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Hosokawa T, Tanami Y, Sato Y, Adachi N, Asanuma H, Oguma E. Clinical audit of ultrasonography for detecting sialoliths in the submandibular gland in paediatric patients: A comparison to computed tomography and magnetic resonance imaging. Australas J Ultrasound Med 2024; 27:19-25. [PMID: 38434548 PMCID: PMC10902828 DOI: 10.1002/ajum.12370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Objectives To compare the performance of ultrasonography with magnetic resonance imaging (MRI) and computed tomography (CT) for detecting submandibular sialoliths. Methods Thirteen patients with suspected submandibular sialoliths who underwent ultrasonography and CT or MRI were included. Sialoliths were diagnosed using CT (11 cases) or MRI (two cases). The submandibular duct was classified into distal and proximal ducts based on the point around the mylohyoid muscle. Sialoliths located in the proximal duct were difficult to differentiate from those located within the submandibular gland (SMG). Therefore, the location of the sialoliths was classified as follows: within the SMG/proximal duct and within the distal duct. The ultrasound results were compared with CT/MRI results. Results Of the 13 patients included, two had sialoliths in both the SMG/proximal duct and the distal duct, three had sialoliths in the SMG/proximal duct, and five had sialoliths in the distal duct on CT or MRI. In this small cohort, all five sialoliths in the SMG/proximal duct were detected by ultrasoonography; however, of the seven cases with sialoliths located in the distal duct, only three could be detected by ultrasonography. Conclusions The incidence of sialoliths in the distal duct was higher than that in the SMG/proximal duct. Ultrasonography showed a good performance compared with CT/MRI in the SMG/proximal duct but not in the distal duct.
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Affiliation(s)
- Takahiro Hosokawa
- Department of RadiologySaitama Children's Medical CenterSaitamaJapan
| | - Yutaka Tanami
- Department of RadiologySaitama Children's Medical CenterSaitamaJapan
| | - Yumiko Sato
- Department of RadiologySaitama Children's Medical CenterSaitamaJapan
| | - Nodoka Adachi
- Department of OtolaryngologySaitama Children's Medical CenterSaitamaJapan
| | - Hiroshi Asanuma
- Department of OtolaryngologySaitama Children's Medical CenterSaitamaJapan
| | - Eiji Oguma
- Department of RadiologySaitama Children's Medical CenterSaitamaJapan
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Cetinkaya V, Bonnet R, Le Thuaut A, Corre P, Mourrain-Langlois E, Delemazure-Chesneau AS, Bertin H. A comparative study of three-dimensional cone beam computed tomographic sialography and ultrasonography in the detection of non-tumoral salivary duct diseases. Dentomaxillofac Radiol 2023; 52:20220371. [PMID: 37052400 PMCID: PMC10304847 DOI: 10.1259/dmfr.20220371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To compare the overall diagnostic outcomes of 3D-CBCT sialography and ultrasonography (US) in the detection of sialolithiasis, ductal dilatation, and ductal stenosis. METHODS This retrospective monocentric study compared the two imaging modalities carried out in the same patients referred for salivary symptoms of the parotid and submandibular glands. The primary endpoint was the capacity of the imaging procedure to diagnose a lesion. The secondary objectives were the detection rates according to the type of lesion, analysis of the causes of failure, and the parameters of radiation exposure and safety (for 3D-CBCT sialography). RESULTS Of the 236 patients who received a 3D-CBCT sialography in our institution, 157 were ultimately included in the per-protocol analysis. 3D-CBCT sialography allowed detection of ductal lesions in 113 patients versus 86 with US. The two imaging modalities yielded congruent interpretations in 104 out of 157 subjects (66.2%). Higher sensitivity and negative predictive value were observed with 3D-CBCT sialography compared with US, irrespective of the lesions studied: 0.85 vs 0.65 and 0.70 vs 0.44, respectively. Regarding the sialolithiasis, both 3D-CBCT sialography and US allowed identification of lesions with high sensitivity and negative predictive value (0.80 vs 0.75 and 0.88 vs 0.78, respectively). CONCLUSIONS US remains the first-line examination for exploration of the salivary lesions. 3D-CBCT sialography is an alternative in case of inconclusive US, and prior to any endoscopic procedure.
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Affiliation(s)
- Volkan Cetinkaya
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, Nantes, France
| | - Raphael Bonnet
- Chirurgie maxillo-faciale et stomatologie, Private practicioner, Clinique Brétéché, Nantes, France
| | - Aurélie Le Thuaut
- Plateforme de méthodologie et biostatistique, Direction de la recherche et de l’innovation, CHU de Nantes, Nantes, France
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Özkan G, Köse E, Yeşiltepe S. Ultrasonographic Evaluation of Soft Tissue Calcifications in the Head and Neck Region Detected on Panoramic Radiographs. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1057-1064. [PMID: 36301624 DOI: 10.1002/jum.16117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/16/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim of this study is to present a comparison between panoramic radiographs and USG imaging with a focus on revealing the advantages of USG over radiographs, and to show the distribution of calcifications detected in USG by considering the age and gender. METHODS A total of 148 patients with soft tissue calcifications as seen on panoramic radiographs were examined with USG imaging. Sialoliths, carotid artery calcifications, tonsilloliths, phleboliths and lymph node calcifications were examined in terms of anatomical localization, distribution and shape. RESULTS In the USG evaluation of these 148 patients, soft tissue calcifications were observed in 113 (76.4%) patients. The mean age of the patients with calcification was 55.6 ± 13.1 (min: 22-max: 77). Bilateral calcifications were detected in 25 (22.1%) patients, whereas unilateral calcifications were found in 88 (77.9%) patients. While the rates of tonsilloliths, sialoliths, phleboliths, and lymph node calcifications were statistically similar in male and female patients, the rate of carotid artery calcifications was found to be higher in men than in women (P = 0.017). No statistical significance was found between age groups in terms of the formation of soft tissue calcifications (P = 0.117). CONCLUSIONS Panoramic radiographs may mislead clinicians in the diagnosis and differential diagnosis of soft tissue calcifications in the head and neck region due to the presence of distortion, superpositions, metal artefacts, and ghost images. USG is an important diagnostic tool in determining the localization of soft tissue calcifications that can be confused on two-dimensional radiographs, their relationship with neighboring structures, and defining calcification. It can be used safely in the detection of soft tissue calcifications as it provides dynamic imaging without the use of radiation or contrast material compared to other advanced imaging methods.
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Affiliation(s)
- Gökhan Özkan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
| | - Emre Köse
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
| | - Selin Yeşiltepe
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
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Koch M, Schapher ML, Mantsopoulos K, Goncalves M, Iro H. Simultaneous Application of Ultrasound and Sialendoscopy and its Value in the Management of Sialolithiasis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:289-297. [PMID: 33063297 DOI: 10.1055/a-1270-7174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Ultrasound (US) and sialendoscopy (SE) are routinely used in patients presenting with sialolithiasis in the submandibular (SMG) and parotid gland (PG). The objective was to assess the value of the simultaneous application of US and SE in the management of sialolithiasis. STUDY DESIGN Retrospective study. SETTING Tertiary referral center for salivary gland diseases. PARTICIPANTS Patients in whom US and SE as single investigation tools were neither conclusive nor useful in the management of sialolithiasis were investigated using both methods simultaneously (simUS + SE). MAIN OUTCOME MEASURES Establishment of the final diagnosis and/or contribution to the planning/performing of treatment in sialolithiasis. RESULTS 74 patients were examined by simUS + SE (58.1 % SMG and 41.9 % PG). In all patients (unclear) hyperechoic reflexes were assessed and/or localized by SE-controlled US navigation. 68.9 % of the patients were investigated for diagnostic or differential-diagnostic reasons including distinguishing extraductal from intraductal calcifications and/or to exclude residual stones after therapy. In 52.7 % simUS + SE was used to plan and/or perform further treatment, in 20.3 % to enable performing a combined approach (all PG) and in 29.7 % to evaluate and plan the most adequate therapy (mainly intraductal vs. extracorporeal shock wave lithotripsy, 68.2 % of these SMG). In two cases SE-controlled and US-guided stone extraction was performed. CONCLUSION SimUS + SE is an innovative approach which proved to be very useful in managing sialolithiasis. It added valuable information regarding the establishment of a diagnosis or differential diagnosis, planning and performing the most adequate treatment, intraoperative control of therapy and postoperative follow-up.
