.
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19
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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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20
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Garavello W, Redaelli M, Galluzzi F, Pignataro L. Juvenile recurrent parotitis: A systematic review of treatment studies. Int J Pediatr Otorhinolaryngol 2018; 112:151-157. [PMID: 30055724 DOI: 10.1016/j.ijporl.2018.07.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 12/18/2022]
Abstract
Juvenile recurrent parotitis is a rare recurrent inflammation of the parotid glands occurring in children. The etiology remains obscure and the treatment is still debated. In the present study, we perform a systematic review of the literature with the purpose of identifying and discussing the treatment options emerged over the last 28 years in order to prevent recurrent episodes of parotitis. We ultimately included 24 studies. The definitions used for juvenile recurrent parotitis varied widely and none of the selected studies referred exactly to the same definition. Only one was a randomized controlled trial and it showed marked benefits with the use of Bear Bile and Huangqi, two traditional Chinese medicines. Two additional study on sialendoscopy included a control group but was not randomized. All the remaining contributions were case series or case reports. The vast majority (n = 19) of the selected studies reported on sialendoscopy. They all documented improvement of the condition following this intervention. An analysis grouping all these studies (corresponding to 336 children) showed that only 25.8% (95% Confidence Interval: 21.5-30.8) of the treated children had further recurrences. However, the only two controlled study on sialendoscopy showed a similar improvement in controls. The remaining four studies were on sialography (n = 2), on oral appliance in the specific group of children with concomitant dental malocclusion (n = 1) on ductal hydrocortisone infusion through catheter inserted in the parotid duct (n = 1). Improvements were documented in all four contributions. This systematic review of the literature did not consent us to draw definite conclusions on the most suitable treatment for juvenile recurrent parotitis. The available evidence is indeed weak and difficult to interpret because of the scarcity of randomized controlled trials, the heterogeneity of the definitions used and the high rate of spontaneous resolution. Future large and well-designed randomized controlled trials that will include children fulfilling a shared definition of the condition are warranted.
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Affiliation(s)
- Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
| | - Monica Redaelli
- Department of Otorhinolaryngology, San Gerardo Hospital, Monza, Italy
| | | | - Lorenzo Pignataro
- Department of Otorhinolaryngology, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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21
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Schwarz Y, Bezdjian A, Daniel SJ. Sialendoscopy in treating pediatric salivary gland disorders: a systematic review. Eur Arch Otorhinolaryngol 2017; 275:347-356. [DOI: 10.1007/s00405-017-4830-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/28/2017] [Indexed: 11/24/2022]
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22
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Rosbe KW. Pediatric Sialendoscopy and Its Role in Pediatric Salivary Gland Disease. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017. [DOI: 10.1007/s40136-017-0162-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Singh PP, Goyal M, Goyal A. Sialendoscopic Approach in Management of Juvenile Recurrent Parotitis. Indian J Otolaryngol Head Neck Surg 2017; 69:453-458. [PMID: 29238673 DOI: 10.1007/s12070-017-1223-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/06/2017] [Indexed: 11/29/2022] Open
Abstract
To assess the role of sialendoscopy as a diagnostic and therapeutic modality in juvenile recurrent parotitis. Juvenile recurrent parotitis (JRP) is the second most frequent salivary gland disease in childhood and is characterized by recurrent non suppurative and non obstructive parotid inflammation. These attacks influence the quality of life and can even lead to gland destruction, and there are no definitive treatment to avoid them. Sialendoscopic dilatation is emerging as the new treatment modality in this aspect. STUDY DESIGN retrospective study. STUDY SETTING Department of Otorhinolaryngology in tertiary care hospital. 17 cases of juvenile recurrent parotitis (i.e. children of age group 3-11 years presenting with complaints of recurrent parotid region swelling and pain, sometimes associated with fever) were included in the study during October 2012-September 2015. All cases underwent sialendoscopy under general anaesthesia. Diagnostic (classifying the ductal lesion) and interventional sialendoscopic procedure (dilatation with instillation of steroid) were carried out in single sitting. Follow up was done for a minimum of 6 months (range 6-36 months). 17 patients with mean age of 5.6 years and gender distribution of 47:53 (boys:girls) underwent sialendoscopy for JRP. 8 patients presented with unilateral parotitis and 9 with bilateral. The mean number of attacks in previous 1 year were 9.2. Average time for procedure was 20 min. All cases had ductal stenosis and ductal mucosa was pale in 15 cases on endoscopy. 1 patient underwent repeat endoscopy after 2 years. 50% had complete resolution of symptoms and 6 patients had one mild (swelling not associated with fever which subsided on its own) attack after treatment. Follow up period ranged from 6 months to 3 years. No complications were observed. Sialendoscopy has emerged as a viable option for assessment and treatment of JRP. Dilatation of the parotid duct and steroid instillation has significantly reduced the morbidity of this condition.
