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Zhao YN, Zheng DN, Qu LY, Xie XY, Liu DG, Yu GY. Removal of intraglandular calculi in Wharton's duct: clinical outcome and treatment algorithm. Int J Oral Maxillofac Surg 2024; 53:382-388. [PMID: 38092608 DOI: 10.1016/j.ijom.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 04/16/2024]
Abstract
The aim of this study was to propose a treatment strategy for intraglandular submandibular calculi based on calculus site. Seventy-three consecutive patients with impalpable intraglandular submandibular calculi were enrolled retrospectively. The calculi were classified as either post-hilar type, central type, or superficial type. Treatment approaches included transoral duct slitting (TDS), interventional basket retrieval (IBR), intraductal laser lithotripsy (ILL), and transcervical lithotomy (TCL). Complete calculus removal with gland preservation was achieved in 64 patients (87.7%). The success rate for post-hilar, central, and superficial calculi was 86.4% (51/59), 90.9% (10/11), and 100% (3/3), respectively. The treatment approach applied in patients with treatment success was TDS in 32 cases, IBR in 20, ILL in nine, and TCL in three. During follow-up (median 17.3 months), one patient experienced gland atrophy and three had ductal stenosis; the remaining 60 patients (93.8%, 60/64) had good clinical outcomes. In the eight failure cases operated by TDS, the deeply situated calculi could not be detached despite the parenchymal incision in five cases, while the procedure was ceased due to the patient's inability to cooperate in the other three cases. In the remaining failure case, the submandibular gland was sacrificed after calculus extraction via TCL. Application of the proposed treatment algorithm might help preserve gland function in patients with intraglandular submandibular calculi.
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Affiliation(s)
- Y-N Zhao
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - D-N Zheng
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - L-Y Qu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - X-Y Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
| | - D-G Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China.
| | - G-Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China
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2
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Hafrén L, Mäkinen LK, Haapaniemi A, Jokela J, Saarinen R. Removal of parotid sialoliths; techniques, complications, and success rate-A cohort study. Clin Otolaryngol 2024; 49:337-342. [PMID: 38229214 DOI: 10.1111/coa.14141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 09/12/2023] [Accepted: 12/16/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Lena Hafrén
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Pulmonology, Heart and Lung Center, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Jokela
- Department of Otorhinolaryngology, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Riitta Saarinen
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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McInerney NJ, Timon F, O'Keeffe N, Nae A, Timon C. Intra-oral Parotid Duct Exploration and Ductoplasty for Large Parotid Duct Stones: How We Do It. Laryngoscope 2024; 134:2269-2271. [PMID: 37792398 DOI: 10.1002/lary.31090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/24/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023]
Affiliation(s)
- N J McInerney
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - F Timon
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - N O'Keeffe
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - A Nae
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - C Timon
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Seth R, Yadav A, Rai V, Gupta A. Ultrasound-Guided Percutaneous Parotid Duct Access After Failed Sialendoscopy in A Case of Sialolithiasis. Cardiovasc Intervent Radiol 2024; 47:401-402. [PMID: 38110754 DOI: 10.1007/s00270-023-03624-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/11/2023] [Indexed: 12/20/2023]
Affiliation(s)
- Raghav Seth
- Department of Interventional Radiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Ajit Yadav
- Department of Interventional Radiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Varun Rai
- Department of ENT, Sir Ganga Ram Hospital, New Delhi, India
| | - Arun Gupta
- Department of Interventional Radiology, Sir Ganga Ram Hospital, New Delhi, India.
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Miller AL, Hysinger EB, Tabangin ME, Torres-Silva C, de Alarcon A, Hart CK. Pulmonary and Clinical Outcomes After Bilateral Submandibular Gland Excision and Parotid Duct Ligation for Refractory Sialorrhea. JAMA Otolaryngol Head Neck Surg 2024; 150:57-64. [PMID: 38008865 PMCID: PMC10666045 DOI: 10.1001/jamaoto.2023.3670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/01/2023] [Indexed: 11/28/2023]
Abstract
Importance Refractory sialorrhea in children can result in pulmonary aspiration and irreversible lung damage. Despite many studies devoted to the surgical treatment of sialorrhea, there is a paucity of objective outcome measures after surgery, especially with regard to pulmonary health. Objectives To assess whether bilateral submandibular gland excision and bilateral parotid duct ligation ("DROOL" procedure) is associated with reduced pulmonary inflammation in bronchoalveolar lavage (BAL) samples after surgery and to assess patient factors associated with improvement after surgery. Design, Setting, and Participants This retrospective case series included all 112 patients undergoing the DROOL procedure at a single tertiary care pediatric children's hospital from January 1, 2012, to December 31, 2021. Statistical analysis was performed from March 30 to June 10, 2023, and August 20 to September 23, 2023. Exposure DROOL procedure for refractory sialorrhea. Main Outcomes and Measures Degree of pulmonary inflammation (neutrophil percentage) according to BAL cytologic findings and overall bronchoscopy findings up to 12 months before and after the DROOL procedure. Secondary outcomes included number of annual hospitalizations, caregiver report of function before and after the procedure, and need for revision procedures and/or additional operations for secretion management. Results A total of 112 patients (median age, 3.4 years [IQR, 2.0-7.1 years]; 65 boys [58.0%]) underwent DROOL procedures and had both preoperative and postoperative BAL samples during the study period. Patients demonstrated objective improvement in pulmonary inflammation after surgery, with the median polymorphonuclear neutrophil percentage decreasing from 65.0% (IQR, 14.0%-86.0%) before the surgery to 32.5% (IQR, 3.0%-76.5%) after the surgery (median difference in percentage points, -9.0 [95% CI, -20.0 to 0.0]). Prior to the DROOL procedure, 34 patients (30.4%; 95% CI, 21.8%-38.9%) were hospitalized 2 or more times annually for respiratory illness, which decreased to 10.1% (11 of 109; 95% CI, 4.4%-15.7%) after surgery (3 patients did not have hospitalization data available following surgery). Most caretakers (73 [65.2%]) reported improved secretion management after the procedure. Conclusions and Relevance This study suggests that patients with impaired secretion management who underwent a DROOL procedure demonstrated improvement in pulmonary inflammation and a reduction in hospitalizations after surgery. Caretakers were also likely to report subjective improvement in secretion management and quality of life. Additional research is necessary to guide optimal timing and patient selection for this procedure.
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Affiliation(s)
- Ashley L. Miller
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Now with Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Erik B. Hysinger
- Aerodigestive and Esophageal Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Meredith E. Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Cherie Torres-Silva
- Aerodigestive and Esophageal Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Alessandro de Alarcon
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Aerodigestive and Esophageal Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Catherine K. Hart
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Aerodigestive and Esophageal Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Kim JS, Yang E, Kim W, Lee W, Kim H, Yi K. Ultrasound-guided thread lifting for the prevention of parotid gland and diagnosing parotid duct complications. Skin Res Technol 2023; 29:e13535. [PMID: 38093502 PMCID: PMC10719469 DOI: 10.1111/srt.13535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Thread lifting is a common minimally invasive plastic surgery procedure. Parotid gland injury caused by thread lifting is a known complication; however, visual evidence of this complication is lacking. OBJECTIVES This study aimed to present cases of parotid gland injury by thread lifting shown using ultrasound and to discuss the importance of ultrasound detection of the location of the parotid gland before thread insertion. METHODS This study included eight patients diagnosed with parotid gland perforation and one with parotid duct injury due to threads from November 2020 to October 2022. RESULTS Six patients showed tenderness and swelling, three were asymptomatic, and one with duct injury showed severe swelling and pain. Although the severity and duration of symptoms have differed, we confirmed the progress of improvement with conservative treatment and confirmed ultrasound findings progressed. CONCLUSIONS Using ultrasound to detect the parotid gland's location before thread lifting might reduce the chance of parotid duct injury. Identifying immediate parotid duct or gland injury with ultrasound can help to act quickly for delayed pain or swelling and reduce the likelihood of additional complications.