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Affiliation(s)
- Michael Koch
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Lothar Schapher
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Miguel Goncalves
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
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Resende EA, Gomes NR, Abreu LG, Castro MAA, Aguiar MCF. The applicability of ultrasound in the diagnosis of inflammatory and obstructive diseases of the major salivary glands: a scoping review. Dentomaxillofac Radiol 2022; 51:20210361. [PMID: 34762496 PMCID: PMC9499200 DOI: 10.1259/dmfr.20210361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The purpose of the present scoping review was to determine the contribution of ultrasound images in the diagnosis of inflammatory and obstructive diseases of the major salivary glands (MSGs). METHODS A search of studies of ultrasonographic assessments of human samples was performed in several electronic databases and grey literature up to July 2021. The extracted data were the examined MSG; the diagnostic value of ultrasound (sensibility, specificity, positive- and negative predictive value, accuracy); features of lesions, including number, echogenicity, echotexture, form, margins, size, posterior acoustic aspect, and location; and related clinical information, such as swelling, palpation, sensible to pain, salivation, lymph nodes, recurrence, duration, and causes. RESULTS After verifying the eligibility criteria, 90 articles focused on detecting inflammatory, and obstructive diseases of the MSG were gathered, with variable study designs and size samples. A wide variety of pathologies were assessed, including sialolitiasis (n = 45), acute sialadenitis (n = 30), chronic sialadenitis (n = 25), granulamatous diseases (n = 15), Kuttner's tumor (n = 11), juvenile recurrent parotitis (n = 9), abscess (n = 7), post-radiotherapy sialadenitis (n = 6), sialadenosis (n = 9), abscess (n = 7), IgG4-related disease sialadenitis (n = 5), HIV-sialadenitis (n = 4), obstructive sialadenitis (n = 3), iodinated contrast-induced sialadenitis (n = 2), and pneumoparotitis (n = 1). Most studies were case reports or series of cases. Few studies exhibited data about the accuracy of ultrasound in detecting MSG diseases. CONCLUSIONS The present scoping review concluded that ultrasound aspects of different MSG pathologies are similar but contribute to their differential diagnosis and can be considered as a valuable initial method for assessing the MSG of adults and children.
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Affiliation(s)
- Eustáquio A. Resende
- Department of Dental Clinics, Oral Pathology, and Oral Surgery of the Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Nathália R. Gomes
- Department of Dental Clinics, Oral Pathology, and Oral Surgery of the Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas G. Abreu
- Department of Child and Adolescent Oral Health of the Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mauricio A. A. Castro
- Department of Dental Clinics, Oral Pathology, and Oral Surgery of the Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Maria C. F. Aguiar
- Department of Dental Clinics, Oral Pathology, and Oral Surgery of the Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Baldovsky MD. Mass on the Floor of the Mouth in a Teenager. Pediatr Rev 2022; 43:e9-e11. [PMID: 35229115 DOI: 10.1542/pir.2020-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kim DH, Kang JM, Kim SW, Kim SH, Jung JH, Hwang SH. Utility of Ultrasonography for Diagnosis of Salivary Gland Sialolithiasis: A Meta-Analysis. Laryngoscope 2022; 132:1785-1791. [PMID: 35043982 DOI: 10.1002/lary.30020] [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: 10/24/2021] [Revised: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We hypothesized that ultrasonography for salivary gland stone detection would have a diagnostic accuracy similar to that confirmed by sialendoscopy, sialography, or surgery. Therefore, we evaluated the diagnostic characteristics of ultrasonography in terms of submandibular and parotid stone detection compared to confirmatory methods. METHODS We searched PubMed, Embase, the Web of Science, SCOPUS, and the Cochrane database to October 31, 2021. The risk of bias was evaluated using the QADAS-2 tool. RESULTS Ten studies involving 1393 patients were included in the analysis. The diagnostic odds ratio of ultrasonography was 162.6013 (95% confidence interval [CI] [53.9883; 489.7208] and I2 value 81.0%). The area under the summary receiver operating characteristic curve was 0.963. The sensitivity, specificity, negative predictive value, and positive predictive value were 0.8992 (95% CI [0.8534; 0.9318]; I2 = 79.9%), 0.9664 (95% CI [0.9290; 0.9844], I2 = 65.6%), 0.8076 (95% CI [0.7256; 0.8694]; I2 = 80.4%), and 0.9853 (95% CI [0.9629; 0.9943]; I2 = 77.4%), respectively. However, high-level among-study heterogeneity (I2 ≥ 50%) was evident, attributable to the inclusion of different glands. On subgroup analysis, significant differences in the negative predictive values (parotid gland only [0.9392], submandibular gland only [0.6718], and parotid and submandibular glands [0.8105]) were apparent. We found no significant among-study difference in the sensitivity, specificity, positive predictive value, or diagnostic odds ratio (P > .05). CONCLUSION Ultrasonography usefully detects submandibular and parotid gland stones. Ultrasonography of the parotid gland was associated with the highest diagnostic accuracy, but further clinical studies are needed. LEVEL OF EVIDENCE NA Laryngoscope, 2022.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jun Myung Kang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - So-Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Bucheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Hoon Jung
- Department of Otolaryngology-Head and Neck Surgery, Bucheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Kraaij S, Brand HS, van der Meij EH, de Visscher JG. Relationship between volume of submandibular salivary stones in vivo determined with Cone-Beam Computer Tomography and in vitro with micro-Computer Tomography. Med Oral Patol Oral Cir Bucal 2021; 26:e598-e601. [PMID: 34415002 PMCID: PMC8412442 DOI: 10.4317/medoral.24605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background Successful removal of salivary stones depends on exact pretreatment information of the location, the size and shape of the stones. This study aimed to compare the volume of submandibular sialoliths determined by preoperative Cone-Beam Computer Tomography (CBCT) scans with the volume of the removed stones on micro-Computer Tomography (micro-CT) scans. Material and Methods In this study, using twenty-one submandibular sialoliths, the pretreatment volumes in-vivo measured on CBCT were compared to the volumes of removed stones determined by micro-CT scans. The volume measured on micro-CT scans served as the gold standard. Pre-operative CBCT’s and in-vitro micro-CT’s were converted into standard tessellation language models (STL-models) using an image segmentation software package. The CBCT and micro-CT images of the stones were subsequently metrologically assessed and compared to each other using reverse engineering software. Results Volumes of submandibular sialoliths determined by CBCT’s correlated significantly with volumes measured on micro-CT’s (Spearman’s coefficient r = 0.916). The interquartile range (IQR) for the volume measured with micro-CT was 117.23. The median is 26.41. For the volume measured with CBCT the IQR was 141.3 and the median 36.61. The average volume on micro-CT is smaller than on CBCT. Conclusions When using CBCT-scans for the detection of submandibular sialoliths one should realize that in-vivo those stones are actually a fraction smaller than assessed on the preoperative scan. This is important when cut-off values of sizes of stones are used in the pretreatment planning of stone removal. Key words:Salivary stone, sialolith, CBCT, micro-CT, volume.