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Affiliation(s)
- P P Singh
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - M Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A Goyal
- Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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24
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Abstract
Juvenile recurrent parotitis (JRP) is a rare disease of childhood occurring between the ages of 3 and 5 years, characterized by recurrent non-suppurative parotitis, spontaneously evolving towards parotid gland dysfunction. Clinically, JRP presents in the form of unilateral or bilateral, usually asynchronous, swelling of the parotid gland. The diagnosis is based on ultrasound characteristics. Widespread use of sialendoscopy has opened up new prospects for the management of this disease. This review of the literature evaluates the role of sialendoscopy in the management of JRP. A Medline search retrieved 68 articles, 18 of which concerned JRP. Standard treatment consists of antibiotics for at least 10 days at the acute phase of the disease. All studies demonstrated the diagnostic value of sialendoscopy by visualizing strictures, hypovascularization and whitish intraductal debris. Sialendoscopy is also useful for treatment, by allowing intraductal lavage and, when possible, dilatation of strictures. Lavage is performed with saline solution, hydrocortisone, antibiotics or a combination of these solutions, with no significant differences in terms of efficacy. The mode of administration with or without sialendoscopy also appears to provide similar results. Sialendoscopy appears to be a diagnostic and therapeutic option, although it has not been shown to be more effective than simple lavage. All lavage solutions appear to be effective.
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25
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Serbetci E, Sengor GA. Sialendoscopy: Experience with the First 60 Glands in Turkey and a Literature Review. Ann Otol Rhinol Laryngol 2017; 119:155-64. [DOI: 10.1177/000348941011900303] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives We performed a retrospective analysis to contribute to the increasing number of reports on sialendoscopy in the literature and give basic concepts for beginners at the same time. Methods Between 2004 and 2009, 83 patients with symptoms of ductal obstruction of the major salivary glands were admitted to our clinic. Diagnostic and/or interventional sialendoscopy was applied to 60 glands (33 submandibular and 27 parotid) of 54 patients. A holmium:yttrium-aluminum-garnet laser or a pneumatic lithotripter was used for intraductal stone fragmentation. Results Sialendoscopy revealed no disorder in 2 cases, and in 38 glands (28 submandibular and 10 parotid) sialolithiasis was the underlying disease. Fifteen glands (5 submandibular and 10 parotid) were found to have other main disorders such as stenosis, synechia, or kink formation. Other findings included sialodochitis in 6 glands (2 submandibular and 4 parotid), a polyp in 1 parotid gland, mucus plugs in 21 glands (6 submandibular and 15 parotid), ductal ectasia in 4 glands (2 submandibular and 2 parotid), and ductal collapse in 1 parotid gland. The overall interventional success rate was 83% of all cases, and no complications occurred. Conclusions The success rate of the interventional sialendoscopy performed in the current study shows consistency with the results given in the related medical literature. In the age of sialendoscopy, the adjunctive intraoral surgeries can be argued to be safer, easier, and more successful than before. Sialendoscopy may be considered to be the best practice not only in sialolithiasis, but also in other treatments of obstructive ductal disorders.