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Affiliation(s)
| | - Eun‐Jung Yang
- Department of Plastic and Reconstructive SurgeryYonsei University College of Medicine, Seodaemun‐guSeoulSouth Korea
| | - Woo‐Ram Kim
- Wyne Plastic Surgery ClinicCheongjuSouth Korea
| | - Won Lee
- Yonsei E1 Plastic Surgery ClinicAnyangSouth Korea
| | - Hee‐Jin Kim
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research InstituteBK21 FOUR ProjectYonsei University College of DentistrySeodaemun‐guSouth Korea
| | - Kyu‐Ho Yi
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research InstituteBK21 FOUR ProjectYonsei University College of DentistrySeodaemun‐guSouth Korea
- Maylin Clinic (Apgujeong)SeoulSouth Korea
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7
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Sánchez Barrueco A, Alcalá Rueda I, Ordoñez González C, Sobrino Guijarro B, Santillán Coello J, Tapia GD, Guerra Gutiérrez F, Campos González A, Brenna A, Cenjor Españo C, Villacampa Aubá JM. Transoral removal of submandibular hilar lithiasis: results on the salivary duct system, glandular parenchyma, and quality-of-life recovery. Eur Arch Otorhinolaryngol 2023; 280:5031-5037. [PMID: 37410145 PMCID: PMC10562331 DOI: 10.1007/s00405-023-08081-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE(S) To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. METHODS Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. RESULTS Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). CONCLUSIONS TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton's duct, and enhancement patients' QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.
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Affiliation(s)
- Alvaro Sánchez Barrueco
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Ignacio Alcalá Rueda
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | | | | | - Jessica Santillán Coello
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Gonzalo Díaz Tapia
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | | | - Alfonso Campos González
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Alessandra Brenna
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
| | - Carlos Cenjor Españo
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - José Miguel Villacampa Aubá
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
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8
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Mosbah E, Abass M, Abouelnasr K, Salem M. Diagnosis and Surgical correction of salivary affections in buffaloes (Bubalus bubalis); a retrospective study. BMC Vet Res 2023; 19:214. [PMID: 37858185 PMCID: PMC10585819 DOI: 10.1186/s12917-023-03755-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 09/26/2023] [Indexed: 10/21/2023] Open
Abstract
AIM This study aimed to describe the diagnosis and treatment of various surgical salivary affections in buffaloes. MATERIALS AND METHODS This study included 135 buffaloes examined at Dakahlia Governorate between 2011 and 2022 suffering from various surgical salivary affections. The recorded surgical affections had salivary fistula (n = 44), ectasia of Stenson's duct (n = 11), ranula/mucocele (n = 46), and cervical sialocele (n = 34). The buffaloes were sedated using an intramuscular injection of xylazine (0.05 mg/kg) and local infiltration analgesia of lidocaine for specific surgical interventions. RESULTS The salivary duct fistula cases were surgically corrected using a retrograde infusion of povidone-iodine into the duct and its double ligation with Prolene following fistulectomy. Intraoral marsupialization was done in buffaloes suffering from ectasia of the parotid duct. The mucocele /ranula was surgically incised with daily flushing with povidone-iodine. The cervical sialocele was treated by giving an elliptical excision on the sialocele, and sialoadenectomy of the mandibular salivary gland was performed to facilitate dynamic fluid/saliva drainage. A 92.5% of diseased buffaloes showed an uneventful recovery without any postoperative complications after the first treatment, whereas 7.5% of animals tended to recur. The most common and almost equally distributed salivary affections recorded in adult buffaloes were parotid duct fistula, mucocele, and cervical sialocele. The Stenson's duct ectasia was commonly registered in calves, being congenital. CONCLUSION Ranula was the most common salivary affection encountered in adult buffaloes, closely followed by parotid duct fistulae and cervical sialoceles. Stenson's duct ectasia was the least encountered salivary affection in calves and was congenital. All salivary affections were corrected easily and safely, with satisfactory outcomes.
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Affiliation(s)
- Esam Mosbah
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Marwa Abass
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt.
| | - Khaled Abouelnasr
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Mohamed Salem
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
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Pang SL, Lo AWI, Wang R, Su YX. Sialendoscopic removal of metastatic adenocarcinoma in a mucous plug from Stensen's duct. Int J Oral Maxillofac Surg 2023; 52:1025-1027. [PMID: 36935282 DOI: 10.1016/j.ijom.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/23/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
Sialendoscopy is a minimally invasive technique used mainly in the diagnosis and treatment of obstructive salivary gland disorders. There has yet to be a report on its use in the diagnosis of metastatic disease. While metastatic cancer has been described in numerous head and neck anatomic subsites, it has not been reported to be found in a mucous plug in Stensen's duct. Sialendoscopy was performed in a 68-year-old female patient who presented with symptoms of ductal obstruction. Basket removal of a mucous plug was done and histopathological analysis of this specimen found adenocarcinoma. The overall clinical picture, imaging, and final histopathological results suggested that this patient had metastatic breast carcinoma to a mucous plug in Stensen's duct, the diagnosis of which was made with the aid of interventional sialendoscopy. This is the first report in which metastatic cancer was identified in a mucous plug in Stensen's duct. Sialendoscopy can be a useful tool to aid in the diagnosis of metastatic diseases in rare and unusual clinical situations.
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Affiliation(s)
- S L Pang
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - A W I Lo
- Division of Anatomical Pathology, Queen Mary Hospital, Hong Kong
| | - R Wang
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Y-X Su
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Cowen J, Ali M, Dave R, Woodhouse J, Anand R, Repanos C, Brennan PA, Bekker J. Radiologically-guided balloon sialoplasty for benign salivary duct obstruction: a 7-year UK service evaluation. Br J Oral Maxillofac Surg 2023; 61:547-552. [PMID: 37640606 DOI: 10.1016/j.bjoms.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023]
Abstract
Obstructive sialadenitis is the most common cause of non-malignant salivary gland disorders, with salivary gland strictures being responsible for approximately 23% of all benign obstructive disease. Significant advances in minimally invasive techniques, including radiologically-guided balloon sialoplasty, offer the potential for successful treatment with reduced complications. At present there is a paucity of follow-up data regarding patient outcomes and repeat interventions in those undergoing the procedure. Patients with parotid or submandibular gland sialadenitis secondary to gland stricture were identified and underwent radiologically-guided balloon sialoplasty at Queen Alexandra Hospital, Portsmouth, UK between 2015 and 2022. Patient outcomes, complications and reintervention rates were recorded prospectively over the seven-year period and analysed retrospectively. A total of 44 patients underwent radiologically-guided balloon sialoplasty. Forty (89%) underwent sialoplasty for parotid gland disease, with a minority (n = 5) receiving an intervention for submandibular gland strictures. A total of 37 (84%) had their obstruction successfully treated (82% of parotid gland obstructions and 100% of submandibular gland obstructions). Five patients (11%) required a repeat intervention. Seventeen successfully treated patients (85%) who attended follow-up clinic appointments described complete resolution of their symptoms, with the remaining three (15%) describing a partial response. Radiologically-guided balloon sialoplasty for the treatment of benign obstructive sialadenitis secondary to a gland stricture is a safe and effective method of eliminating the obstruction and relieving patients' symptoms. Most patients were symptom free at short-term follow up, with a minority requiring a second sialoplastic intervention.
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Affiliation(s)
- Jake Cowen
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK.
| | - Muhammad Ali
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Roma Dave
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Joe Woodhouse
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Rajiv Anand
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Costa Repanos
- Department of Ear, Nose and Throat Surgery, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Jasper Bekker
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
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11
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Camous D. [Lithiasic salivary gland pathologies]. Rev Prat 2023; 73:756-758. [PMID: 37796264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
LITHIASIC SALIVARY GLAND PATHOLOGIES. Sialolithiasis is the most frequent pathology affecting the salivary glands. Almost 80% of these lithiasis affect the submandibular gland, in the Wharton duct whilst 20% occur in the parotid gland in the Stenon duct. The diagnosis is based on typical patient interrogation and clinical symptoms (intermittent facial swelling associated with eating, sialadenitis) and/or on paraclinical examination. Ultrasound echography is often prescribed, but CT-scan and sialo-MRI offer a more precise preoperative assessment. Minimally-invasive gland-preserving techniques such as sialendoscopy (combined or not with transoral duct surgery) are nowadays considered to be the method of first choice. These methods reach success rates above 80% and significantly reduce surgical complications and hospital stay.