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Affiliation(s)
- S Kraaij
- Department of Oral Biochemistry Academic Centre for Dentistry Amsterdam (ACTA), room 12N-37 Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
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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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10
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Sialendoscopy and CT navigation assistance in the surgery of sialolithiasis. Radiol Oncol 2021; 55:284-291. [PMID: 33768767 PMCID: PMC8366728 DOI: 10.2478/raon-2021-0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A sialendoscopy-assisted combined approach is well established in the surgery of sialolithiasis. In cases of proximal salivary stones, transcutaneous sialendoscopy-assisted extractions with parotid and submandibular gland preservation is the primary intention of treatment. We recently added computer tomography (CT) navigation to improve the results of this challenging surgery equally in both localizations. PATIENTS AND METHODS Al l the patients who submitted to sialendoscopy and sialendoscopy-assisted procedures at the tertiary institution between January 2012 and October 2020 were included in the present study. From November 2019, CT navigation was added in cases with sialolithiasis and a presumably poor sialendoscopic visibility. We evaluated the parameters of the disease, diagnostic procedures, sialendoscopic findings and outcomes, with or without optical surgical navigation. RESULTS We performed 178 successful salivary stone removals in 372 patients, of which 118 were combined sialendos-copy-assisted approaches, including 16 transcutaneous proximal, 10 submandibular and 6 parotid stone operations. Surgical navigation was used in six patients, four times for submandibular and twice for parotid sialolithiasis. These were all non-palpable, sialendoscopically invisible or partially visible stones, and we managed to preserve five of the six salivary glands. CONCLUSIONS The addition of CT navigation to sialendoscopy-assisted procedures for non-palpable, sialendoscopically invisible and fixed stones is a significant advantage in managing sialolithiasis. By consistently performing sialendoscopy and related preservation procedures, we significantly reduced the need for sialoadenectomies in patients with obstructive salivary gland disease.
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Quiz J, Gillespie MB. Transoral Sialolithotomy Without Endoscopes: An Alternative Approach to Salivary Stones. Otolaryngol Clin North Am 2021; 54:553-565. [PMID: 34024483 DOI: 10.1016/j.otc.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sialoendoscopy is a valuable technique for a variety of obstructive and nonobstructive disorders of the major salivary glands. However, the utility of sialoscopes is limited for salivary stones, which frequently required open removal. Transoral sialolithotomy without scopes is an efficient, low-cost alternative with excellent outcomes available for most of the submandibular stones.
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Affiliation(s)
- Janyn Quiz
- Department of Otolaryngology-Head & Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA
| | - M Boyd Gillespie
- Department of Otolaryngology-Head & Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA.
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van der Meij EH, Beumer LJ, Matthews-Brzozowski A, de Visscher JGAM. Submandibular gland obstruction caused by an implant-retained lower denture: a report of three cases. Int J Oral Maxillofac Surg 2021; 50:1298-1302. [PMID: 33632577 DOI: 10.1016/j.ijom.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/15/2020] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate the role of lower dentures in the development of distally located stenoses of Wharton's duct and to further identify contributing factors to this mechanism. In a database of 352 patients with submandibular gland obstruction, three patients with four obstructed glands with stenosis of the ostium of Wharton's duct suspected to be caused by a lower denture were identified and further retrospectively analysed by studying medical records, operation reports, and clinical photographs. In all three cases, the causative lower dental prosthesis was implant-retained. All affected sublingual caruncles were in close relationship with the implants or the implant bar. Initially, all patients were advised to leave out the lower denture for a period of several weeks. One patient was free of symptoms after this period and did not develop any complaints after adjustment and replacement of the prosthesis. Surgical treatment with posterior rerouting of the orificium of Wharton's duct was performed in the remaining two patients because of persistent signs of obstruction. All patients were free of symptoms after long-term follow-up. Although not frequently occurring, implant-retained dental prostheses seem to play a role in the development of some distally located stenoses of Wharton's duct.
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Affiliation(s)
- E H van der Meij
- Department of Oral and Maxillofacial Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
| | - L J Beumer
- Department of Oral and Maxillofacial Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - A Matthews-Brzozowski
- Department of Oral and Maxillofacial Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - J G A M de Visscher
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Vrije Universiteit Medical Center, Amsterdam and Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands
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13
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Badger CD, Patel S, Romero NJ, Fuson A, Joshi AS. In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi. Otolaryngol Head Neck Surg 2020; 164:124-130. [PMID: 32600219 DOI: 10.1177/0194599820937676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The present study was developed to evaluate the accuracy of in vivo ultrasound sizing for parotid and submandibular salivary gland calculi, as compared with ex vivo pathology sizing with a standard plastic ruler after extraction. STUDY DESIGN Retrospective chart review. SETTING Ultrasound is frequently used to size salivary calculi and make treatment decisions, but the accuracy of measurements from this modality has not been validated. SUBJECTS AND METHODS We evaluated and reviewed the charts and ultrasound examinations of 167 patients who underwent procedures for the treatment of sialolithiasis involving the parotid and submandibular glands. US examinations were performed between 2009 and 2016 in a tertiary-level hospital setting by the senior author. Measurements were collected from ultrasound evaluation before sialolithotomy, and pathology measurements were taken after removal. Ultrasound measurements in millimeters were compared with the measurements collected with a ruler. The differences were calculated and compared. RESULTS A total of 167 calculi measurements were compared. Good concurrent validity between pathology and ultrasound measurements was suggested by a Pearson correlation of 0.92 (95% CI, 0.887-0.937). On Bland-Altman plot, correlation of the difference between US and pathology measurements showed a mean difference of 0.095 mm (95% CI, -0.19 to 0.38 mm) with a limit of agreement ranging from -3.59 mm (95% CI, -3.84 to -3.34 mm) to +3.78 mm (95% CI, +3.53 to +4.03 mm). CONCLUSIONS Ultrasound is an accurate, relatively precise, and minimally invasive imaging tool for salivary gland sialolithiasis. Preoperative size of calculi can be used to guide management and clinical decision making. LEVEL OF EVIDENCE 2C.
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Affiliation(s)
- Christopher D Badger
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Sahil Patel
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Nahir J Romero
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Andrew Fuson
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
| | - Arjun S Joshi
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington DC, USA
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André R, Becker M, Lombardi T, Buchholzer S, Marchal F, Seebach JD. Comparison of Clinical Characteristics and Magnetic Resonance Imaging of Salivary Glands With Magnetic Resonance Sialography in Sjögren's Syndrome. Laryngoscope 2020; 131:E83-E89. [PMID: 32413167 DOI: 10.1002/lary.28742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES/HYPOTHESIS To compare the results of magnetic resonance imaging with magnetic resonance sialography (MRSIAL) and the clinical and laboratory characteristics in a well-characterized cohort of patients with primary or secondary Sjögren's syndrome (SS) meeting the American-European Consensus Group criteria. STUDY DESIGN Retrospective, observational, monocentric study. METHODS Thirty-six patients (81% female, mean age = 48 ± 35 years) with primary or secondary SS who underwent MRSIAL were included in the study. RESULTS MRSIAL revealed characteristic radiological signs in the parotid, sublingual, and submandibular salivary glands in 35/36 patients (97%). Patients presenting with anti-Sjögren's syndrome-related antigen A (SSA) autoantibodies showed more often fatty infiltration, a "pepper-and-salt" appearance, ductal stenosis, and/or ductal dilation of the parotid gland (88%, 88%, and 72% respectively) than patients negative for anti-SSA (12%, 4%, and 28% respectively). MRSIAL demonstrated signs characteristic of SS in all 11 patients with negative minor salivary gland biopsy. For 15 patients undergoing ultrasound examination only, 11 (73%) had SS findings, but all 15 had SS findings on MRSIAL. Two cases of parotid lymphoma were detected by MRSIAL (6%). CONCLUSIONS MRSIAL is a reliable technique to detect glandular anomalies in patients with SS, and seems to provide a valuable aid in the diagnosis of SS. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E83-E89, 2021.