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Affiliation(s)
- Erhun Serbetci
- Otorhinolaryngology Group, Nisantasi ENT Group, Istanbul, Turkey
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26
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Mahalakshmi S, Kandula S, Shilpa P, Kokila G. Chronic Recurrent Non-specific Parotitis: A Case Report and Review. Ethiop J Health Sci 2017; 27:95-100. [PMID: 28458496 PMCID: PMC5390234 DOI: 10.4314/ejhs.v27i1.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Chronic recurrent non-specific parotitis is characterized by recurrent episodes of swelling and pain of unknown etiology in the parotid gland. Sialography is a hallmark in the diagnosis of salivary gland disorders; newer imaging modalities like CT-Sialography, sialoendoscopy and MRI can be used. Various treatment modalities have been tried, from conservative approach to surgical excision depending on the recurrence rate and severity of the condition. Although symptomatic treatment with antibiotics and analgesic, injection of intraductal medicament, aggressive treatment like duct ligation or excision of gland are some of the treatment modalities, there is no established algorithm as to which treatment method should be opted in such clinical situation. Case Detail A 20 years old male patient reported with pain and salty taste in the mouth that had began before a week. Examination revealed an elevated right parotid papilla; ropy, cloudy appearing saliva was oozing out on milking the gland. Unstimulated and stimulated whole salivary flow rate was assessed using drooling method. Sialography was used as a diagnostic and a therapeutic aid. In our case, sialography as a treatment showed a good response with no recurrence after two years of follow-up. We highlighted the role of sialography as a therapeutic aid. Conclusion Recurrent attacks significantly affect the quality of life and also lead to progressive gland destruction. Preventing or reducing the frequency of recurrence remains the goal of therapeutic procedure. Hence, conventional sialography is useful in the diagnosis and also effective as a therapeutic aid in recurrent parotitis.
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Affiliation(s)
- Saibaba Mahalakshmi
- Department of Oral Medicine and Radiology, Sri Siddhartha Dental College & Hospital, Sri Siddhartha Academy of Higher Education, Tumkur
| | - Srinivas Kandula
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Science, KIIT University, Bhubneshwar
| | - Patil Shilpa
- Department of Oral Medicine and Radiology, AECS Maaruti College of Dental Sciences & Research Centre, Bangalore
| | - Ganganna Kokila
- Department of Oral Pathology and Microbiology, Sri Siddhartha Dental College & Hospital, Sri Siddhartha Academy of Higher Education, Tumkur
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27
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Abstract
Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions.
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28
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Erkul E, Gillespie MB. Sialendoscopy for non-stone disorders: The current evidence. Laryngoscope Investig Otolaryngol 2016; 1:140-145. [PMID: 28894810 PMCID: PMC5510257 DOI: 10.1002/lio2.33] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 07/31/2016] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Review the current literature on the use of sialendoscopy in the treatment of non-stone disorders of the major salivary glands. DATA SOURCES Eligible articles that reported on the use of sialendoscopy in the treatment of non-stone disorders were identified using MEDLINE, Embase, and Google Scholar through May 2016. The search used key words sialendoscopy, salivary endoscopy, salivary scope, salivary duct stenosis, salivary duct stricture, Sjogren's disease, radioiodine sialadenitis, salivary duct obstruction, sialadenitis, chronic sialadenitis, juvenile recurrent parotitis, parotitis, and radiation sialadenitis. REVIEW METHODS Full-length prospective and retrospective original articles; systemic reviews; and meta-analysis, including adults and children with adequate data for evaluating the sialendoscopy for non-stone disorders, were included. Individual case reports were excluded. RESULTS There is an increasing trend for the use of sialendoscopy for salivary obstruction caused by a wide variety of non-stone disorders worldwide. The studies of sialendoscopy for non-stone disorders are often retrospective, of smaller sample size, and more subjective in measurement of patient outcome. The most common indications currently for the procedure are scars, juvenile recurrent parotitis, radioiodine sialadenitis, and Sjögren syndrome, respectively. CONCLUSION Although the initial evidence for the use of sialendoscopy for non-stone disorders is not as established as that for stones, it remains a promising gland-preserving tool in the management of non-stone disorders of major salivary glands.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology Gulhane Military Medical Academy, Haydarpasa Training Hospital Istanbul Turkey
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery Medical University of South Carolina Charleston South Carolina U.S.A
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29
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30
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Abstract
The differential diagnosis for "rare" parotid gland diseases is broad and encompasses infectious, neoplastic, autoimmune, metabolic, and iatrogenic etiologies. The body of knowledge of parotid gland diseases has grown owing to advances in imaging and pathologic analysis and molecular technology. This article reviews rare parotid diseases, discussing the respective disease's clinical presentation, diagnosis, imaging, pathogenesis, treatment, and prognosis.
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Affiliation(s)
- Akshay Sanan
- Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospital, Thomas Jefferson University, 925 Chestnut Street, 6th Floor, Philadelphia, PA 19107, USA
| | - David M Cognetti
- Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospital, Thomas Jefferson University, 925 Chestnut Street, 6th Floor, Philadelphia, PA 19107, USA.
