Chronic Sialadenitis Research Articles

Cone beam computed tomography use in sialolithiasis of the submandibular salivary gland

A 62-year-old diabetic male patient presented with right sided facial pain associated with a firm palpable mobile mass in the right submandibular area. Following initial examination, cone beam computed tomography (CBCT) investigation demonstrated multiple smooth homogenous calcifications (Figure 1) collectively measuring 12mm x 9mm x 8mm within the region of the right submandibular gland (Figure 2). On resection of the submandibular gland, the histological features of the lesion were confirmed to be those of chronic sclerosing sialadenitis supporting the clinical impression of a sialolith.

Suture Stenting After Sialendoscopy: A Novel Technique That Reduces Risk of Recurrent Parotitis.

Chronic sialadenitis is associated with decreased quality of life and recurrent infections. While sialendoscopy with stenting is effective in relieving symptoms of sialadenitis, currently available stents are rigid and poorly tolerated by patients, leading to early removal and potential for adverse scarring. This study examines whether sutures can be used as a stenting material to improve patient comfort and reduce recurrence risk. This is a retrospective cohort study of a consecutive series of adult patients with chronic sialadenitis undergoing sialendoscopy with or without suture stenting. Data were collected between 2014 and 2018 with a 3-year follow-up period ending in 2021. The primary outcome measure was recurrence of sialadenitis within 3 years of surgery. Secondary outcomes were stent dislodgement and patient-reported discomfort. We included 63 patients with parotid sialadenitis of whom 28 underwent suture stenting and 35 did not receive stenting after sialendoscopy. Stents were well tolerated, with a mean duration of 34.5 days, and only 2 of 28 stents (7.1%) accidentally dislodged within the first week. Suture stenting significantly reduced symptom recurrence after sialendoscopy (OR = 0.09, 95% CI 0.02-0.45, p = 0.003; 3-year sialadenitis recurrence rate: 7.1% vs. 45.7%, p = 0.005). Cox multivariate regression for clinicodemographic variables showed an HR of 0.04 (95% CI 0.01-0.19, p < 0.001) for the risk of symptom recurrence. Suture stenting after sialendoscopy is low cost, available across all institutions, well-tolerated by patients, and highly efficacious in reducing risk of recurrent sialadenitis after sialendoscopy. 3 Laryngoscope, 134:614-621, 2024.

Usefulness of Stensen’s Duct Steroid Irrigation in Patients With Chronic Sialadenitis of the Parotid Gland

Background and Objectives Inflammatory and obstructive diseases of the salivary glands can cause recurrent pain, swelling, and dry mouth, significantly affecting the quality of life. In most cases, symptoms improve after medical treatment, but if symptoms persist or recur, other treatment methods should be considered. The purpose of this study was to evaluate the therapeutic effect of salivary duct steroid irrigation in refractory chronic sialadenitis.Subjects and Method A retrospective study was conducted on 19 patients who underwent Stensen’s duct steroid irrigation from January 2016 to December 2021. All patients enrolled in study had no improvement of symptoms after medical treatment. The clinical characteristics including etiology, location, symptom duration, underlying disease, treatment response and complications of the patients were analyzed.Results Stensen’s duct steroid irrigation was effective in 12 of 19 patients (63%), of which 5 (26%) showed complete disappearance of symptoms. There was no difference in the treatment effect by etiology. The rate of non-response to treatment was high when the symptom duration was more than one year. Temporary parotid gland swelling occurred in two patients after irrigation, while other side effects such as bleeding and infection did not occur.Conclusion Salivary duct steroid irrigation is a simple and safe procedure, which may be considered as a treatment method for medically refractory chronic sialadenitis.

Gasless Endoscopic Submandibular Gland Excision Through Hairline Approach.