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Affiliation(s)
- Raphaël André
- Department of Dermatology, Geneva University Hospitals, Geneva, Switzerland.,Department of Allergology and Clinical Immunology, Geneva University Hospitals, Geneva, Switzerland
| | - Minerva Becker
- Department of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Tommaso Lombardi
- Department of Oral Medicine and Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Samanta Buchholzer
- Department of Maxillofacial Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Francis Marchal
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Jorg D Seebach
- Department of Allergology and Clinical Immunology, Geneva University Hospitals, Geneva, Switzerland
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Abstract
The differential diagnosis for facial swelling is broad and can be a diagnostic challenge in the pediatric emergency department. We describe the first pediatric case of acute parotitis with sialolithiasis where the diagnosis was facilitated by point-of-care ultrasound.
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Saga-Gutierrez C, Chiesa-Estomba CM, Larruscain E, Ángel González-García J, Sistiaga JA, Altuna X. Transoral Sialolitectomy Combined With Sialoendoscopy Versus Open Submaxilectomy for the Management of Hilar Lithiasis of the Submandibular Gland. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Dual-Source Dual-Energy CT in Submandibular Sialolithiasis: Reliability and Radiation Burden. AJR Am J Roentgenol 2019; 213:1291-1296. [PMID: 31573848 DOI: 10.2214/ajr.19.21299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE. This study aims to compare the diagnostic accuracy of virtual unenhanced CT images derived from dual-source dual-energy contrast-enhanced CT with that of standard unenhanced CT images for evaluation of sialolithiasis. MATERIALS AND METHODS. All dual-energy CT studies of the neck performed during the preceding 5 years were reviewed for submandibular gland calculi. Only patients who had unenhanced CT and contrast-enhanced CT performed as part of the same evaluation were included in this study. This review yielded 30 patients. Virtual unenhanced CT images were derived from the dual-energy dataset and compared with the true unenhanced CT images by two separate radiologists who assessed the total number of calculi encountered, their location, the largest dimension, and the attenuation of the calculi. The radiation burden incurred for true unenhanced CT and virtual unenhanced CT and the total radiation burden were calculated. RESULTS. Our analysis revealed that measurements of stone size showed good interobserver agreement. The mean stone size was 7.9 ± 5.9 (SD) mm on virtual unenhanced CT and 8.4 ± 5.9 mm on true unenhanced CT (range, 2.0-31.8 mm); the difference was statistically insignificant. The mean stone attenuation differed considerably (p < 0.01) between the virtual and true unenhanced CT images (494.8 ± 187.5 HU and 924.4 ± 374.9 HU, respectively), but correlated well. The mean radiation dose for a dual-phase IV contrast-enhanced CT study was 23.13 mGy (volume CT dose index). The mean dose was 10.93 mGy for the true unenhanced CT phase, thereby suggesting a 47.25% reduction in administered radiation dose when a single-phase contrast-enhanced CT study with virtual unenhanced image reconstructions is performed. CONCLUSION. Virtual unenhanced CT images derived from dual-source dual-energy CT scans of the neck provide accurate assessment of sialolithiasis akin to that provided by conventional CT protocols but at only a fraction of the radiation dosage.
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Schapher M, Goncalves M, Mantsopoulos K, Iro H, Koch M. Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2338-2348. [PMID: 31227261 DOI: 10.1016/j.ultrasmedbio.2019.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/04/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
Transcutaneous ultrasound (TCUS) is an accepted diagnostic method in salivary gland diseases. However, sparse data are available on the use of transoral ultrasound (TOUS) in sialadenopathies. One hundred five patients presenting with various obstructive sialadenopathies were examined using TOUS and TCUS. Ultrasound findings were validated by direct visualization in subsequent sialendoscopy examinations. By TOUS, but not by TCUS, all patients with sialolithiasis (70/105) could be identified and virtually all concrements, even very small ones, were detected and distinguished from artifacts. Ductal stenoses (16/105) could be correctly differentiated from sialoliths, and exceptional insights into the delicate anatomy of parotid duct stenoses were gained. TOUS provided detailed information on other space-occupying lesions (14/105) and circumvented the method-related diagnostic weaknesses of TCUS. As a valuable tool in the diagnosis of obstructive sialadenopathies, TOUS seems superior to TCUS in pathologies involving the distal parotid duct, the submandibular duct system and the floor of the mouth.
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Affiliation(s)
- Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
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Hoffman HT, Pagedar NA. Ultrasound-Guided Salivary Gland Techniques and Interpretations. Atlas Oral Maxillofac Surg Clin North Am 2019; 26:119-132. [PMID: 30077320 DOI: 10.1016/j.cxom.2018.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Henry T Hoffman
- Department of Otolaryngology, University of Iowa, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Nitin A Pagedar
- Department of Otolaryngology, University of Iowa, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, IA 52242, USA
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Sproll C, Naujoks C, Holtmann H, Kübler NR, Singh DD, Rana M, Lommen J. Removal of stones from the superficial lobe of the submandibular gland (SMG) via an intraoral endoscopy-assisted sialolithotomy. Clin Oral Investig 2019; 23:4145-4156. [PMID: 30834990 DOI: 10.1007/s00784-019-02853-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Sialolithiasis is the most common cause of chronic sialadenitis of the submandibular gland (SMG). Symptomatic superficial lobe stones are often treated by submandibulectomy. A gland preserving operation allows for transoral stone removal through endoscopically assisted sialolithotomy. Herein, we provide clinical and sonographical follow-up data in patients who underwent sialolithotomy under general anesthesia. MATERIALS AND METHODS Sixty patients treated at the Department of Oral and Maxillofacial Surgery at Düsseldorf University Hospital for superficial lobe sialolithiasis of SMG were included in this study. All received transoral sialolithotomy under general anesthesia. Follow-up was conducted via standardized patient questionnaires, clinical examination, and B-mode and color Doppler sonography. RESULTS Mean patient age was 48.9 years. 56.6% of right and 43.4% of left SMG were affected. Mean follow-up was 45 months. Fifty-five of 59 detected stones could be removed. Mean operation time was 71 min. 3.3% of patients reported recurrent episodes of postoperative pain and 10% felt recurrent episodes of gland swelling. Persistent postoperative lingual nerve hypesthesia was described in one patient. No facial nerve damages occurred. Salivary flow rates remained reduced in most of the affected glands upon stone removal. Sonographical follow-up data of the previously affected SMG after intraoral endoscopy-assisted sialolithotomy showed a regular gland size in 70.8% of cases, a parenchyma free of inflammation in 93.8%, and without signs of fibrosis in 72.9% of cases. 68.7% of patients showed a regular structure of Wharton's duct at time of follow-up. In total, 89.6% of patients were diagnosed stone-free within both glands on follow-up. No case required subsequent submandibulectomy. CONCLUSIONS Sialolithotomy of Wharton's duct for removal of stones from the SMG's superficial lobe is a promising alternative to submandibulectomy. CLINICAL RELEVANCE Reduction of postoperative morbidity through endoscopically assisted sialolithotomy for removal of superficial lobe stones from SMG. TRIAL REGISTRATION Ethics Committee of Heinrich-Heine-University Düsseldorf (no. 5586).