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Xie LS, Pu YP, Zheng LY, Yu CQ, Wang ZJ, Shi H. Function of the parotid gland in juvenile recurrent parotitis: a case series. Br J Oral Maxillofac Surg 2016; 54:270-4. [PMID: 26852271 DOI: 10.1016/j.bjoms.2016.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 01/13/2016] [Indexed: 11/30/2022]
Abstract
Our aim was to find out how the parotid gland functions in 44 patients with juvenile recurrent parotitis, and to assess the value of measuring the serum amylase activity. Clinical and personal details were recorded, and all patients had their serum amylase activity measured together with sialography during the chronic phase. The function of the gland was classified by sialographic images. The chi square test and Spearman's rank correlation coefficient were used in the statistical analyses. There was a significant association between the degree of glandular function and serum amylase activity (p=0.014). The patients with unilateral and bilateral disease differed significantly in their degree of glandular function (p=0.020), those with bilateral disease having poorer function. There were no significant correlations between other clinical variables and glandular function. Serum amylase activity is an important diagnostic variable in juvenile recurrent parotitis, and poor parotid function reflects the severity of the disease.
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Affiliation(s)
- Li-song Xie
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key laboratory of Stomatology, Shanghai, China
| | - Yi-ping Pu
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key laboratory of Stomatology, Shanghai, China
| | - Ling-yan Zheng
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key laboratory of Stomatology, Shanghai, China
| | - Chuang-qi Yu
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key laboratory of Stomatology, Shanghai, China.
| | - Zhi-jun Wang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key laboratory of Stomatology, Shanghai, China
| | - Huan Shi
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key laboratory of Stomatology, Shanghai, China
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Geres AE, Mereshian PS, Fernández S, Rey Caro DG, Castro R, Podio R, Ojeda S. Sialadenitis after radioiodine therapy. Analysis of factors that influence the response to medical treatment. ACTA ACUST UNITED AC 2015; 62:493-8. [PMID: 26459118 DOI: 10.1016/j.endonu.2015.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 07/23/2015] [Accepted: 07/23/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the incidence of 131I-induced sialadenitis (SD) in patients with differentiated thyroid cancer (DTC), to analyze clinical and other factors related to metabolic radiotherapy that may predict the lack of response to conventional medical therapy (CMT), and to determine the effectiveness of intraductal steroid instillation in patients failing CMT. MATERIAL AND METHODS Fifty-two patients with DTC, 45 females (86.5%) and 7 males (13.5%) with a mean age of 44.21±13.3 years (r=17-74) who received ablation therapy with 131I after total thyroidectomy. Patients with diseases and/or medication causing xerostomia were excluded. Patients underwent salivary gland scintigraphy with 99Tc (10mCi). RESULTS Eighteen patients (34.62%) had SD and received antibiotics, antispasmodics, and oral steroids for 15 days. They were divided into two groups: responders to medical therapy (n=12, age 44.3±14.4 years, 2 men [17%], 10 women [83%], cumulative dose 225±167.1 mCi) and non-responders to medical treatment, who underwent steroid instillation into the Stensen's duct (n=6 [33%], 2 men [33%], 4 women [67%], age 50±13.8 years, cumulative dose 138.3±61.7 mCi). Scintigraphy showed damage to the parotid and submaxillary glands. CONCLUSION Incidence of 131I-induced sialadenitis was similar to that reported by other authors. Age, mean cumulative dose of 131I, and involvement of parotid and submaxillary glands did not condition response to CMT; however, male sex was a conditioning factor. Symptom persistence for more than 15 days makes instillation into the Stensen's duct advisable. This is an effective and safe method to avoid surgical excision of salivary glands.