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Affiliation(s)
- Domitille Camous
- Service ORL, hôpital Lariboisière, AP-HP, Sorbonne Université, Paris, France
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12
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Callander JK, Plonowska-Hirschfeld K, Gulati A, Chang JL, Ryan WR. Symptom Outcomes After Sialendoscopy-Assisted Salivary Duct Surgery: A Prospective 6-Year Study. Laryngoscope 2023; 133:792-800. [PMID: 35848880 DOI: 10.1002/lary.30294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/01/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective is to evaluate the long-term impact of sialendoscopic-assisted salivary duct surgery (SASDS) on sialadenitis symptoms using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. METHODS The COSS questionnaire, which scores symptoms on a 0-100 scale, was administered prospectively to adult patients pre-operatively, 1-year, and 6-years post-operatively. We examined COSS scores and categories representing complete (<10), partial (10-25), and no (>25) resolution of symptoms with attention to factors significantly associated with incomplete resolution (≥10). RESULTS Approximately 6-years after SASDS, 111 patients reported scores for 128 symptomatic glands (72 with sialolithiasis, 56 without sialolithiasis). For glands with sialolithiasis, the median COSS score pre-SASDS was 27.5 (interquartile range [IQR]: 13.5-43), which was significantly reduced to 1.0 (IQR: 0-5.5) at 1-year and 1.5 (IQR 0-5) at 6-years postoperatively. Glands without sialolithiasis had a median COSS score of 40.5 (IQR: 23-52.5) preoperatively, that significantly reduced to 13.5 (IQR 5-21) at 1-year and 14 (IQR 6.5-25.5) at 6-years post-operatively. There was no significant difference in scores from 1- to 6-years. Intraoperative presence of sialolith, absence of stenosis, stenosis in the distal duct, and submandibular gland involvement were significant predictors of complete resolution of symptoms at 6-years. CONCLUSION Approximately 6-years after SASDS for sialadenitis, the majority of patients have durable symptom improvement. The sialolithiasis group had higher rates of complete resolution compared to the non-sialolithiasis group. Presence of ductal stenosis on sialendoscopy, non-distal stenoses, and parotid gland involvement were risk factors for persistent long-term sialadenitis symptoms. Laryngoscope, 133:792-800, 2023.
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Affiliation(s)
- Jacquelyn K Callander
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Karolina Plonowska-Hirschfeld
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Arushi Gulati
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Jolie L Chang
- Division of General Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Center, University of California San Francisco, San Francisco, California, U.S.A
- Surgery Service, Department of Veterans Affairs Medical Center, San Francisco, California, U.S.A
| | - William R Ryan
- Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Center, University of California San Francisco, San Francisco, California, U.S.A
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Kc AK, Shrestha BL, Bhattarai A. Intraglandular Foreign Body - Unusual Aetiology of Submandibular Gland Sialadenitis. Kathmandu Univ Med J (KUMJ) 2023; 21:241-243. [PMID: 38628023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Obstructive sialadenitis of submandibular gland is commonly due to sialoliths and strictures in the Wharton's duct. Other endogenous pathologies include mucous plugs and polyps. Foreign bodies of Wharton's duct and submandibular gland are rare. Retrograde migration of foreign bodies via ductal orifice, traversing the ductal system to its final intraglandular location is an even rare entity. These often present with painful swelling of the gland and at times with a purulent sialitis. Diagnostic modalities include plain radiography, ultrasonography, sialography, as well as computed tomography and magnetic resonance imaging. Treatment includes antibiotics, incision and drainage of abscess, and removal of foreign body either surgically (intra-oral approach or sialadenectomy) or more recently via sialoendoscopy. This is a case report of 30 years male with accidental cannulation of Wharton's duct with grass that eventually got lodged in the deep lobe of the gland, and was managed with sialadenectomy.
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Affiliation(s)
- A K Kc
- Department of Otorhinolaryngology-Head and Neck Surgery, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B L Shrestha
- Department of Otorhinolaryngology-Head and Neck Surgery, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - A Bhattarai
- Department of Otorhinolaryngology-Head and Neck Surgery, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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14
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柳 登, 郑 丹, 赵 雅, 张 亚, 叶 欣, 张 丽, 谢 晓, 张 雷, 张 祖, 俞 光. [Recent progress in the treatment of intractable sialolithiasis]. Beijing Da Xue Xue Bao Yi Xue Ban 2023; 55:8-12. [PMID: 36718683 PMCID: PMC9894789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Indexed: 02/01/2023]
Abstract
Sialolithiasis occurs in approximately 0.45% to 1.20% of the general population. The typical clinical symptom manifests as a painful swelling of the affected glands after a meal or upon salivary stimulation, which extremely affects the life quality of the patients. With the development of sialendoscopy and lithotripsy, most sialoliths can be successfully removed with preservation of the gland. However, sialoliths in the deep hilar-parenchymal submandibular ducts and impacted parotid stones located in the proximal ducts continue to pose great challenges. Our research center for salivary gland diseases (in Peking University School and Hospital of Stomatology) has used sialendoscopy for 17 years and treated >2 000 patients with salivary gland calculi. The success rate was approximately 92% for submandibular gland calculi and 95% for parotid calculi. A variety of minimally invasive surgical techniques have been applied and developed, which add substantial improvements in the treatment of refractory sialolithiasis. Further, the radiographic positioning criteria and treatment strategy are proposed for these intractable stones. Most of the hilar-parenchymal submandibular stones are successfully removed by a transoral approach, including transoral duct slitting and intraductal basket grasping, while a small portion of superficial stones can be removed by a mini-incision in submandibular area. Impacted stones located in the distal third of parotid gland ducts are removed via "peri-ostium incision", which is applied to avoid a cicatricial stenosis from a direct ostium incision. Impacted parotid stones located in the middle and proximal third of the Stensen's duct are removed via a direct mini-incision or a peri-auricular flap. A direct transcutaneous mini-incision is commonly performed under local anesthesia with an imperceptible scar, and is indicated for most of impacted stones located in the middle third, hilum and intraglandular ducts. By contrast, a peri-auricular flap is performed under general anesthesia with relatively larger operational injury of the gland parenchyma, and should be best reserved for deeper intraglandular stones. Laser lithotripsy has been applied in the treatment of sialolithiasis in the past decade, and holmium ∶YAG laser is reported to have the best therapeutic effects. During the past 3 years, our research group has performed laser lithotripsy for a few cases with intractable salivary stones. From our experiences, withdrawal of the endoscopic tip 0.5-1.0 cm away from the extremity of the laser fiber, consistent saline irrigation, and careful monitoring of gland swelling are of vital importance for avoidance of injuries of the ductal wall and the vulnerable endoscope lens during lithotripsy. Larger calculi require multiple treatment procedures. The risk of ductal stenosis can be alleviated by endoscopic dilation. In summary, appropriate use of various endoscopy-assisted lithotomy helps preserve the gland function in most of the patients with refractory sialolithiasis. Further studies are needed in the following aspects: Transcervical removal of intraglandular submandibular stones, intraductal laser lithotripsy of impacted parotid stones and deep submandibular stones, evaluation of long-term postoperative function of the affected gland, et al.
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Affiliation(s)
- 登高 柳
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 丹妮 郑
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 雅宁 赵
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 亚琼 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 欣 叶
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 丽琪 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 晓艳 谢
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 雷 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 祖燕 张
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 光岩 俞
- />北京大学口腔医学院·口腔医院影像科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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Gontarz M, Orłowska-Heitzman J, Gąsiorowski K, Bargiel J, Marecik T, Szczurowski P, Zapała J, Wyszyńska-Pawelec G. Myoepithelial Carcinoma Arising in a Salivary Duct Cyst of the Parotid Gland: Case Presentation. Medicina (Kaunas) 2023; 59:medicina59020184. [PMID: 36837386 PMCID: PMC9962360 DOI: 10.3390/medicina59020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/18/2023]
Abstract
Cystic lesions observed in parotid glands are relatively rare and comprise 2-5% of all parotid primaries. A salivary duct cyst (SDC) is a true cyst representing 10% of all salivary gland cysts. The risk of malignant transformation of SDC's epithelium is extremely rare. In the literature, only three cases of carcinoma ex SDC of the parotid gland are described. This report presents the first in the literature case of myoepithelial carcinoma (MECA) arising from a parotid SDC. A 75-year-old male patient was referred to the Department of Cranio-Maxillofacial Surgery of the Jagiellonian University in Cracow, Poland due to a cystic tumor arising from the right parotid gland. Superficial parotidectomy with facial nerve preservation was performed. Histological examination confirmed a rare case of MECA emerging from the SDC. The immunohistochemical profile of MECA ex SDC was presented. During 6 months of the follow-up, local recurrence or distant metastasis was not observed.