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Affiliation(s)
- Christoph Sproll
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany
| | | | - Henrik Holtmann
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Norbert R Kübler
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Daman Deep Singh
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Majeed Rana
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Julian Lommen
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany.
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Romero NJ, Fuson A, Kieliszak CR, Joshi AS. Sonolocation during submandibular sialolithotomy. Laryngoscope 2019; 129:2716-2720. [DOI: 10.1002/lary.27816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/02/2018] [Accepted: 09/10/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Nahir J. Romero
- The Division of Otolaryngology–Head and Neck SurgeryGeorge Washington University Washington DC
| | - Andrew Fuson
- The Division of Otolaryngology–Head and Neck SurgeryGeorge Washington University Washington DC
| | - Christopher R. Kieliszak
- the Department of Otolaryngology–Head and Neck SurgeryOhioHealth Doctors Hospital Columbus Ohio U.S.A
| | - Arjun S. Joshi
- The Division of Otolaryngology–Head and Neck SurgeryGeorge Washington University Washington DC
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22
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Saga-Gutierrez C, Chiesa-Estomba CM, Larruscain E, González-García JÁ, Sistiaga JA, Altuna X. Transoral sialolitectomy combined with sialoendoscopy versus open submaxilectomy for the management of hilar lithiasis of the submandibular gland. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018; 70:342-347. [PMID: 30579511 DOI: 10.1016/j.otorri.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/02/2018] [Accepted: 09/07/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The treatment of salivary obstructive pathology by minimally invasive techniques has been an object of assessment by different studies for decades. Lithiasis at the level of the salivary duct will be the most frequent cause of obstruction, representing more than 50% of the pathology of the major salivary glands and almost 80% of these affecting the Wharton duct. MATERIAL AND METHODS A prospective study comparing the results of combined transoral sialolitectomy (CTS) and open submaxillectomy techniques by cervicotomy in 2 groups of patients treated by lithiasis at the level of the hilum of the submaxillary gland. RESULTS 22 patients were included in the study 16 (72.7%) were men and 6 (27.3%) were women, the average age was 54.41 years ± 12.75 (Min: 30/Max: 77). Regarding the variables associated with the disease: average lithiasis, size of the stone, hospital stay, lingual nerve alteration or complications for both techniques, differences were not found between both groups. There were only statistically significant differences in the average stay in favor of the CTS (P=.001). CONCLUSION The minimally invasive approaches to the salivary ductal system, associated or not with sialoendoscopy, can be efficacy and can be associated with lower number of complications. The natural tendency should be aimed to gradually replacing open sialoadenectomy techniques, reserving its indication for the treatment of tumor pathology.
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Affiliation(s)
- Carlos Saga-Gutierrez
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Carlos Miguel Chiesa-Estomba
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
| | - Ekhiñe Larruscain
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - José Ángel González-García
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Jon Alexander Sistiaga
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Xabier Altuna
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
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3D Reconstruction and Prediction of Sialolith Surgery. Case Rep Dent 2018; 2018:3951956. [PMID: 30538868 PMCID: PMC6257896 DOI: 10.1155/2018/3951956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/29/2018] [Accepted: 08/28/2018] [Indexed: 11/17/2022] Open
Abstract
Imaging examinations play an important role in the diagnosis of sialolithiasis, whose symptoms are initially confounded with other diseases. The objective of the present case report is to highlight imaging and processing techniques as well as image analysis for the preoperative assessment and planning of surgical interventions and adequate treatment of massive sialoliths. A 35-year-old male patient presented complaining of pain in the submandibular region and purulent secretions from a lingual caruncle with slightly increased volume in the region. Imaging examinations were ordered as follows: cone beam computed tomography, ultrasonography, and three-dimensional reconstruction, including clinical evaluation. A final diagnosis of sialolithiasis was established. Surgery was indicated and carried out by using a lateral transcervical approach for complete resection of the gland, which was based on the calculation of the total volume of the sialolith, thus increasing the surgery's success.
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Goncalves M, Mantsopoulos K, Schapher M, Iro H, Koch M. Ultrasound Supplemented by Sialendoscopy: Diagnostic Value in Sialolithiasis. Otolaryngol Head Neck Surg 2018; 159:449-455. [DOI: 10.1177/0194599818775946] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To assess the value of ultrasound, if indicated, supplemented by sialendoscopy, in the diagnosis of sialolithiasis. Study Design Retrospective study. Setting Referring center for salivary gland diseases. Subjects and Methods All patients who presented with a suspected diagnosis of obstructive sialopathy between January 2011 and April 2017 and had not undergone any treatment were retrospectively evaluated. A total of 2052 patients and 2277 glands were included in the study. Ultrasound examinations were carried out initially and followed by sialendoscopy in all cases. Direct demonstration of sialothiasis by sialendoscopy, transoral ductal surgery, and discharge of concrements/observation of fragments during sialendoscopy after extracorporeal shock-wave lithotripsy were regarded as definitive evidence of sialolithiasis. Results Ultrasound had an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 94.77%, 94.91%, 94.57%, 96.14%, and 92.89%, respectively, for the diagnosis of sialolithiasis. All false-positive findings were correctly diagnosed, and in all false-negative findings, stones/fragments were visualized by sialendoscopy. Over 95% of the false-negative findings in major salivary glands (64/67) had visible ductal dilation in sonography, and in 73.1%, the stones not detected on ultrasound were located in the distal part of the duct, which is easily accessible with the sialendoscope. Conclusion This study shows that sialolithiasis can be diagnosed using ultrasonography with a high degree of certainty. If supplemented by sialendoscopy, the correct diagnosis could be established in virtually all cases of sialolithiasis. Ultrasound supplemented by sialendoscopy has the potential to serve as an alternative diagnostic standard in the future.
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Affiliation(s)
- Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
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Frank SJ, Koenigsberg T, Gutman D, Koenigsberg M. Applications of 3-Dimensional Ultrasonography in the Neck, Excluding the Thyroid. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:1791-1806. [PMID: 29288583 DOI: 10.1002/jum.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/27/2017] [Accepted: 09/30/2017] [Indexed: 06/07/2023]
Abstract
Ultrasonography (US) of the neck is an accepted, useful imaging modality for many applications beyond its usefulness in thyroid disease. Two-dimensional US has been effectively used for evaluation of many types of neck conditions, and now, 3-dimensional US can be added to the imaging armamentaria. Three-dimensional US is useful in the evaluation of cervical lymph nodes, recurrent/residual thyroid neoplasia, parathyroid glands, parotid and submandibular glands, as well as thyroglossal duct cysts and other assorted palpable and visible abnormalities because of its unique capabilities, including multiplanar reconstruction, accessibility of the coronal view, volume calculation, and regularly spaced incremental slice evaluation.
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Affiliation(s)
- Susan J Frank
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Tova Koenigsberg
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David Gutman
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mordecai Koenigsberg
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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Ugga L, Ravanelli M, Pallottino AA, Farina D, Maroldi R. Diagnostic work-up in obstructive and inflammatory salivary gland disorders. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:83-93. [PMID: 28516970 PMCID: PMC5463527 DOI: 10.14639/0392-100x-1597] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023]
Abstract
Inflammatory and obstructive disorders of the salivary glands are caused by very different pathological conditions affecting the gland tissue and/or the excretory system. The clinical setting is essential to address the appropriate diagnostic imaging work-up. According to history and physical examination, four main clinical scenarios can be recognised: (1) acute generalised swelling of major salivary glands; (2) acute swelling of a single major salivary gland; (3) chronic generalised swelling of major salivary glands, associated or not with "dry mouth"; (4) chronic or prolonged swelling of a single major salivary gland. The algorithm for imaging salivary glands depends on the scenario with which the patient presents to the clinician. Imaging is essential to confirm clinical diagnosis, define the extent of the disease and identify complications. Imaging techniques include ultrasound (US), computed tomography (CT) and magnetic resonance (MR) with MR sialography.