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Affiliation(s)
- Alejandra E Geres
- Postgraduate Department of Endocrinology, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Paula Szafryk Mereshian
- Postgraduate Department of Endocrinology, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Silvia Fernández
- Postgraduate Department of Endocrinology, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Ricardo Castro
- Department of Nuclear Medicine, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ricardo Podio
- Department of Nuclear Medicine, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Silvia Ojeda
- Probability and Statistics Department, Faculty of Mathematics, Astronomy and Physics, Universidad Nacional de Córdoba, Córdoba, Argentina
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Heineman TE, Kacker A, Kutler DI. Idiopathic Chronic Parotitis: Imaging Findings and Sialendoscopic Response. ORL J Otorhinolaryngol Relat Spec 2015; 77:302-9. [PMID: 26376430 DOI: 10.1159/000438760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 07/14/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The purpose of this study was to correlate imaging and sialendoscopic findings to therapeutic response in patients with idiopathic chronic parotitis. METHODS We retrospectively reviewed 122 consecutive sialendoscopies performed in an academic medical center by two surgeons between 2008 and 2013. Forty-one (34%) and 54 (44%) patients were excluded on the basis of having parotid or submandibular sialolith, respectively. Nineteen cases were included in the study with idiopathic chronic parotitis. There was a median follow-up of 5 months. RESULTS Computed tomography (CT) imaging had a sensitivity and specificity of 80.0 and 71.4%, respectively, for predicting abnormal findings on sialendoscopy, while magnetic resonance imaging (MRI) had 100% accuracy in a small set of cases. In glands with noticeable pathology present on preoperative imaging or sialendoscopy, 11 out of 12 glands (92%) treated experienced symptomatic improvement, while 3 out of 7 glands (43%) without pathology on imaging or endoscopy experienced symptomatic improvement (p = 0.038). CONCLUSIONS Sialendoscopy for the treatment of idiopathic chronic parotid disease can improve pain and swelling with a higher frequency of success in patients with abnormalities noted on endoscopy. CT and MRI have a moderate degree of accuracy in predicting which patients will benefit from therapeutic sialendoscopy.
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Affiliation(s)
- Thomas E Heineman
- Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medical College, New York, N.Y., USA
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Rosbe KW, Milev D, Chang JL. Effectiveness and costs of sialendoscopy in pediatric patients with salivary gland disorders. Laryngoscope 2015; 125:2805-9. [DOI: 10.1002/lary.25384] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 12/17/2022]
Affiliation(s)
| | - Dimiter Milev
- Division of Hospital Medicine; Department of Medicine
| | - Jolie L. Chang
- Otolaryngology/Head and Neck Surgery; University of California; San Francisco, San Francisco California U.S.A
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Adeboye SO, Macleod I. Recurrent parotitis of childhood or juvenile recurrent parotitis--a review and report of two cases. DENTAL UPDATE 2014; 41:73-6. [PMID: 24640481 DOI: 10.12968/denu.2014.41.1.73] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Recurrent parotitis of childhood is an uncommon condition which affects children of variable age. The condition may be misdiagnosed so delaying treatment. These two case reports highlight the variable signs and symptoms of this unusual condition and the value of ultrasound as an aid to diagnosis. CLINICAL RELEVANCE This is to improve awareness of recurrent parotitis of childhood and aid early diagnosis.
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Ardekian L, Klein H, Al Abri R, Marchal F. Sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis. ACTA ACUST UNITED AC 2014; 115:17-21. [PMID: 24468237 DOI: 10.1016/j.revsto.2013.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 12/12/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of the current study was to analyze the use of sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis (JRP), note possible complications, and the rate of disease recurrence. We believe that this cutting edge procedure may be very effective both for the diagnosis and treatment of JRP, with few complications and low rates of recurrence. PATIENTS AND METHODS A retrospective descriptive case study was conducted on a sample of patients presenting with JRP. Data was collected from the patient's medical records. Diagnostic sialendoscopy was performed to identify and classify the ductal pathology, treated by interventional therapeutic sialendoscopy. We carefully noted all complications and the disease recurrence rates. RESULTS The patient sample included 50 children presenting with JRP (33 M, 17 F; age range: 2 to 16 years). Seven children presented with bilateral parotitis, the remaining 43 with unilateral parotitis. The study was conducted from 2003 to 2012. There was a statistically significant association between sialendoscopic data and the actual outcome. Seven children underwent additional sialendoscopy because of recurrence. They were all in the group of children presenting with unilateral parotitis. DISCUSSION Our results validate the expected outcome. Sialendoscopy is an accurate technique for the diagnosis of JPR, and an effective tool for the treatment of JRP, with a low rate of complications and recurrence.
