Comparison of Chronic Sialadenitis Symptom Burden in Patients With Sialolithiasis Versus Stenosis Before and After Sialendoscopy.

Abstract

To define symptomatology and responses to treatment in chronic sialadenitis from sialolithiasis versus duct stenosis and establish a minimal clinically significant difference (MCID) in the validated Obstructive Salivary Problem Impact Test (SPIT). Prospective, cohort. Tertiary-care center. Patients completed the SPIT questionnaire at presentation and 3 to 6 months after surgery. SPIT scores and domains were compared between patients with symptomatic sialolithiasis and those with stenosis of a major salivary gland. Seventy-ninepatients completed the SPIT, including 43 (54%) with sialolithiasis and 36 (46%) with stenosis. Stenosis patients displayed greater baseline scores compared to sialolithiasis patients (45.4 ± 19.9 vs 33.3 ± 18.5, P < .013). Frequency and severity of gland swelling and pain (21.9 ± 8.9 vs17.1 ± 9.6, P = .02) and functional/psychosocial impact subscores were greater in the stenosis versussialolithiasis groups (18.0 ± 10.9 vs11.3 ± 9.4, P < .01). For 43 patients who underwent surgical intervention, SPIT scores improved at 3 to 6 months postoperatively in all domains (-18.6 ± 19.4, P < .01). Degree of improvement did not differ between sialolithiasis versusstenosis groups (-22.0 ± 20.9 vs-13.3 ± 15.8, P = .13). The MCID in SPIT score was found to be -13 points. A postoperative SPIT score of less than 10 suggested symptom resolution. When compared to sialolithiasis, chronic salivary obstruction from stenosis is associated with greater baseline SPIT scores, indicating poorer sialadenitis-related quality of life due to greater symptom frequency and functional impact. Based on SPIT survey outcomes, a score decrease of 13 points or SPIT score <10 represent significant symptom improvement.