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Affiliation(s)
- L Ugga
- Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy
| | - M Ravanelli
- Department of Radiology, University of Brescia, Brescia, Italy
| | - A A Pallottino
- Department of Radiology, Campus Biomedico University, Rome, Italy
| | - D Farina
- Department of Radiology, University of Brescia, Brescia, Italy
| | - R Maroldi
- Department of Radiology, University of Brescia, Brescia, Italy
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Friedman E, Patiño MO, Udayasankar UK. Imaging of Pediatric Salivary Glands. Neuroimaging Clin N Am 2018; 28:209-226. [DOI: 10.1016/j.nic.2018.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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28
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Ruiz R, Brygo A, Nicot R, Ferri J. Sialolithiasis removal under general anesthesia: A descriptive retrospective study in the maxillofacial surgery department in Lille University Hospital. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 119:97-101. [DOI: 10.1016/j.jormas.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/01/2017] [Accepted: 11/02/2017] [Indexed: 11/29/2022]
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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. Int J Oral Maxillofac Surg 2018; 47:223-227. [DOI: 10.1016/j.ijom.2017.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 11/19/2022]
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30
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Yao L, Zhang Y, Chen Q, Wang S, Wang Q, Yi J, Zhang L, Matz EL, Hu X, Huang G. Diagnosis of lymphoepithelial carcinoma in parotid gland with three dimensional computed tomography angiography reconstruction: A case report. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:155-164. [PMID: 29480238 DOI: 10.3233/xst-17347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Lymphoepithelial carcinoma (LEC) is an uncommon malignant neoplasm. Due to the complicated anatomical structure of the human head, standard imaging modalities including ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scan remain limited in detection of salivary tumors. We used three-dimensional computed tomography angiography (3D-CT angiography) for the assessment and pre-operative surgical planning of facial fractures of a case with LEC. The study results demonstrated that 3D-CT angiography provided an insightful approach to preoperative evaluation in the treatment of salivary tumors.
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Affiliation(s)
- Li Yao
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Qijun Chen
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Shuai Wang
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Qingjian Wang
- Department of Medical Image, Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Jie Yi
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Ligang Zhang
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Ethan L Matz
- Wake Forest Institute for Regenerative Medicine, School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Xiaohua Hu
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Guilin Huang
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
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31
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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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Gardon MA, Foletti JM, Avignon S, Graillon N, Chossegros C. CT scan assessment in salivary gland lithiasis diagnosis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 119:110-112. [PMID: 29175510 DOI: 10.1016/j.jormas.2017.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/22/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of the study was to assess computed tomography (CT) scan efficiency for the diagnosis of salivary lithiasis. METHODS Patients who were included were all the patients who consulted in our department for main salivary gland (submandibular and parotid) obstruction symptoms between June 2014 and December 2016. A CT scan without injection was prescribed for all of them. The 163 patients were divided into two groups after the CT scan: patients with and without lithiasis. During surgery, we confirmed the presence or absence of the lithiasis previously diagnosed on the CT scan. The patients were divided in two groups: case and control groups. For statistical analysis, the sensitivity, specificity, and the negative and positive predictive values of the preoperative CT scan were calculated. RESULTS A total of 163 patients with a salivary obstructive syndrome were included. On the CT scans, we found lithiases (hyperdense images) in 157 glands ("CT scan⊕" group), and we found no lithiasis in 6 glands ("CT scan" group). In the "CT scan⊕" group, 203 lithiases were present. During surgery, we found and removed lithiases in 155 patients (case group), and 8 patients had no lithiases (control group). The overall sensitivity, specificity, positive predictive value, and negative predictive values of the CT scan for the detection of lithiasis were 100%, 75%, 99%, and 100%, respectively. The specificity of CT scans for the lithiasis located in the anterior and middle third of the duct was 100%. DISCUSSION According to our study, the CT scan is very efficient in diagnosing salivary main gland lithiases in patients with an obstructive syndrome.
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Affiliation(s)
- M A Gardon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France.
| | - J M Foletti
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial & plastic surg department, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - S Avignon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - N Graillon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - C Chossegros
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France; Laboratoire parole et langage, 5, rue Pasteur, 13100 Aix-en-Provence, France
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Goncalves M, Schapher M, Iro H, Wuest W, Mantsopoulos K, Koch M. Value of Sonography in the Diagnosis of Sialolithiasis: Comparison With the Reference Standard of Direct Stone Identification. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2227-2235. [PMID: 28556090 DOI: 10.1002/jum.14255] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 02/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to assess the effectiveness of sonography for diagnosing sialolithiasis in comparison with the existing reference standard of direct identification of a stone. METHODS A total of 659 glands with signs of obstructive sialadenopathy were evaluated retrospectively. Sonographic examinations of the large head salivary glands had been performed initially in all cases. Direct depiction of a stone during sialoendoscopy or transoral ductal surgery or observation of stone fragmentation with discharge of concrements after extracorporeal shock wave lithotripsy, was regarded as definitive evidence and as the reference standard for the presence of sialolithiasis. The sonographic results were compared with those for direct identification of stones. RESULTS The sensitivity of sonography was 94.7%, with specificity of 97.4%, a positive predictive value of 99.4%, and a negative predictive value of 79.6%. Stones that were not diagnosed correctly on sonography were most often located in the distal area of the duct. CONCLUSIONS These results show that sialolithiasis can be diagnosed by sonography with a high degree of certainty. Sonography thus appears to be highly appropriate as the examination method of choice.
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Affiliation(s)
- Miguel Goncalves
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Wolfgang Wuest
- Institute of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Larson AR, Aubin-Pouliot A, Delagnes E, Zheng M, Chang JL, Ryan WR. Surgeon-Performed Ultrasound for Chronic Obstructive Sialadenitis Helps Predict Sialendoscopic Findings and Outcomes. Otolaryngol Head Neck Surg 2017; 157:973-980. [DOI: 10.1177/0194599817728867] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To determine the accuracy of surgeon-performed ultrasound (SP-US) features for predicting intraoperative sialendoscopic findings and to correlate ultrasound features with short-term symptomatic outcomes following sialendoscopy-assisted salivary duct surgery (SASDS). Study Design Case series with chart review. Setting The practices of 2 academic sialendoscopy surgeons. Subjects and Methods Between February 2014 and September 2015, 82 patients with 105 symptomatic glands underwent SASDS, of whom 56 patients (75 glands) met inclusion criteria. SP-US and sialendoscopic findings were reviewed for patients with chronic obstructive sialadenitis who underwent SASDS and who had been prospectively evaluated with the University of California–San Francisco Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire (scored 0-100) administered preoperatively and 3 months postoperatively. Results The positive predictive value (PPV) and negative predictive value (NPV) of SP-US for identifying sialoliths intraoperatively were 94% (33/35) and 91% (39/43), respectively. Of glands with sialoliths on SP-US, 97% (34/35) had complete symptom resolution (COSS ≤10) after SASDS. The PPV and NPV of salivary duct dilation on SP-US for finding a corresponding stenosis on sialendoscopy were 93% (14/15) and 50% (14/28), respectively. Nonsialolith SP-US features with the highest PPV for complete or partial symptom resolution (COSS ≤25) following SASDS included distal duct dilation of all glands (86%; 6/7) and dilation of both distal and proximal parotid ducts (75%; 6/8). Conclusion SP-US has high accuracy for ruling in and ruling out sialoliths, as well as for ruling in but not for necessarily ruling out stenosis presence and location. Ultrasound is helpful in estimating degree of short-term symptom response following SASDS.