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Affiliation(s)
- L Ardekian
- Rambam Medical Center, Department of Oral and Maxillofacial Surgery, bat Galim, Haifa, 35254, Israel.
| | - H Klein
- Rambam Medical Center, Department of Oral and Maxillofacial Surgery, bat Galim, Haifa, 35254, Israel
| | - R Al Abri
- Rambam Medical Center, Department of Oral and Maxillofacial Surgery, bat Galim, Haifa, 35254, Israel
| | - F Marchal
- Rambam Medical Center, Department of Oral and Maxillofacial Surgery, bat Galim, Haifa, 35254, Israel
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39
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Juvenile recurrent parotitis: A retrospective comparison of sialendoscopy versus conservative therapy. Laryngoscope 2013; 124:451-5. [DOI: 10.1002/lary.24291] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 06/13/2013] [Accepted: 06/13/2013] [Indexed: 11/07/2022]
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40
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Ruan WH, Huang ML, He XL, Zhang F, Tao HB. Effects of huangqi and bear bile on recurrent parotitis in children: a new clinical approach. J Zhejiang Univ Sci B 2013; 14:253-8. [PMID: 23463769 DOI: 10.1631/jzus.b1200072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the pharmacological effects of traditional Chinese medicine, bear bile capsule and Huangqi granule, on recurrent parotitis in children. METHODS In this prospective, controlled, and randomized study, a total of 151 young children were divided into three groups: Group A included massaging the children's parotid region and melting vitamin C in their mouth daily; Group B included swallowing bear bile capsule and Huangqi granule daily; and Group C included massages and vitamin C as prescribed in Group A, and traditional Chinese medicine as prescribed in Group B. Children were treated individually for one month and then a follow-up study was conducted for 1 to 3.5 years. Analysis of variance (ANOVA) and Ridit analysis were employed for statistical analysis. RESULTS The recurrence rate decreased in every group, but was significantly more in Groups B and C when compared to Group A. The recurrences significantly decreased (P<0.01) in Group B and their recovery rate was as high as 63%, significantly better than those of the other groups (P<0.01). CONCLUSIONS Huangqi and bear bile could be a novel clinical approach for treating recurrent parotitis in children.
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Affiliation(s)
- Wen-hua Ruan
- Department of Stomatology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Chuangqi Y, Chi Y, Lingyan Z. Sialendoscopic findings in patients with obstructive sialadenitis: long-term experience. Br J Oral Maxillofac Surg 2013; 51:337-41. [DOI: 10.1016/j.bjoms.2012.07.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 07/23/2012] [Indexed: 11/30/2022]
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Nguyen AM, Francis CL, Larsen CG. Salivary endoscopy in a pediatric patient with HLA-B27 seropositivity and recurrent submandibular sialadenitis. Int J Pediatr Otorhinolaryngol 2013; 77:1045-7. [PMID: 23639340 DOI: 10.1016/j.ijporl.2013.03.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/19/2013] [Accepted: 03/22/2013] [Indexed: 11/16/2022]
Abstract
Patients with human leukocyte antigen (HLA)-B27 seropositivity have a genetic predisposition to form spondyloarthropathies, especially ankylosing spondylitis. Other related inflammatory or autoimmune disorders include reactive arthritis, uveitis, psoriatic arthritis, and Crohn's disease. Although juvenile recurrent parotitis is not uncommon, recurrent submandibular sialadenitis is rare in pediatric patients. Sialadenitis is typically caused by salivary stones, infection, or duct stricture. To our knowledge, there has not been report of HLA-B27 positivity and recurrent sialadenitis described previously. We describe a patient with HLA-B27 seropositivity and multiple episodes of left submandibular sialadenitis who underwent diagnostic and therapeutic sialendoscopy. Previous treatment included antibiotics, sialogogues, warm compresses, and hydration before he underwent definitive sialendoscopy treatment at a tertiary care medical center. Salivary endoscopy showed salivary stasis and sludging within the left submandibular gland duct, with no salivary stones. Topical steroid was applied to the duct. At one year following his surgery, he has not had any recurrent episodes of sialadenitis. HLA-B27 seropositivity is associated with many inflammatory disorders; we report a case in which the patient had coexisting recurrent sialadenitis. In the pediatric population, sialadenitis is traditionally managed with antibiotics and supportive care, however our patient underwent salivary endoscopy. Sialendoscopy is an emerging modality that potentially avoids radiation exposure from CT or sialography and should be considered as another preferred treatment option. More investigation is required to prove a possible correlation between existing HLA-B27 and the propensity to develop this clinical problem.
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Affiliation(s)
- Amy M Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Kansas University Medical Center, Kansas City, KS 66160, USA.