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Affiliation(s)
- Michał Gontarz
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
- Correspondence: ; Tel.: +48-12-4002800
| | - Jolanta Orłowska-Heitzman
- Department of Pathomorphology, Jagiellonian University Medical College, University Hospital, 30-688 Cracow, Poland
| | - Krzysztof Gąsiorowski
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
| | - Jakub Bargiel
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
| | - Tomasz Marecik
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
| | - Paweł Szczurowski
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
| | - Jan Zapała
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
| | - Grażyna Wyszyńska-Pawelec
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland
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16
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Chen DW, Billings KR, Ida JB, Lavin J, Ghadersohi S, Valika T. Salivary gland surgery and nonviral respiratory-related hospitalizations in children with neurodevelopmental impairment. Int J Pediatr Otorhinolaryngol 2022; 163:111362. [PMID: 36327912 DOI: 10.1016/j.ijporl.2022.111362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/31/2022] [Accepted: 10/12/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Neurodevelopmentally impaired (NI) children with chronic sialorrhea are at elevated risk for aspiration and respiratory tract infections. Direct resection or ligation ("DROOL") of the submandibular glands (SMG) with parotid duct ligation are surgical interventions intended to decrease salivary output. The objective of this study is to determine the impact of DROOL surgery on the incidence of nonviral respiratory-related (NVR) post-procedure hospital encounters including emergency department visits and admissions. METHODS Retrospective case series of NVR related outcomes after DROOL surgery in children performed at a single institution, tertiary referral center. RESULTS A total of 35 gastrostomy tube-dependent patients (60% male, average age 8.2 [SD 6.0] years) with NI underwent DROOL surgery (86% SMG excision). Pre- and post-surgical follow-up time was 3.6 and 3.2 years, respectively. Presurgical and postsurgical NVR hospital encounters occurred in 28 (80%) and 14 (40%) patients, respectively (p < 0.01). Mean (SD) postoperative NVR hospital encounters occurred less frequently when compared to presurgical period (0.4 [0.6] vs. 1.0 [1.2] per year, p < 0.01) with average change of -0.7 encounters per year (SD 1.4, 95% CI -1.0 to -0.2). Patients with encounters within a year preceding DROOL (OR 4.9, p = 0.04, 95% CI 1.1-22.8), or those with at least 3 preoperative encounters (OR 8.0, p = 0.01, 95% CI 1.6-40.3) were significantly associated with a postsurgical NVR event. Fewer patients used anti-sialorrhea medication postoperatively compared to preoperatively (60% vs. 17%, p < 0.01). No patient developed surgical site complications requiring operative interventions. CONCLUSIONS DROOL surgery for chronic sialorrhea in patients with NI was associated with decreased hospitalization and ED visits for NVR respiratory events post-procedurally. Sialorrhea may be an actionable source of recurrent respiratory illnesses requiring hospitalizations. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Diane W Chen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA
| | - Kathleen R Billings
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA
| | - Jonathan B Ida
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA
| | - Jennifer Lavin
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA
| | - Saied Ghadersohi
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA
| | - Taher Valika
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA.
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17
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Pagliuca G, Clemenzi V, Stolfa A, Martellucci S, Greco A, de Vincentiis M, Gallo A. Use of Irrigation Device for Duct Dilatation during Sialendoscopy. Int J Environ Res Public Health 2022; 19:14830. [PMID: 36429550 PMCID: PMC9690385 DOI: 10.3390/ijerph192214830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Continuous irrigation of the duct with isotonic saline is one of the fundamental stages of a successful sialendoscopic procedure. It allows for an adequate luminal distension for the removal of debris and mucous plugs and for the conservative treatment of strictures. This procedure, which commonly involves the use of a medical syringe, can be laborious, and it is often necessary to interrupt irrigation during surgery due to the high resistance to saline. SETTING Academic university hospital. METHOD We propose the use of an irrigation device which consists of a high-pressure syringe barrel, an ergonomic piston handle, and a gauge used to monitor the inflation and deflation of balloon catheters. The system allows for a simple and safe dilation, ensuring good visualization of the salivary duct lumen during sialendoscopy. CONCLUSIONS The irrigation system described can be widely used to perform a diagnostic or interventional sialendoscopy more effectively than with a typical manual irrigation procedure.
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Affiliation(s)
- Giulio Pagliuca
- Otolaryngology University Unit, Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Veronica Clemenzi
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, 04100 Rome, Italy
| | - Andrea Stolfa
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, 04100 Rome, Italy
| | | | - Antonio Greco
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, 04100 Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Andrea Gallo
- Otolaryngology University Unit, Santa Maria Goretti Hospital, 04100 Latina, Italy
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, 04100 Rome, Italy
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18
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Abstract
INTRODUCTION Salivary glands lithiasis (Sialolithiasis) is defined as calcified concretions in the salivary glands. Most common localization is in submandibular gland. Usually, submandibular stones are mainly located in Wharton's duct, whereas parotid stones are more often located in the gland parenchyma. Sialoliths are usually 5-10 mm in size, and stones more than 10 mm are unusual sizes. Exact etiology of sialolith formation is still unknown. CASE REPORT We discuss a case of a 70-year-old patient, presenting painful swelling and a giant submandibular gland sialolith successfully treated with open surgery. CONCLUSIONS A careful anamnesis and physical examination of the patient are important in the diagnosis of sialolithiasis. In addition, several imaging techniques, such as panoramic X-rays and Ultrasound, can be applied. The management can be both medical and surgical.
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Affiliation(s)
- C Ungari
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - A Cicconetti
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - E Cerbelli
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - A Sulpasso
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - F Filiaci
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
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Yaremenko AI, Razumova AY, Kutukova SI, Petrov NL, Kovtun EV. [Ductoplasty of the post-traumatic stricture of a parotid duct]. Stomatologiia (Mosk) 2022; 101:64-67. [PMID: 36268923 DOI: 10.17116/stomat202210105164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A report on the primary application of the modern technique of plastic removal of stricture of the Stenonic duct. A clinical case of surgical intervention in the localization of stricture and salivary stone is considered. The analysis of the patient's medical history, ultrasound diagnostics, multispiral computed tomography of the maxillofacial region was carried out. Based on the results of the examination, the choice of the surgical intervention technique was made.
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Affiliation(s)
- A I Yaremenko
- I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
| | - A Y Razumova
- I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
| | - S I Kutukova
- I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
| | - N L Petrov
- I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
| | - E V Kovtun
- I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
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20
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Abstract
Duct scar in the form of stenoses or stricture is the second leading cause of obstructive sialadenitis after stone. Over the past decade, there has been a growing experience demonstrating the effectiveness of endoscopic techniques in the minimally invasive management of salivary duct stenosis. Less information, however, is available with regard to open approaches for recurrent or complex ductal stenoses. This article reports on a case of gland preservation using an open ductal technique that originally was applied in cases of traumatic Stensen's duct injury.
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Affiliation(s)
- Leighton F Reed
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA
| | - Trevor Hackman
- Department of Otolaryngology-Head and Neck Surgery, UNC Hospitals, 170 Manning Drive, Chapel Hill, NC 27599-7070, USA.
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21
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Gilley DR, Clark A, Tassone P. A case of parapharyngeal space salivary duct cyst with fine needle biopsy suspicious for squamous cell carcinoma. Am J Otolaryngol 2021; 42:102924. [PMID: 33476969 DOI: 10.1016/j.amjoto.2021.102924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To report a unique case of salivary duct cyst presenting as parapharyngeal space mass and review relevant literature regarding salivary duct cyst and fine needle aspiration biopsy of salivary gland lesions. METHODS After a case description, a review of the literature regarding salivary duct cyst etiology, pathophysiology, presentation, histologic features, and the accuracy of FNA in the context of salivary gland lesions was conducted. RESULTS Salivary duct cysts are rare, often acquired, cystic dilatations of salivary ducts thought to arise secondary to ductal obstruction, commonly occurring in the major salivary glands. Fine needle aspiration is the biopsy method of choice for most head and neck lesions. There is controversy surrounding this method in salivary lesions, but recent data indicates it can be just as reliable as in other locations. CONCLUSIONS Here, we highlight a patient with a salivary duct cyst presenting as a parapharyngeal mass, which has not been described in the literature. Overall, FNA in salivary lesions is highly pathologist dependent, which likely contributes to varying accuracy in the literature.
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Affiliation(s)
- David R Gilley
- Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO, USA.
| | - Andrew Clark
- University of Missouri School of Medicine, Degree Program, Columbia, MO, USA
| | - Patrick Tassone
- Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO, USA
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Wang R, Su YX. Reliable ductal access in sialoendoscopy. Int J Oral Maxillofac Surg 2020; 49:1592-1594. [PMID: 32620451 DOI: 10.1016/j.ijom.2020.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/05/2020] [Accepted: 05/25/2020] [Indexed: 11/19/2022]
Abstract
During sialoendoscopy, insertion of the endoscope through the ductal orifice is usually a challenging procedure, especially for beginners. Based on our experience, we have found that using the Kolenda Salivary Access Introducer Set is the most reliable and easily learned ductal access approach. We report details of the technique and discuss the advantages of this approach.
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Affiliation(s)
- R Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong Special Administrative Region
| | - Y-X Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong Special Administrative Region.