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Affiliation(s)
- Andrew R. Larson
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Annick Aubin-Pouliot
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Elise Delagnes
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Melissa Zheng
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Jolie L. Chang
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - William R. Ryan
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
- Salivary Gland Center, Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
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Knopf A, Cortolezis N, Bas M, Mansour N, Hofauer B. Multimodal ultrasonographic algorithm in the differentiation of submandibular masses. Acta Otolaryngol 2017; 137:640-645. [PMID: 28084145 DOI: 10.1080/00016489.2016.1269363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
CONCLUSION The multimodal diagnostic algorithm is a simple diagnostic tool in the pre-operative assessment of submandibular masses that enables one-stage surgical concepts. BACKGROUND The pre-operative assessment of submandibular masses is of major clinical impact. This study assesses the diagnostic utility of a newly introduced diagnostic algorithm in the differentiation of submandibular masses based on epidemiological and B-mode ultrasonographic data. METHODS One hundred and eighty-eight patients with submandibular triangle masses were included. Epidemiological and ultrasonographic data of 128 consecutively included patients were assessed and structured in a multimodal algorithm. The diagnostic algorithm was prospectively validated in a further 60 patients. RESULTS Single epidemiological and ultrasonographic data do not reliably predict the lesional entity. The multimodal diagnostic algorithm achieved a diagnostic sensitivity/specificity of 100%/100% in sialolithiasis, 44%/100% in benign submandibular gland diseases (BSD), 94%/96% in nodal lymphoma/unspecific lymphadenitis, and 91%/84% in carcinomas. Reduced sensitivity in BSD or specificity in carcinomas increased after intra-operative fresh frozen section in patients suspected for BSD.
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Affiliation(s)
- Andreas Knopf
- Department of Otorhinolaryngology/Head and Neck Surgery, Technische Universität München, München, Germany
| | - Nikolaus Cortolezis
- Department of Otorhinolaryngology/Head and Neck Surgery, Technische Universität München, München, Germany
| | - Murat Bas
- Department of Otorhinolaryngology/Head and Neck Surgery, Technische Universität München, München, Germany
| | - Naglaa Mansour
- Department of Otorhinolaryngology/Head and Neck Surgery, Technische Universität München, München, Germany
| | - Benedikt Hofauer
- Department of Otorhinolaryngology/Head and Neck Surgery, Technische Universität München, München, Germany
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Ng SK, Chan JYK, Wong EWY, Vlantis AC. Diagnostic accuracy of sialendoscopy referenced to current imaging modalities. SURGICAL PRACTICE 2017. [DOI: 10.1111/1744-1633.12239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Siu-Kwan Ng
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Jason Ying-Kuen Chan
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Eddy Wai-Yeung Wong
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
| | - Alexander Chris Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery; The Chinese University of Hong Kong, Prince of Wales Hospital; Hong Kong
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Thomas WW, Douglas JE, Rassekh CH. Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis. Otolaryngol Head Neck Surg 2017; 156:834-839. [DOI: 10.1177/0194599817696308] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To determine the accuracy of the 2 most utilized imaging modalities in obstructive sialadenitis secondary to sialolithiasis—computed tomography (CT) and ultrasonography (US)—using sialendoscopic findings as a comparison standard. To review the impact of CT and US on the management of sialolithiasis managed with sialendoscopy alone and through combined approaches. Study Design Retrospective cohort study. Setting Quaternary academic referral center. Subjects and Methods All cases of patients undergoing sialendoscopy by a single surgeon for suspected parotid and submandibular gland pathology between the October 2013 and April 2016 were reviewed. Results Sixty-eight patients were in this cohort, of whom 44 underwent US, CT, and sialendoscopy; 20 underwent CT and sialendoscopy only; and 4 underwent US and sialendoscopy only. The sensitivity and specificity were 65% and 80% for US and 98% and 88% for CT, respectively. These 68 patients had 84 total stones addressed, with 79 being removed and 5 remaining in situ. The methods of stone removal were sialendoscopy alone (34 stones), open transoral approaches (36 stones), and an external approach: transcervical for submandibular and transfacial for parotid (11 stones). Conclusion US had a lower sensitivity (65%) than what has been reported in the literature (70%-94%), and the majority of missed stones were anterior Wharton’s duct stones. These sialoliths were likely missed due to an incomplete examination. US and CT were complementary in this study, and the findings suggest that both modalities can be utilized to optimize the outcome of sialendoscopy and combined approaches.
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Affiliation(s)
- W. Walsh Thomas
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer E. Douglas
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christopher H. Rassekh
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Abdel Razek AAK, Mukherji S. Imaging of sialadenitis. Neuroradiol J 2017. [DOI: 10.1177/1971400916682752 and 67=89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sialadenitis is an inflammation or infection of the salivary glands that may affect the parotid, submandibular and small salivary glands. Imaging findings vary among unilateral or bilateral salivary gland enlargement, atrophy, abscess, ductal dilation, cysts, stones and calcification. Imaging can detect abscess in acute bacterial suppurative sialadenitis, ductal changes with cysts in chronic adult and juvenile recurrent parotitis. Imaging is sensitive for detection of salivary stones and stricture in obstructive sialadenitis. Immunoglobulin G4-sialadenitis appears as bilateral submandibular gland enlargement. Imaging is helpful in staging and surveillance of patients with Sjögren’s syndrome. Correlation of imaging findings with clinical presentation can aid diagnosis of granulomatous sialadenitis. Post-treatment sialadenitis can occur after radiotherapy, radioactive iodine or surgery.
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Abstract
Sialadenitis is an inflammation or infection of the salivary glands that may affect the parotid, submandibular and small salivary glands. Imaging findings vary among unilateral or bilateral salivary gland enlargement, atrophy, abscess, ductal dilation, cysts, stones and calcification. Imaging can detect abscess in acute bacterial suppurative sialadenitis, ductal changes with cysts in chronic adult and juvenile recurrent parotitis. Imaging is sensitive for detection of salivary stones and stricture in obstructive sialadenitis. Immunoglobulin G4-sialadenitis appears as bilateral submandibular gland enlargement. Imaging is helpful in staging and surveillance of patients with Sjögren's syndrome. Correlation of imaging findings with clinical presentation can aid diagnosis of granulomatous sialadenitis. Post-treatment sialadenitis can occur after radiotherapy, radioactive iodine or surgery.
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40
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Abdel Razek AAK, Mukherji S. Imaging of sialadenitis. Neuroradiol J 2017. [DOI: 10.1177/1971400916682752 and 21=21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sialadenitis is an inflammation or infection of the salivary glands that may affect the parotid, submandibular and small salivary glands. Imaging findings vary among unilateral or bilateral salivary gland enlargement, atrophy, abscess, ductal dilation, cysts, stones and calcification. Imaging can detect abscess in acute bacterial suppurative sialadenitis, ductal changes with cysts in chronic adult and juvenile recurrent parotitis. Imaging is sensitive for detection of salivary stones and stricture in obstructive sialadenitis. Immunoglobulin G4-sialadenitis appears as bilateral submandibular gland enlargement. Imaging is helpful in staging and surveillance of patients with Sjögren’s syndrome. Correlation of imaging findings with clinical presentation can aid diagnosis of granulomatous sialadenitis. Post-treatment sialadenitis can occur after radiotherapy, radioactive iodine or surgery.