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Saarinen R, Kolho KL, Davidkin I, Pitkäranta A. The clinical picture of juvenile parotitis in a prospective setup. Acta Paediatr 2013; 102:177-81. [PMID: 22924783 DOI: 10.1111/apa.12004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To characterize the features of juvenile parotitis in a prospective setup and epidemiology. METHODS All children with parotitis admitted to Helsinki University Central Hospital 2005-2010 were recruited. Clinical characteristics, given treatment, outcome, blood leukocyte count, C-reactive protein, serum amylase and trypsinogen, SPINK-1 genotype and mumps antibodies were recorded. To map the epidemiology, a questionnaire was sent to 1000 randomly selected 13-year-old children. RESULTS The prospective study included 41 children (aged ≤ 17) with acute parotitis, all in good general condition. Serum amylase, but not trypsinogen, was elevated in majority of the cases (79%) and C-reactive protein in 68%. Eleven (27%) children had an elevated blood leukocyte count. None had acute mumps. Most children recovered well, 51% being treated symptomatically only. Seven children were treated on ward. Seventeen (46%) children had recurrent symptoms. One child (2.4%) had SPINK P55S mutation. According to the epidemiological questionnaire, 1.1% of the respondents (8/728, response rate 73%) reported a verified episode(s) of parotitis. CONCLUSION Juvenile parotitis has a frequency close to 1%. In the majority, the general condition is good during the episode. Serum amylase serves as an additional marker for the disease. Parotitis has a tendency to recur in almost half of the cases.
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Affiliation(s)
- Riitta Saarinen
- Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University, Helsinki, Finland.
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Tomar RPS, Vasudevan R, Kumar M, Gupta DK. Juvenile recurrent parotitis. Med J Armed Forces India 2012; 70:83-4. [PMID: 24623953 DOI: 10.1016/j.mjafi.2012.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 08/19/2012] [Indexed: 11/28/2022] Open
Affiliation(s)
- R P S Tomar
- Classified Specialist (Pediatrics & Neonatology), MH Jalandhar Cantt, Punjab 144005, India
| | - R Vasudevan
- Senior Advisor (Pediatrics), MH Jalandhar Cantt, Punjab, India
| | - Manoj Kumar
- Classified Specialist (ENT), MH Jalandhar Cantt, Jalandhar, Punjab, India
| | - D K Gupta
- Graded Specialist (ENT), MH Jalandhar Cantt, Jalandhar, Punjab, India
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Modern management of juvenile recurrent parotitis. The Journal of Laryngology & Otology 2012; 126:1254-60. [DOI: 10.1017/s0022215112002319] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAims:To evaluate modern diagnostic and therapeutic management of juvenile recurrent parotitis, and to show the benefits of operative sialoendoscopy on the basis of our experience in 14 patients and the results of others.Results:Ultrasonography is sensitive in detecting the pathological features of juvenile recurrent parotitis. Interventional sialoendoscopy is a safe and effective method of treating the disease. In our case series, after a mean follow-up time of 30 months only 5 patients experienced recurrence of symptoms, with a mean symptom-free period of 20 months.Conclusion:The use of modern, minimally invasive diagnostic tools such as colour Doppler ultrasonography, magnetic resonance sialography and sialoendoscopy represents a new frontier in the management of juvenile recurrent parotitis. Operative sialoendoscopy also has the important therapeutic benefit of reducing the number of recurrences of acute episodes of parotitis, thus giving patients a better quality of life until puberty.
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Gary C, Kluka EA, Schaitkin B, Walvekar RR. Interventional sialendoscopy for treatment of juvenile recurrent parotitis. J Indian Assoc Pediatr Surg 2012; 16:132-6. [PMID: 22121310 PMCID: PMC3221154 DOI: 10.4103/0971-9261.86865] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate our preliminary experience with interventional sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis (JRP). MATERIALS AND METHODS Three consecutive pediatric patients with JRP who underwent interventional sialendoscopy were identified. Interventional sialendoscopy consisted of serial dilation of the Stenson's duct, endoscopy of the ductal system and saline irrigation followed by instillation of triamcinolone acetate. Clinical, demographic, procedure-related data and complications were documented. End points of the study were technical success, defined as completion of the procedure, subjective improvement in symptoms as indicated by the patients or their parents and assessment of safety in terms of complications. RESULTS Three male patients with a mean age of 9 years (range 6-11 years) underwent interventional sialendoscopy for JRP. Endoscopic findings included a blanched stenotic duct with intraductal debris in those who were symptomatic. Technical success was 100%. The mean number of episodes of JRP in the year prior to presenting to our service among the three patients was 5 (range 4-6 per year). There were no new episodes of JRP reported at the last follow-up. There were no major complications. CONCLUSION Our preliminary experience concurs with the current literature and suggests that interventional sialendoscopy is effective for the management of JRP and can be considered for patients who fail conservative medical management.
