Causes of chronic obstructive parotitis and management by sialoendoscopy

Abstract

Sialoendoscopy is a relatively new technique to detect causes of obstruction in the parotid gland directly and manage the chronic obstructive parotitis effectively combined with continuous lavage and drug perfusion simultaneously. To describe the cause, exploration, and combined management of chronic obstructive parotitis using sialoendoscopy. Between October 2004 and June 2006, 23 patients with obstructive symptoms were diagnosed by sialography and explored by diagnostic sialoendoscopy. The obstructions were then removed by interventional sialoendoscopy. After obstructions were removed successfully, 0.25% chloramphenicol was used to lavage the duct continuously, and then 40% iodized oil was perfused into duct. The results of follow-up were evaluated by visual analog scales (VAS) of the clinical appearances at different stages. Twenty of the 23 patients were found with various types of stenosis and dilatation of duct on sialography, and 21 patients were explored using sialoendoscopy successfully. The features of these 21 cases found endoscopically were of 4 types: sialolith (n = 4; 19.0%), duct polyps (n = 5; 23.8%), stenosis (n = 3; 14.3%), and mucus plug (n = 9; 42.9%). Seventeen cases were treated successfully, removing obstructions via sialoendoscopy, giving a success rate of 80.9% (17 out of 21). The satisfactory rate after 6 months was 82.4% by VAS and secretion observation. Sialoendoscopy is a promising image-guided technique for evaluation and treatment of obstructive disease of the parotid salivary glands.