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Zajkowski P, Ochal-Choińska A. Standards for the assessment of salivary glands - an update. J Ultrason 2016; 16:175-90. [PMID: 27446602 PMCID: PMC4954863 DOI: 10.15557/jou.2016.0019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/02/2016] [Accepted: 05/07/2016] [Indexed: 11/22/2022] Open
Abstract
The paper is an update of 2011 Standards for Ultrasound Assessment of Salivary Glands, which were developed by the Polish Ultrasound Society. We have described current ultrasound technical requirements, assessment and measurement techniques as well as guidelines for ultrasound description. We have also discussed an ultrasound image of normal salivary glands as well as the most important pathologies, such as inflammation, sialosis, collagenosis, injuries and proliferative processes, with particular emphasis on lesions indicating high risk of malignancy. In acute bacterial inflammation, the salivary glands appear as hypoechoic, enlarged or normal-sized, with increased parenchymal flow. The echogenicity is significantly increased in viral infections. Degenerative lesions may be seen in chronic inflammations. Hyperechoic deposits with acoustic shadowing can be visualized in lithiasis. Parenchymal fibrosis is a dominant feature of sialosis. Sjögren syndrome produces different pictures of salivary gland parenchymal lesions at different stages of the disease. Pleomorphic adenomas are usually hypoechoic, well-defined and polycyclic in most cases. Warthin tumor usually presents as a hypoechoic, oval-shaped lesion with anechoic cystic spaces. Malignancies are characterized by blurred outlines, irregular shape, usually heterogeneous echogenicity and pathological neovascularization. The accompanying metastatic lesions are another indicator of malignancy, however, final diagnosis should be based on biopsy findings.
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Affiliation(s)
- Piotr Zajkowski
- Department of Diagnostic Imaging, the Second Faculty of Medicine, Medical University of Warsaw, Poland
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Jokela J, Haapaniemi A, Ojala J, Mäkitie A, Saarinen R. Sialendoscopy in sialadenitis: an unselected cohort of 228 patients. Clin Otolaryngol 2016; 41:416-20. [PMID: 26333199 DOI: 10.1111/coa.12531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J Jokela
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Haapaniemi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J Ojala
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - R Saarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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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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Schwarz D, Kabbasch C, Scheer M, Mikolajczak S, Beutner D, Luers JC. Comparative analysis of sialendoscopy, sonography, and CBCT in the detection of sialolithiasis. Laryngoscope 2014; 125:1098-101. [DOI: 10.1002/lary.24966] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/12/2014] [Accepted: 09/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
- David Schwarz
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | | | - Martin Scheer
- Department of Oral and Maxillofacial Surgery; Johannes Wesling Hospital; Minden Germany
| | - Stefanie Mikolajczak
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | - Jan C. Luers
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
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Afzelius P, Nielsen MY, Ewertsen C, Bloch KP. Imaging of the major salivary glands. Clin Physiol Funct Imaging 2014; 36:1-10. [DOI: 10.1111/cpf.12199] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/18/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Pia Afzelius
- Department of Diagnostic Imaging; North Zealand Hospital; Copenhagen Denmark
| | - Ming-Yuan Nielsen
- Department of Diagnostic Imaging; North Zealand Hospital; Copenhagen Denmark
| | - Caroline Ewertsen
- Department of Radiology, Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Klaus Poulsen Bloch
- Department of Diagnostic Imaging; North Zealand Hospital; Copenhagen Denmark
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FDG-PET/CT pitfalls in oncological head and neck imaging. Insights Imaging 2014; 5:585-602. [PMID: 25154759 PMCID: PMC4195840 DOI: 10.1007/s13244-014-0349-x] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/08/2014] [Accepted: 07/21/2014] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Positron emission tomography-computed tomography (PET/CT) with fluorine-18-fluorodeoxy-D-glucose (FDG) has evolved from a research modality to an invaluable tool in head and neck cancer imaging. However, interpretation of FDG PET/CT studies may be difficult due to the inherently complex anatomical landmarks, certain physiological variants and unusual patterns of high FDG uptake in the head and neck. The purpose of this article is to provide a comprehensive approach to key imaging features and interpretation pitfalls of FDG-PET/CT of the head and neck and how to avoid them. METHODS We review the pathophysiological mechanisms leading to potentially false-positive and false-negative assessments, and we discuss the complementary use of high-resolution contrast-enhanced head and neck PET/CT (HR HN PET/CT) and additional cross-sectional imaging techniques, including ultrasound (US) and magnetic resonance imaging (MRI). RESULTS The commonly encountered false-positive PET/CT interpretation pitfalls are due to high FDG uptake by physiological causes, benign thyroid nodules, unilateral cranial nerve palsy and increased FDG uptake due to inflammation, recent chemoradiotherapy and surgery. False-negative findings are caused by lesion vicinity to structures with high glucose metabolism, obscuration of FDG uptake by dental hardware, inadequate PET scanner resolution and inherent low FDG-avidity of some tumours. CONCLUSIONS The interpreting physician must be aware of these unusual patterns of FDG uptake, as well as limitations of PET/CT as a modality, in order to avoid overdiagnosis of benign conditions as malignancy, as well as missing out on actual pathology. TEACHING POINTS • Knowledge of key imaging features of physiological and non-physiological FDG uptake is essential for the interpretation of head and neck PET/CT studies. • Precise anatomical evaluation and correlation with contrast-enhanced CT, US or MRI avoid PET/CT misinterpretation. • Awareness of unusual FDG uptake patterns avoids overdiagnosis of benign conditions as malignancy.
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Abstract
Objective To study the sensitivity and specificity of physical examination, ultrasound (US) alone, and sonopalpation (concurrent US and transoral palpation) for identification of submandibular gland (SMG) calculi. Study Design Case series with prospective data collection. Setting Tertiary-level academic center. Subject and Methods Patients with suspected SMG swelling were examined by physical examination, US alone, and sonopalpation. The presence or absence and location of sialolithiasis was noted in each group. Sialendoscopy, open sialolithotomy, or sialadenectomy was performed as the gold standard for definitive diagnosis. Sensitivity and specificity for each technique was then determined. Results Sixty-nine patients were identified with SMG swelling. Physical examination, US, and sonopalpation positively identified sialoliths in 49, 54, and 57 patients, respectively. Fifty-nine patients eventually demonstrated calculi. Sensitivity of physical examination, US alone, and sonopalpation for SMG calculi was 83%, 91%, and 96.6%, respectively. Specificity for physical examination was 60%, 80% for US alone, and 90% for sonopalpation. Of 59 patients with stones, 17 patients underwent purely endoscopic procedures, 36 patients underwent combined or purely transoral approaches, and 6 underwent sialadenectomy. Of the 3 modalities, only sonopalpation was able to both identify and localize pathology and guide treatment management. Conclusion US is effective in the diagnosis and management of SMG stones during sialendoscopy or sialolithotomy. Sonopalpation has increased sensitivity and specificity over US alone or physical examination not only for the detection of SMG calculi but also for localization of pathology in the ductal system.
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Affiliation(s)
- Nitin J. Patel
- Division of Otolaryngology–Head and Neck Surgery, The George Washington University, Washington, District of Columbia, USA
| | - Sean Hashemi
- The George Washington University, Washington, District of Columbia, USA
| | - Arjun S. Joshi
- Division of Otolaryngology–Head and Neck Surgery, The George Washington University, Washington, District of Columbia, USA
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50
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Kiringoda R, Eisele DW, Chang JL. A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders. Laryngoscope 2014; 124:2696-701. [DOI: 10.1002/lary.24787] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/28/2014] [Accepted: 05/22/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
| | - David W. Eisele
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
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