Sialoendoscopy as a diagnostic and therapeutic option for obstructive diseases of the large salivary glands-a retrospective analysis.

Abstract

The diagnosis and therapy of obstructive inflammatory disorders of the salivary glands have changed in the past decades following the introduction of sialoendoscopy. The aims of the present study were to analyze the relevance of sialoendoscopy using our own data and to compare the results to those of other studies. A retrospective analysis of 70 patients was performed, who were treated for obstructive disorders of the parotid and/or submandibular gland in whom sialoendoscopy was indicated. Two categories of interventions were considered: diagnostic interventional sialoendoscopy and endoscope-assisted interventions. Interventional sialoendoscopy procedures requiring extirpation of the gland were included in the analysis, as were abnormal intraductal processes that were detected during endoscopy. Treatment was successful in 58 of 67 (86.6%) procedures (sialoendoscopy without surgical intervention n = 59; endoscope-assisted surgical intervention n = 8). Based on the underlying disease, the success rate was 88.6% (n = 39) in patients with obstructive sialadenitis without sialolithiasis and 86.6% (n = 19) in patients with sialolithiasis. It was not possible to draw definitive conclusions on the underlying disease from the observed pathological intraductal changes. Sialoendoscopy is an effective and safe diagnostic and therapeutic option with low complication rate. However, limiting factors such as the size or the position of potentially removable obstacles must be taken into consideration. The rate of gland extirpations can be reduced using sialoendoscopy.