Interventional sialendoscopy in parotidomegaly related to eating disorders

Giuseppe Colella,Gianpaolo Tartaro,Roberto De Luca,Antonio Troiano,Giorgio Lo Giudice,Carmelo Lo Faro,Vincenzo Santillo

doi:10.1186/s40337-021-00378-9

Abstract

BackgroundTo evaluate the viability and efficacy of sialendoscopy for the management of parotidomegaly related to eating disorders, 6 patients suffering from eating disorders and recurring symptoms of glandular swelling were followed up at the Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU University of Campania “Luigi Vanvitelli”. After the detection of the impaired gland through clinical and radiographical analysis, the diagnostic unit was introduced into the duct and was advanced in, reaching the ductal system. Plaques were washed out, any strictures were dilated both by hydrostatic pressure application and steroid solution injection directly in the fibrotic area.ResultsBoth glands resulted affected in 83% of patients. 11 parotid glands were explored and treated. Strictures were found in 2 glands (33%), sialectasis in 3 glands (50%), strictures and sialectasis together in 1 glands (17%). In 3 parotid glands (50%) Stenon’s duct was affected, in two (33%) only secondary ducts, in 1 (17%) both. We reached symptomatic improvement in 5 patients (83%), reporting the spherical volume of the parotid region and pain reduction.ConclusionsOur results demonstrate that sialendoscopy is a safe and effective therapeutic method to treat EDs salivary symptoms. Treating the underlining psychiatric pathology should be the primary goal in patient care to lower the possible recurrence rate and increase the successful outcome of this technique.

Highlights

To evaluate the viability and efficacy of sialendoscopy for the management of parotidomegaly related to eating disorders, 6 patients suffering from eating disorders and recurring symptoms of glandular swelling were followed up at the Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU University of Campania “Luigi Vanvitelli”
Plain English summary Patients affected by Eating Disorders such as Anorexia Nervosa and Bulimia Nervosa often follow compensatory behaviors to control their weight
AN clinical characteristics lead to two subtypes: Anorexia Nervosa Restricting type (AN-R) and Anorexia Nervosa Binge-eating/Purging type (AN-BP) whereas Bulimia Nervosa (BN) is distinguished by compensatory actions after binge eating

Summary

Introduction

To evaluate the viability and efficacy of sialendoscopy for the management of parotidomegaly related to eating disorders, 6 patients suffering from eating disorders and recurring symptoms of glandular swelling were followed up at the Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU University of Campania “Luigi Vanvitelli”. Patients may follow inappropriate compensatory behaviors in order to avoid guilt perceived after eating or weight gain, such as chewing and spitting, self-induced vomiting, fasting or intake restriction after food consumption, drug intake such as laxatives or diuretics, inappropriate use of enemas, and over-exercising. The mechanisms underlining salivary gland swelling are still up to debate, this condition must be treated by the physician: the impact on the patients’ body image is significant, magnified by the social pressure to pursuit a symmetric, imperfection-free face, possibly worsening their dysmorphic disorder. This paper aims to evaluate the reliability of sialendoscopy in the management of parotidomegaly related to eating disorders

Objectives

Methods

Results

Discussion

Conclusion