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Lin VTG, Nabell LM, Spencer SA, Carroll WR, Harada S, Yang ES. First-Line Treatment of Widely Metastatic BRAF-Mutated Salivary Duct Carcinoma With Combined BRAF and MEK Inhibition. J Natl Compr Canc Netw 2019; 16:1166-1170. [PMID: 30323086 DOI: 10.6004/jnccn.2018.7056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/29/2018] [Indexed: 11/17/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare and aggressive malignancy for which limited data exist to guide treatment decisions. With the advent of advanced molecular testing and tumor genomic profiling, clinicians now have the ability to identify potential therapeutic targets in difficult-to-treat cancers such as SDC. This report presents a male patient with widely metastatic SDC found on targeted next-generation sequencing to have a BRAF p.V600E mutation. He experienced a prolonged and robust response to first-line systemic chemotherapy with dabrafenib and trametinib. During his response interval, new data emerged to justify subsequent treatment with both an immune checkpoint inhibitor and androgen blockade after his disease progressed. To our knowledge, this is the first report of frontline BRAF-directed therapy eliciting a response in metastatic SDC.
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Tsai FD, Haddad RI. Toward a Personalized Approach in the Treatment of Salivary Ductal Carcinoma. J Natl Compr Canc Netw 2018; 16:1269-1270. [PMID: 30323095 DOI: 10.6004/jnccn.2018.7089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Haas OL, Scolari N, da Silva Meirelles L, Favoretto AX, de Oliveira RB. Sialolith removal in the submandibular region using surgical diode laser: report of two cases and literature review. Oral Maxillofac Surg 2018; 22:105-111. [PMID: 29356906 DOI: 10.1007/s10006-018-0674-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/09/2018] [Indexed: 06/07/2023]
Abstract
PURPOSE Sialolithiasis is defined as the presence of one or more calcified structures within the duct of a major or minor salivary gland. It occurs as a result of deposition of calcium salts around an accumulation of organic debris in the duct lumen. The main signs and symptoms are edema and bacterial infection with abscess formation. METHODS This study aimed to report two cases of submandibular sialolithiasis treated surgically with diode laser and conduct a review of the literature by means of a systematic search. In the two cases, the calculi were located in the distal part of the submandibular duct and could be palpated intraorally. Surgery was performed in an outpatient setting under local anesthesia. A linear incision was made in the floor of the mouth, in the region of the opening of Wharton's duct, to expose and remove the calculi. Laser cutting was performed using a diode laser module coupled to a 400-μm optical fiber emitting at a wavelength of 980 nm (infrared), 2.5 W output power, and in continuous pulse mode. RESULTS The use of diode laser is a safe and minimally invasive option for this type of procedure. CONCLUSION Offering advantages such as enhanced coagulation properties and high-quality incision, absence of bleeding, low risk of nerve damage, and few comorbidities.
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Affiliation(s)
- Orion Luiz Haas
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Neimar Scolari
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Lucas da Silva Meirelles
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil.
| | - André Xavier Favoretto
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Rogério Belle de Oliveira
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
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26
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Zhang YQ, Ye X, Liu DG, Zhao YN, Xie XY, Yu GY. [Endoscopy-assisted sialodochoplasty for the treatment of severe sialoduct stenosis]. Beijing Da Xue Xue Bao Yi Xue Ban 2018; 50:160-164. [PMID: 29483740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effects of endoscopy-assisted sialodochoplasty for the treatment of severe sialoduct stenosis with concurrent megaducts. METHODS From Jul.2010 to Dec. 2016, 8 patients presenting with severe parotid duct stenosis and 3 patients with occlusion of the Wharton's duct underwent endoscopy-assisted sialodochoplasty.All these patients had concurrent severe ductal ectasiaand manifested a painful swelling of the involved salivary glands.The diameter of ectasia and length of stenosis of the sialoducts were measured preoperatively by sialography, computed tomography, or ultrasonography. The megaducts were opened transorally and sutured to the buccal or oral floor mucosa, therefore creating a neo-ostium. All the patients were followed up periodically after operation. The treatment effects were evaluated by clinical signs, sialogram and sialometry. RESULTS The length of the Stensen's duct stenosis was 5-12 mm, and the diameter of the concurrent ectasia was 8-16 mm. The length of the Wharton's duct stenosis was 10-20 mm, and the diameter of the concurrent ectasia was 6-8 mm.The neo-ostiums healed uneventfully 2 weeks after operation. The duration of the follow-up varied from 6 to 78 months (median: 24 months). Among the 8 patients with Stensen's duct stenosis, two experienced re-obliteration of the neo-ostium, but the buccal bulge and clinical symptoms disappeared; one reported recurrent clinical symptoms after initial alleviation, which could be controlled with self-massaging; the remaining 5 patients had satisfactory clinical results, i.e., disappearance of the obstruction symptoms and buccal bulge, patent ostium,clean saliva and improvement of the ductal ectasia on sialogram. Three patients with Wharton's duct occlusion were asymptomatic with clear saliva and patent ostium;two exhibited approximately normal appearance and one showed improvement of the sialogram.Sialometry was performed in 9 patients with patent neo-ostium of the involved glands,the resting saliva flow rate of the affected glands showed no differences compared with the normal side, and stimulated flow rate showed a significant increase, though less than the control side.The clinical results included good in 5 patients, fair in 4 patients, and poor in 2 patients, with a total effective rate of 82% (9/11). CONCLUSION Endoscopy-assisted sialodochoplasty appears to be effective and can be a viable option for patients presenting with severe sialoducts tenosis and concurrent ectasia.
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Affiliation(s)
- Y Q Zhang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X Ye
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - D G Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y N Zhao
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X Y Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - G Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Kang S, Kufta K, Sollecito TP, Panchal N. A treatment algorithm for the management of intraoral burns: A narrative review. Burns 2017; 44:1065-1076. [PMID: 29032979 DOI: 10.1016/j.burns.2017.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 07/25/2017] [Accepted: 09/19/2017] [Indexed: 11/19/2022]
Abstract
Oral mucosa follows a distinctly different trajectory of wound healing than skin. Although there are contemporary guidelines regarding treatment of burns to the skin, there is no standard of care specific to intraoral burns. This narrative review proposes an evidence-based treatment algorithm for the management of intraoral burns. Data was collated through a comprehensive review of the literature and only included studies that have reported particular success with favorable short- and long-term prognoses. In order to critically appraise the strength of the treatment recommendations, the GRADE criteria was applied to each arm of the algorithm. The algorithm was initially subdivided into the four primary etiologies of intraoral burns - thermogenic, cryogenic, chemical, electrical. Our findings emphasize the importance of conservative modalities of intra-oral burn treatment.
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Affiliation(s)
- Steve Kang
- University of Pennsylvania School of Dental Medicine, Robert Schattner Center, Oral Surgery Clinic, 240 S. 40th Street, Philadelphia, PA 19104, United States.
| | - Kenneth Kufta
- University of Pennsylvania School of Dental Medicine, Robert Schattner Center, Oral Surgery Clinic, 240 S. 40th Street, Philadelphia, PA 19104, United States; University of Pennsylvania Health System, Perelman Center for Advanced Medicine, South Pavilion, 4th Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Thomas P Sollecito
- University of Pennsylvania School of Dental Medicine, Robert Schattner Center, Oral Surgery Clinic, 240 S. 40th Street, Philadelphia, PA 19104, United States; University of Pennsylvania Health System, Perelman Center for Advanced Medicine, South Pavilion, 4th Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Neeraj Panchal
- University of Pennsylvania School of Dental Medicine, Robert Schattner Center, Oral Surgery Clinic, 240 S. 40th Street, Philadelphia, PA 19104, United States; University of Pennsylvania Health System, Perelman Center for Advanced Medicine, South Pavilion, 4th Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States; Philadelphia Veterans Affairs Medical Center, University of Pennsylvania Presbyterian Medical Center, 565 Wright Saunders, 51 N. 39th Street, Philadelphia, PA 19104, United States.
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28
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Kambeyanda R, Singh R, Armstrong M. Propeller Damage to the Parotid Duct. Am Surg 2017; 83:e308-e310. [PMID: 28822370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Man CB, Patel R, Karavidas K. Intraoperative sialendoscopy to assist with and confirm repair of Stensen's duct. Br J Oral Maxillofac Surg 2017; 55:e45-e46. [PMID: 28655400 DOI: 10.1016/j.bjoms.2017.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/06/2017] [Indexed: 11/16/2022]
Affiliation(s)
- C-B Man
- Oral & Maxillofacial Surgery, Luton & Dunstable University Hospital, Lewsey Road, Luton, LU4 0DZ, United Kingdom.
| | - R Patel
- Oral & Maxillofacial Surgery, Luton & Dunstable University Hospital, Lewsey Road, Luton, LU4 0DZ, United Kingdom
| | - K Karavidas
- Oral & Maxillofacial Surgery, Luton & Dunstable University Hospital, Lewsey Road, Luton, LU4 0DZ, United Kingdom
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Sakthivel P, Yogal R, Singh S, Sharma P, Singh CA. Giant Sialolith of Submandibular Duct. JNMA J Nepal Med Assoc 2017; 56:262-264. [PMID: 28746326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Sialolithiasis is one of the most common diseases of salivary glands and commonly involves submandibular gland and ducts. "Giant sialoliths" typically measure more than 15 mm in any dimension. Here, an unusual case of sialolith in submandibular duct is reported which progressed into a giant sialolith in six months' time is reported. A 42-year-old man presented with complaints of recurrent pain and swelling in the right submandibular area. A large stone was palpable intraorally within the Wharton's duct and intra-operatively, an elongated giant sialolith of 50 mm length was found which is the second largest to be published till date.