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Affiliation(s)
- Celeste Gary
- Department of Otolaryngology Head Neck Surgery, LSU Health Sciences Center, New Orleans, LA
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Baszis K, Toib D, Cooper M, French A, White A. Recurrent parotitis as a presentation of primary pediatric Sjögren syndrome. Pediatrics 2012; 129:e179-82. [PMID: 22184654 DOI: 10.1542/peds.2011-0716] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Parotitis is a common condition seen in the pediatric population, usually as an isolated occurrence associated with viral or bacterial infection. The differential diagnosis expands when recurrent parotitis is encountered. One etiology is primary pediatric Sjögren syndrome (SS), an autoimmune condition typically associated with dryness of the eyes and mouth in adults. Pediatric patients often present with isolated recurrent bilateral parotitis, however, and we describe 4 such cases in children aged 9 to 17 years at presentation. Despite lack of ocular complaints, 3 of these patients had ocular findings on ophthalmologic exam. Our patients also exhibited classic laboratory abnormalities, including positive antinuclear antibody, SS A, and SS B antibodies; presence of rheumatoid factor; and hypergammaglobulinemia. Consideration of SS in the child with recurrent parotitis is important for timely and appropriate referral and treatment. We review the differential diagnosis of parotitis in children as well as the salient features of pediatric SS.
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Affiliation(s)
- Kevin Baszis
- Division of Pediatric Rheumatology, Washington University School of Medicine, St Louis, Missouri, USA.
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Reddy R, White DR, Gillespie MB. Obstructive Parotitis Secondary to an Acute Masseteric Bend. ORL J Otorhinolaryngol Relat Spec 2011; 74:12-5. [DOI: 10.1159/000334246] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 10/03/2011] [Indexed: 11/19/2022]
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Konstantinidis I, Chatziavramidis A, Tsakiropoulou E, Malliari H, Constantinidis J. Pediatric sialendoscopy under local anesthesia: limitations and potentials. Int J Pediatr Otorhinolaryngol 2011; 75:245-9. [PMID: 21131065 DOI: 10.1016/j.ijporl.2010.11.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/02/2010] [Accepted: 11/03/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Sialendoscopy in children is a recently described procedure. The small amount of existed literature presents the procedure under general anesthesia. We report our experience on pediatric sialendoscopy under local anesthesia at an outpatient setting. METHODS In a period of 1.5 years 9 children with age >8 years suffering from recurrent parotid swellings were assessed with sialendoscopy. In 8 out of 9 cases the parents accepted a procedure under local anesthesia. In 7 cases the procedure was completed uneventfully however in one case was discontinued and repeated under general anesthesia. The endoscope used was a 1.1mm Marchal type. Prior to endoscopy xylocaine solution 4% was applied on the papilla area for 15min. Intraductal injection of xylocaine 2% (5ml) was performed prior the insertion of the endoscope. During the procedure parents evaluated pain by means of a 6-point smiley scale. Social life and school activity were also evaluated by means of an 11-point scale pre- and 1 year post-sialendoscopy. RESULTS Seven out of eight children (8 sialendoscopies) tolerated and completed the sialendoscopy assessment. The mean duration of the procedure was 39.2min. No major complications were reported at the early post-endoscopy period. Four children presented no further swellings, two experienced one recurrence and one needed a repeat sialendoscopy (3 recurrent episodes). Sialendoscopy findings showed fibrinous debris in 4 children, mucous plugs in 2, evidence of sialodochitis with purulent debris in one child and stenosis in 3 children. The diagnosis in our cases was Juvenile Recurrent Parotitis in 6 children and chronic microbial parotitis in one case. Social life and school activity were improved in 6 children 1-year post-sialendoscopy according to parent's ratings. CONCLUSIONS Sialendoscopy under local anesthesia can be an alternative option in children of age >8 years and satisfactory cooperative skills, avoiding unnecessary general anesthesias and hospital stay.
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Affiliation(s)
- I Konstantinidis
- Sialendoscopy Clinic, 2nd ORL Department, Aristotle University, Papageorgiou Hospital, Ring Road, Efkarpia, Thessaloniki 56403, Greece.
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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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