Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

The Therapeutic Outcome of Sialendoscopy in Patients with Sialoadenitis

Document Type : Original

Authors
Mohammad Farhadi 1
Saleh Mohebbi 2
Ahmad Daneshi 3
Mohammad Jafaripanah 3
Marjan Mirsalehi 3
Ali Omidvari 3
1 ENT And Head and Neck Research Center, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences.
2 Skull Base Research Center, the Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
3 ENT And Head and Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
10.22038/ijorl.2023.63433.3174
Abstract
Abstract
Introduction:
Recent advances have led to the development of sialendoscopy, an accurate, minimally invasive procedure with high diagnostic and therapeutic capabilities in treating sialolithiasis. This study aimed to evaluate the results and complications of sialendoscopy in patients suffering from sialoadenitis.
Materials and Methods:
This study was a prospective interventional case series study on patients with sialoadenitis due to sludge or stone formation preoperatively confirmed by sonography or computed tomography (CT) scanning. Diagnostic sialendoscopy was performed, and the presence of stenosis, sludge, or stones inside the gland or duct was examined, and surgery was done. During follow-up time (18.8 ± 7.4 months), recurrence of symptoms, the need for reoperation, and postoperative complications were also assessed.
Results:
The sialendoscopy was performed in 51 patients, including 55 glands. Forty-five Patients (88.2%) reported pain relief, and 46 patients (90.2%) reported that the treatment using sialendoscopy was better than conservative methods. The duct restenosis also occurred in one patient requiring open surgery. In assessing the main factors predicting the need for reoperation, the site of involvement (parotid versus submandibular glands) and the size of the stone were identified as the main determinants. The best cut-off value for stone size in predicting reoperation requirement was 7.0mm, with a sensitivity of 100% and a specificity of 85.7%.
Conclusion:
Intraoperative sialendoscopy is a successful diagnostic and therapeutic tool with minimal postoperative complications in salivary gland duct involvement patients.    
Keywords
Sialendoscopy
Sialadenitis
Surgery
Parotid gland
Submandibular gland
  1. Day AT, Rivera E, Farlow JL, Gourin CG, Nussenbaum B. Surgical Fires in Otolaryngology: A Systematic and Narrative Review. Otolaryngol Head Neck Surg. 2018 Apr;158(4):598-616. doi: 10.1177/0194599817746926. Epub 2018 Jan 23.
  2. Kopeć T, Szyfter W. Sialendoscopy as a non-invasive treatment method of sialolithiasis and non-inflammatory processes causing salivary gland swelling. Otolaryngol Pol. 2010 Nov-Dec; 64(6): 370-4. doi: 10.1016/S0030-6657(10) 70589-8.
  3. Abdel Razek AAK, Mukherji S. Imaging of sialadenitis. Neuroradiol J. 2017 Jun;30(3):205-215. doi: 10.1177/1971400916682752. Epub 2017 Jan 6.
  4. Hammett JT, Walker C. Sialolithiasis. 2020 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021
  5. Troeltzsch M, Pache C, Probst FA, Troeltzsch M, Ehrenfeld M, Otto S. Antibiotic concentrations in saliva: a systematic review of the literature, with clinical implications for the treatment of sialadenitis. J Oral Maxillofac Surg. 2014 Jan;72(1):67-75. doi: 10.1016/j.joms.2013.06.214. Epub 2013 Aug 29.
  6. Nouraei SA, Ismail Y, McLean NR, Thomson PJ, Milner RH, Welch AR. Surgical treatment of chronic parotid sialadenitis. J Laryngol Otol. 2007 Sep;121(9):880-4. doi: 10.1017/S002221510600 5445. Epub 2006 Dec 14.
  7. N KanaI; S Maharaj. The evolution of sialendoscopy in clinical practice. S Afr Dent J 2019;74(9): 485-90.
  8. Klinovskaya AS, Gurgenadze AP, Bazikyan EA, Abrahamyan KD, Chunikhin AA. Sialendoscopy in diagnosis and treatment of salivary gland disorders]. Stomatologiia (Mosk). 2020;99(3):83-86. doi: 10.17116/stomat20209903183.
  9. Turner MD. Surgical Armamentarium for Sialendoscopy. Atlas Oral Maxillofac Surg Clin North Am. 2018 Sep;26(2):85-91. doi: 10.1016/j. cxom.2018.05.001.
  10. Galdermans M, Gemels B. Success rate and complications of sialendoscopy and sialolithotripsy in patients with parotid sialolithiasis: a systematic review. Oral Maxillofac Surg. 2020 Jun;24(2):145-150. doi: 10.1007/s10006-020-00834-x.
  11. Capaccio P, Torretta S, Pignataro L (2009) Extracorporeal lithotripsy techniques for salivary stones. Otolaryngol Clin N Am 42(6):1139–1159. https://doi.org/10.1016/j.otc.2009.08.003
    12. Schmitz S, Zengel P, Alvir I, Andratschke M, Berghaus A, Lang S (2008) Long-term evaluation of extracorporeal shock wave lithotripsy in the treatment of salivary stones. J Laryngol Otol 122(1):65–71. https://doi.org/10.1017/S0022215107007396
    13. Pniak T, Štrympl P, Staníková L, Zeleník K, Matoušek P, Komínek P (2016) Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods. Open Med 11(1):461–464. https://doi.org/10.1515/med-2016-0081
    14. Goates AJ, Kung RW, Tracy CR, Hoffman HT (2017) Intraductal laser fiber tip fracture and retrieval during sialendoscopic laserassisted lithotripsy. Ann Otol Rhinol Laryngol 126(11):774–777. https://doi.org/10.1177/0003489417728736

 

  1. Maarten Galdermans 1, Bert Gemels 2. Success rate and complications of sialendoscopy and sialolithotripsy in patients with parotid sialolithiasis: a systematic review. Oral Maxillofac Surg. 2020 Jun; 24(2):145-150. doi: 10.1007/s10006-020-00834-x.
  2. Takeshi Matsunobu 1, Takaomi Kurioka 2, Yoshihiro Miyagawa 2, Koji Araki 2, Atsushi Tamura 2, Katsuki Niwa 2, Masayuki Tomifuji 2, Taku Yamashita 2, Akihiro Shiotani 2. Minimally invasive surgery of sialolithiasis using sialendoscopy. Auris Nasus Larynx. 2014 Dec; 41(6): 528-31. doi: 10.1016/j.anl.2014.05.009. Epub 2014 Jun 23.
  3. D Cox 1, L Chan 1, D Veivers 1. Prognostic factors for therapeutic sialendoscopy. J Laryngol Otol. 2018 Mar;132(3):275-278. doi: 10.1017/ S0022215117000822. Epub 2017 May 11.
  4. Johannes Zenk 1, Michael Koch, Nils Klintworth, Barbara König, Katharina Konz, M Boyd Gillespie, Heinrich Iro. Sialendoscopy in the diagnosis and treatment of sialolithiasis: a study on more than 1000 patients. Otolaryngol Head Neck Surg . 2012 Nov;147(5):858-63. doi: 10.1177/01945 99812452837. Epub 2012 Jun 29.
Iranian Journal of Otorhinolaryngology
Volume 35, Issue 2
March and April 2023
Pages 91-96