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Affiliation(s)
- P Sakthivel
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - R Yogal
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - S Singh
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - P Sharma
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - C A Singh
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
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Hone RWA, Rahman E, Wong G, Annan Y, Alexander V, Al-Lami A, Varadharajan K, Parker M, Simo R, Pitkin L, Mace A, Ofo E, Balfour A, Nixon IJ. Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis. Eur Arch Otorhinolaryngol 2016; 274:1983-1991. [PMID: 28011997 PMCID: PMC5340845 DOI: 10.1007/s00405-016-4391-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/11/2016] [Indexed: 01/12/2023]
Abstract
Salivary bypass tubes (SBT) are increasingly used to prevent pharyngocutaneous fistula (PCF) following laryngectomy and pharyngolaryngectomy. There is minimal evidence as to their efficacy and literature is limited. The aim of the study was to determine if SBT prevent PCF. The study was a multicentre retrospective case control series (level of evidence 3b). Patients who underwent laryngectomy or pharyngolaryngectomy for cancer or following cancer treatment between 2011 and 2014 were included in the study. The primary outcome was development of a PCF. Other variables recorded were age, sex, prior radiotherapy or chemoradiotherapy, prior tracheostomy, type of procedure, concurrent neck dissection, use of flap reconstruction, use of prophylactic antibiotics, the suture material used for the anastomosis, tumour T stage, histological margins, day one post-operative haemoglobin and whether a salivary bypass tube was used. Univariate and multivariate analysis were performed. A total of 199 patients were included and 24 received salivary bypass tubes. Fistula rates were 8.3% in the SBT group (2/24) and 24.6% in the control group (43/175). This was not statistically significant on univariate (p value 0.115) or multivariate analysis (p value 0.076). In addition, no other co-variables were found to be significant. No group has proven a benefit of salivary bypass tubes on multivariate analysis. The study was limited by a small case group, variations in tube duration and subjects given a tube may have been identified as high risk of fistula. Further prospective studies are warranted prior to recommendation of salivary bypass tubes following laryngectomy.
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Affiliation(s)
- Robert W A Hone
- Faculty of Medical Science, Post Graduate Medical Institute, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex, UK.
- Medway Maritime Hospital, Windmill Road, Gillingham, Kent, ME7 5NY, UK.
| | - Eqramur Rahman
- Faculty of Medical Science, Post Graduate Medical Institute, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex, UK
| | - Gentle Wong
- Ear, Nose and Throat Department, Brighton and Sussex University Hospital, 177 Preston Rd, Brighton, UK
| | - Yvette Annan
- Ear, Nose and Throat Department, Charing Cross Hospital, Fulham Palace Rd, London, UK
| | - Victoria Alexander
- Ear, Nose and Throat Department, Guy's Hospital, Great Maze Pond, London, UK
| | - Ali Al-Lami
- Ear, Nose and Throat Department, St Georges Hospital, Blackshaw Rd, London, UK
| | - Kiran Varadharajan
- Ear, Nose and Throat Department, William Harvey Hospital, Kennington Road, Willesborough, Ashford, Kent, UK
| | - Michael Parker
- Faculty of Medical Science, Post Graduate Medical Institute, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex, UK
| | - Ricard Simo
- Ear, Nose and Throat Department, Guy's Hospital, Great Maze Pond, London, UK
| | - Lisa Pitkin
- Ear, Nose and Throat Department, Royal Surrey County Hospital, Egerton Rd, Guildford, Surrey, UK
| | - Alasdair Mace
- Ear, Nose and Throat Department, Charing Cross Hospital, Fulham Palace Rd, London, UK
| | - Enyinnaya Ofo
- Ear, Nose and Throat Department, William Harvey Hospital, Kennington Road, Willesborough, Ashford, Kent, UK
| | - Alistair Balfour
- Ear, Nose and Throat Department, St Georges Hospital, Blackshaw Rd, London, UK
| | - Iain J Nixon
- Ear, Nose and Throat Department, St Georges Hospital, Blackshaw Rd, London, UK
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Prutton JS, Bonadio C, Vaughan B, Nieto JE, Harvey AM, Estell KE. Sialoendoscopy as a treatment for an obstructed mandibular salivary duct in a horse. Can Vet J 2016; 57:869-872. [PMID: 27493288 PMCID: PMC4944566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 14-year-old Quarter Horse was examined for a draining tract of 8 months' duration on the right mandible that was non-responsive to antibiotic therapy and surgical therapy. Further investigation and subsequent treatment with sialoendoscopy and ultrasonography were performed to relieve an obstruction of plant awns in the mandibular salivary duct.
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Affiliation(s)
- Paul Walker
- John Hunter Children's Hospital, Newcastle, Australia.
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Abstract
OBJECTIVE: Sialoscopy has developed into an important diagnostic and therapeutic tool for diseases of the major salivary glands. STUDY DESIGN AND SETTING: We evaluated 103 patients with chronic swelling of the major salivary glands. Routine diagnostic measures revealed no clear diagnosis. The findings of 109 sialoscopies are described. A semi-rigid endoscope (with a diameter of 1.1 mm and 2 integrated working channels) was used for sialoscopy, 51.5% of the cases in Warthon's duct and 48.5% in Stensen's duct. RESULTS: Pathologic findings resulted in 83.0% of the submandibular and in 96% of the parotid ducts. Obstruction neither due to sialolithiasis nor stenosis was observed in 56.3%, whereas sialolithiasis was observed in 20.3% of the patients. In 36 (35%) patients, an interventional sialoscopy was performed. CONCLUSIONS: In cases of invisible salivary duct obstruction, especially in those with low mineralized calculi, strictures, stenoses, or postinflammatory changes, sialoscopy gives immediate and direct information about causal pathologies. Moreover, further therapy can be planned within the same procedure. EBM RATING: C
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Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany
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Abstract
OBJECTIVES: To investigate the efficacy and quality of life impact of intra-oral surgery for sialorrhea and to provide long-term outcome measures. METHODS: A retrospective review and telephone survey of patients seen in a multi-disciplinary saliva control clinic who underwent surgery between 1999 and 2003. RESULTS: Sixteen of 31 patients underwent 4-duct ligation, 12 patients underwent submandibular gland duct ligation, and three patients underwent a 3-duct ligation procedure. The mean presurgical drooling score (maximum 10) was 9.5, 8.8, and 9, respectively. Recurrence was seen in 68% of patients at a mean of four months. Additional surgery was required in five patients. Phone survey was accomplished in 10 patients. Two of 10 caregivers reported sustained improvement of sialorrhea at two and three years. CONCLUSIONS: Intra-oral surgery provides minimal longterm control of sialorrhea. Additional medical and surgical therapy was needed in a significant portion of patients in this long-term review.
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Affiliation(s)
- Timothy J Martin
- Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's Hospital of Wisconsin, Medical College of WI, Milwaukee, WI 53226, USA.
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Abstract
OBJECTIVE: To document the etiology and successful treatment of severe recurrent pneumoparotid. STUDY DESIGN: Computed tomography, ductal measurement by probe size, surgical treatment. RESULTS: We performed a superficial parotidectomy for a 13-year-old with a history of recurrent parotitis. He subsequently developed recurrent pneumoparotid in the contralateral gland with subcutaneous dissection of air into the face, neck, and mediastinum. At surgery, Stensen's ducts were measured and found to be abnormally patent bilaterally compared to standardized norms. Parotid duct ligation, commonly used for sialorrhea, was employed as a novel treatment and was curative. CONCLUSION: Insufflation of air into the parotid duct system can trouble woodwind instrument players, can complicate dental procedures, or can be self-induced. It is generally a benign condition requiring no therapy. Occasionally, pneumoparotid can be recurrent and lead to inflammation and infection of the parotid or subcutaneous emphysema. SIGNIFICANCE: In selected cases of recurrent pneumoparotid, ductal ligation may be curative.
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Affiliation(s)
- Sehjin Han
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University School of Medicine, Chicago, IL, USA
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Bhayani MK, Acharya V, Kongkiatkamon S, Farah S, Roberts DB, Sterba J, Chambers MS, Lai SY. Sialendoscopy for Patients with Radioiodine-Induced Sialadenitis and Xerostomia. Thyroid 2015; 25:834-8. [PMID: 25860842 PMCID: PMC5118964 DOI: 10.1089/thy.2014.0572] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND We examined outcomes in patients treated for radioactive iodine-induced sialadenitis (RAIS) and xerostomia with sialendoscopy. METHODS Data was prospectively collected for all patients undergoing sialendoscopy for RAIS from a single institution. Interventional details and intraoperative findings were recorded. Qualitative data were obtained through patient examination, telephone interviews, and use of a standard quality of life questionnaire, Xerostomia Questionnaire. Quantitative data were obtained from patients who underwent sialometry. RESULTS Twenty-six patients (24 women and 2 men; median age, 43 years; age range, 19-57 years) underwent interventional sialendoscopy after conservative management of symptoms proved unsuccessful. Sialadenitis was present in 25 patients and xerostomia in 22 patients. Mucus plugging in the duct of the gland was the most common finding (22 patients) followed by stenosis (18 patients), inflammation (eight patients), and erythema (eight patients). Median follow-up time was 23.4±12.1 months. Sixteen patients (64%) reported complete resolution; seven (28%), partial resolution; one (4%), no change in symptoms; and one (4%), regression in RAIS-related symptoms. Patients subjectively noted the following regarding their xerostomia symptoms: seven (31.8%) had complete resolution; 10 (45.5%), partial resolution; four (18.2%), no change; and one (4.5%), regression. Statistical analysis of the available sialometry data revealed a statistically significant difference in saliva production at 6 months following sialendoscopy for unstimulated saliva production (p=0.028). CONCLUSION Sialendoscopy is an effective treatment option for the management of RAIS and xerostomia refractory to conservative therapy and medical management. Patients in our cohort report durable improvement in symptoms after intervention.
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Affiliation(s)
- Mihir K. Bhayani
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Varun Acharya
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Suchada Kongkiatkamon
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sally Farah
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dianna B. Roberts
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer Sterba
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark S. Chambers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Y. Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Al Hawat A, Vairel B, De Bonnecaze G, Sadeler A, Vergez S. Sialendoscopy learning curve: comparing our first and last 100 procedures. B-ENT 2015; 11:281-285. [PMID: 26891540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES Sialendoscopy is a relatively new minimally invasive technique that permits direct salivary tree visualization and is important in obstructive sialadenitis management and treatment. The present study aimed to examine the sialendoscopy learning curve between March 2009 and March 2013. METHODOLOGY We compared the first and last 100 sialendoscopies performed in our department with regard to anaesthesia type, operating time, success rate, technical difficulty, major complications, and clinical improvement. RESULTS General anaesthesia rates were 63% and 38% (P = 0.0004) among the first and last 100 sialendoscopies, respectively. Among the first and last 100 procedures, respectively, average operating times were 39 and 25 minutes (P = 0.00055) for diagnostic sialendoscopies and 68 and 65 minutes (P = 0.35) for interventional sialendoscopies. Successful stone extraction rates were 65% and 90.2% (P = 0.0058) among the first and last 100 procedures, respectively, while the corresponding rates of successful stenosis dilation were 92.5% and 97.1% (P = 0.27). Technical difficulty was encountered in 25% and 17% (P = 0.164) of the first and last 100 sialendoscopies, respectively. Neither group experienced major complications. All patients tolerated the procedures well and had excellent outcomes. CONCLUSION Progressive learning regarding sialendoscopy enabled more frequent operation under local anaesthesia, thus better meeting the requirements of a minimally invasive technique. We were able to decrease the operative time in diagnostic sialendoscopy. These two factors support the inclusion of diagnostic sialendoscopy into the diagnostic panel in obstructive glandular diseases.
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Wu CB, Xi H, Zhou Q, Zhang LM. Sialendoscopy-assisted treatment for radioiodine-induced sialadenitis. J Oral Maxillofac Surg 2014; 73:475-81. [PMID: 25544300 DOI: 10.1016/j.joms.2014.09.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/23/2014] [Accepted: 09/27/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE Chronic sialadenitis is a common complication of radioactive iodine for the treatment of thyroid disease. The aim of this study was to describe the authors' experience with interventional sialendoscopy for the management of radioiodine-induced sialadenitis. MATERIALS AND METHODS Twelve patients with radioiodine-induced sialadenitis treated with sialendoscopy from January 2013 through December 2013 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University were retrospectively reviewed. Age, gender, and time to development of radioiodine-induced sialadenitis were obtained from the hospital database. All patients were asked to undergo visual analog scale (VAS) and salivary gland scintigraphy (SGS) examinations before and 6 months after surgery. A paired t test was conducted, and a P value less than .05 was considered statistically significant. RESULTS Twelve patients (15 parotid glands and 4 submandibular glands) successfully underwent interventional sialendoscopy under local anesthesia. Ductal stenosis was the most common feature identified by endoscopy. Among the 12 patients, swelling occurred in 91.7%. Compared with the preoperative score of 6, the mean VAS score 6 months after sialendoscopy was 3; 15 glands (78.9%) showed improved uptake and excretion by SGS. The postoperative VAS score was significantly lower than the preoperative VAS score (P < .05), and the postoperative SGS result was significantly higher than the preoperative SGS result (P < .05). CONCLUSIONS Interventional sialendoscopy could be an effective technique for the treatment of sialadenitis caused by radioactive iodine.
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Affiliation(s)
- Chuan-Bin Wu
- Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning Province, China
| | - Hong Xi
- Resident, Department of Pediatric Dentistry, School of Stomatology, Jilin University, Changchun, Jilin Province, China
| | - Qing Zhou
- Professor, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning Province, China.
| | - Liang-Mei Zhang
- Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning Province, China
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40
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Kaplan A, Fernandez A, Osborne R. Accessory parotid malignancy requiring ductal transection. Ear Nose Throat J 2014; 93:60-66. [PMID: 24526476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- Avery Kaplan
- Osborne Head and Neck Institute, Los Angeles, CA, USA
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Abstract
Sialectasis is an uncommon medical condition of the salivary glands. Conservative treatments of sialectasis include repeated aspiration, compression, dilation of the papilla and stent placement. This is the first reported case that we know of, using marsupialisation for distal sialectasis. Our case highlights the diagnostic and therapeutic challenges posed by sialectasis and demonstrates the efficacy of marsupialisation for distally based sialectasis when conservative treatments fail.
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42
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Shinoto M, Shioyama Y, Nakamura K, Nakashima T, Kunitake N, Higaki Y, Sasaki T, Ohga S, Yoshitake T, Ohnishi K, Asai K, Hirata H, Honda H. Postoperative radiotherapy in patients with salivary duct carcinoma: clinical outcomes and prognostic factors. J Radiat Res 2013; 54:925-930. [PMID: 23559598 PMCID: PMC3766298 DOI: 10.1093/jrr/rrt026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 02/23/2013] [Accepted: 03/02/2013] [Indexed: 06/02/2023]
Abstract
This study sought to investigate the clinical outcome and the role of postoperative radiotherapy for patients with salivary duct carcinoma (SDC) who had undergone surgery and postoperative radiotherapy. We performed a retrospective analysis of 25 SDC patients treated between 1998 and 2011 with surgery and postoperative radiotherapy. The median prescribed dose was 60 Gy (range, 49.5-61.4 Gy). The clinical target volume (CTV) was defined as the tumor bed in four patients, the tumor bed and ipsilateral neck in 14 patients, and the tumor bed and bilateral neck in six patients. Local control (LC), disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and prognostic variables were analyzed with the log-rank test. The 5-year LC, DFS and OS were 67%, 45% and 47%, respectively. Disease recurrence was found in 12 patients: seven as local, four as regional and eight as distant failure. Perineural and lymphovascular invasion was a significant prognostic factor for LC (P = 0.03). Local failure was common, and the presence of local recurrence significantly affected the OS (P < 0.05). We conclude that surgery and postoperative radiotherapy is expected to decrease the risk of local failure and contribute to good prognoses for patients with SDC. It might be advisable to have the CTV include the cranial nerves involved and the corresponding parts of the skull base in cases of pathologically positive perineural invasion.
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Affiliation(s)
- Makoto Shinoto
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshiyuki Shioyama
- Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsumasa Nakamura
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Torahiko Nakashima
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naonobu Kunitake
- Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yuichiro Higaki
- Department of Head and Neck Surgery, National Kyushu Cancer Center, Fukuoka, Japan
| | - Tomonari Sasaki
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Saiji Ohga
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tadamasa Yoshitake
- Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kayoko Ohnishi
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kaori Asai
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hideki Hirata
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Angiero F, Crippa R. Nevus of hoffmann-zurhelle: a case around the right parotid duct. Anticancer Res 2013; 33:3365-3368. [PMID: 23898105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Nevus lipomatosus cutaneous superficialis (NLCS) is an extremely rare hamartomatous disorder comprising of ectopic mature adipose tissue. The lesions take the form of large, slow-growing, sessile or pedunculated tumors. We report the case of an 11-year-old boy with NLCS, dating back many months, that was growing as a cuff around the parotid duct. The lesion was successfully removed by diode laser excision (980 nm) and a diagnosis of NLCS was rendered. At one-year follow-up the tumor has not recurred. To our knowledge this is the first report of NLCS in the oral cavity; the characteristic clinical and morphological features aided in the diagnosis of this hamartoma. The peculiarity of this case is its location; the extreme rarity of NLCS, in general, probably makes this case unique.
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Affiliation(s)
- Francesca Angiero
- Ospedale San Martino-Padiglione 4, Largo Rosanna Benzi, 10 (16132) Genoa, Italy.
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Jin L, Qin L, Xia D, Liu X, Fan Z, Zhang C, Gu L, He J, Ambudkar IS, Deng D, Wang S. Active secretion and protective effect of salivary nitrate against stress in human volunteers and rats. Free Radic Biol Med 2013; 57:61-7. [PMID: 23277147 PMCID: PMC4059197 DOI: 10.1016/j.freeradbiomed.2012.12.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 11/16/2012] [Accepted: 12/17/2012] [Indexed: 02/06/2023]
Abstract
Up to 25% of the circulating nitrate in blood is actively taken up, concentrated, and secreted into saliva by the salivary glands. Salivary nitrate can be reduced to nitrite by the commensal bacteria in the oral cavity or stomach and then further converted to nitric oxide (NO) in vivo, which may play a role in gastric protection. However, whether salivary nitrate is actively secreted in human beings has not yet been determined. This study was designed to determine whether salivary nitrate is actively secreted in human beings as an acute stress response and what role salivary nitrate plays in stress-induced gastric injury. To observe salivary nitrate function under stress conditions, alteration of salivary nitrate and nitrite was analyzed among 22 healthy volunteers before and after a strong stress activity, jumping down from a platform at the height of 68 m. A series of stress indexes was analyzed to monitor the stress situation. We found that both the concentration and the total amount of nitrate in mixed saliva were significantly increased in the human volunteers immediately after the jump, with an additional increase 1h later (p<0.01). Saliva nitrite reached a maximum immediately after the jump and was maintained 1h later. To study the biological functions of salivary nitrate and nitrite in stress protection, we further carried out a water-immersion-restraint stress (WIRS) assay in male adult rats with bilateral parotid and submandibular duct ligature (BPSDL). Intragastric nitrate, nitrite, and NO; gastric mucosal blood flow; and gastric ulcer index (UI) were monitored and nitrate was administrated in drinking water to compensate for nitrate secretion in BPSDL animals. Significantly decreased levels of intragastric nitrate, nitrite, and NO and gastric mucosal blood flow were measured in BPSDL rats during the WIRS assay compared to sham control rats (p<0.05). Recovery was observed in the BPSDL rats upon nitrate administration. The WIRS-induced UI was significantly higher in the BPSDL animals compared to controls, and nitrate administration rescued the WIRS-induced gastric injury in BPSDL rats. In conclusion, this study suggests that stress promotes salivary nitrate secretion and nitrite formation, which may play important roles in gastric protection against stress-induced injury via the nitrate-dependent NO pathway.
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Affiliation(s)
- Luyuan Jin
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Lizheng Qin
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Dengsheng Xia
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Xibao Liu
- Molecular Physiology and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-1190, USA
| | - Zhipeng Fan
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Chunmei Zhang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Liankun Gu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China
| | - Junqi He
- Department of Biochemistry and Molecular Biology, Capital Medical University School of Basic Medicine, Beijing 100069, People’s Republic of China
| | - Indu S. Ambudkar
- Molecular Physiology and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-1190, USA
| | - Dajun Deng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China
- Corresponding author. Fax: +86 10 88122437
| | - Songlin Wang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
- Department of Biochemistry and Molecular Biology, Capital Medical University School of Basic Medicine, Beijing 100069, People’s Republic of China
- Corresponding author at: Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China. Fax: +86 10 67062012
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Afanas'ev VV, Dubov DV. [Treatment of significant parotid ducts deformities]. Stomatologiia (Mosk) 2013; 92:38-39. [PMID: 24300706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The paper summarizes authors experience in treatment of 14 patients with congenital parotid ducts deformities (megastenon type). The results showed reconstructive surgical treatment to be sufficiently effective in such cases. If restoration of parotid function is not possible one should consider interventions for secretion reduction and duct walls excision.
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Chanu NP, Sahni JK, Aneja S, Naglot S. Four-duct ligation in children with drooling. Am J Otolaryngol 2012; 33:604-7. [PMID: 22682954 DOI: 10.1016/j.amjoto.2012.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 03/25/2012] [Accepted: 04/02/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objective of this study is to assess the improvement in drooling in children undergoing 4-duct ligation procedure for excessive drooling and to study its effect on their quality of life. MATERIALS AND METHODS A prospective, nonrandomized interventional study was done between November 2009 and September 2011. Thirty drooling children of both sexes aged 4 to 15 years underwent 4-duct ligation, that is, ligation of bilateral submandibular ducts and bilateral parotid ducts. Comparison of preoperative and postoperative drooling scores using Thomas-Stonell and Greenberg classification was done. Glasgow Children's Benefit Inventory Score was used to assess the improvement in the quality of life. RESULTS Success rate in terms of improvement in drooling was 93.33%. A complication rate of 16.67% was found. The mean improvement in total drooling score after 12 months was 4.43. The paired t test applied on preoperative and postoperative combined drooling scores showed P < .001. The mean Glasgow Children's Benefit Inventory score was 36.15. In the postoperative period, transient swelling of cheeks, transient swelling of submandibular glands, change in the consistency of saliva, cheek abscess, collection of saliva in the cheek, and parotid duct fistula were observed. CONCLUSIONS Four-duct ligation causes marked improvement in drooling and significantly increases the quality of life in drooling children. It has few complications, which can be managed effectively.
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Affiliation(s)
- Ningthoujam Pinky Chanu
- Otorhinolaryngology and Head and Neck Surgery, LHMC and Associated Hospitals, New Delhi, India.
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Celebiler Ö, Şirinoğlu H. A new method for the treatment of severe drooling: the four duct diversion: our experience in 8 children. Clin Otolaryngol 2012; 37:67-70. [PMID: 22433140 DOI: 10.1111/j.1749-4486.2011.02421.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Shiyuti MI, Mohamad I, Wan Din SJ, Naik VR, Bhavaraju VMK. Salivary duct carcinoma in the neck. Ann Acad Med Singap 2011; 40:473-474. [PMID: 22206059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Vergez S, Marx M, De Bonnecaze G, Vairel B, Decotte A, Serrano E, Dupret-Bories A. [How I do it: salivary duct preservation in the excision of small oral tumors]. Rev Laryngol Otol Rhinol (Bord) 2011; 132:119-122. [PMID: 22416494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Benign tumors, in-situ carcinomas and small carcinomas of the anterior floor mouth or of the internal surface of the cheek may require resection of salivary duct papilla i.e. papilla of submandibular duct or Stensen's duct. If a lymph node dissection is not required, excision of submandibular or parotid duct which papilla is interested in the resection can be avoided using a surgical technique not reported. The authors present two cases illustrating a simple surgical proceeding of salivary duct resection/transposition. The present method can be used to keep a functional principal salivary gland with an optimal oncologic result.
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Affiliation(s)
- S Vergez
- CHU Rangueil-Larrey, Service d'ORL et Chirurgie Cervico-Faciale, 24 chemin de Pouvourville 31059 Toulouse, France.
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50
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Abstract
UNLABELLED Atresia of the submandibular duct orifice is a rare developmental anomaly, which causes swelling of the duct by accumulation of saliva. The cystic mass in the floor of the mouth can cause feeding problems, which can be treated by surgical opening of the duct. We report the first Swedish case in a male infant, who had severe difficulties to feed because of bilateral swellings of the submandibular ducts caused by orifice atresia. CONCLUSION This is the first case that has described failure to thrive because of this condition and catch up after treatment. It is important to remember that evaluation of feeding problem in an infant must include inspection of the oral cavity.
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Affiliation(s)
- Eva Ellegård
- Department of Otorhinolaryngology, Kungsbacka Hospital, Kungsbacka, Sweden.
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