The aim of this study was to evaluate the therapeutic effect of gasless endoscopic submandibular gland excision through hairline approach and the safety, feasibility and practicability of this technique. Twenty-five patients with submandibular gland lesions who underwent gasless endoscopic submandibular gland excision through hairline approach at the Department of Head and Neck Oncology of the West China Hospital of Stomatology from May 1 st 2021 to May 31 st 2022 were included in this prospective study. The variables were analyzed statistically with SPSS software version 23.0 (IBM Corp, Armonk, New York, USA). There was a female predominance (72%), female to male ratio was 2.6. The mean age was 30.6±10.2 years (range: 11 to 52year). All 25 cases of endoscopic submandibular gland excision through hairline approach were done without conversion to conventional approach. This approach was indicated in 14 cases (56%) for pleomorphic adenoma, 8 cases (32%) for chronic sialadenitis, 2 cases (8%) for adenoid cystic carcinoma, and 1 case (4%) for lymphadenitis. The incision length mean was 4.8±0.4mm (range: 4 to 5mm); the operation duration mean was 100.6±39.7min (range: 51 to 197min); the intraoperative bleeding mean was 13.2±5.7ml (range: 5 to 20ml); the hospital length of stay mean was 4.5±0.8 days (range: 3 to 6days). The follow-up mean was 10±3.4 months (range: 5 to 16months). The patients were very satisfied with postoperative cosmetic result (score mean: 9.2±1). No recurrence of disease and complications such as postoperative bleeding, hematoma, nerve damage, skin necrosis, infection, and hair loss occurred. Gasless endoscopic submandibular gland excision through hairline approach is safe, feasible and practicable, resulting in a very satisfied cosmetic result without significant complications; the intraoperative bleeding is less, the operative field is clear, the operation duration decreases with accumulation of experience.

Lymphoid cell rich fine-needle aspirations of the salivary gland: What is the risk of malignancy?

Lymphoid cell rich fine-needle aspirations (FNAs) of the salivary glands pose a diagnostic dilemma, with a wide range of differential diagnoses that include several benign and malignant entities. There is limited literature regarding the entities that are commonly encountered in this situation. Our goal was to characterize the surgical outcome in these cases and to evaluate the risk of malignancy. This is a retrospective study at a tertiary care institution. Our database was queried over a 10-year period. FNAs yielding a prominent population of well-visualized lymphoid cells were included in the study. Only cases with surgical follow-up were evaluated. FNAs with epithelial cells, diagnostic features of any entity (such as granulomas or chondromyxoid stroma), history of metastatic malignancy, or scant cellularity were excluded from the study. Lymphoid cells were classified as atypical according to morphologic findings (monomorphism, irregular nuclear contours, and abnormal chromatin patterns). Statistical analysis was performed. Of the 224 lymphoid cell rich FNAs identified, 29 (28%) had surgical follow-up in our data records. Twenty-two were from the parotid and seven from the submandibular gland. Ten cases (35%) were non-neoplastic (benign lymphoepithelial cyst [n = 4], reactive lymph node [n = 5] and chronic sialadenitis [n = 1]). Benign epithelial neoplasms including pleomorphic adenoma (n = 2) and Warthin's tumor (n = 1) were identified in 10% of the cases. One case with non-atypical lymphocytes proved to be a mucoepidermoid carcinoma (n = 1). Lymphomas were detected in 52% (n = 15). Of note, none of these patients had a history of lymphoid malignancy. 8/15 were low-grade and 7/15 were high-grade lymphoma. Most of these cases (11/15) had atypical lymphocytes on FNA. Ancillary studies were available in a few cases and supportive of the diagnosis of lymphoma, including cell block and immunohistochemistry (n = 7, 47%), flow cytometry (n = 3, 27%), and clonality polymerase chain reaction (PCR) (n = 1; 7%). Most of these were performed in cases with atypical lymphocytes. In cases with non-atypical lymphocytes, five cases were malignant on surgical excision (5/17). Morphology on FNA had a specificity of 92% for malignancy and sensitivity of 69%. The positive predictive value on FNA of atypical lymphocytes for malignancy was 92%. Lymphoid cell rich FNAs carry a 52% incidence rate lymphoma in our small study population. Specificity of FNA for malignancy is high (92%) and lymphocyte atypia is a strong predictor of malignancy. Ancillary studies may be of added value in FNAs with non-atypical lymphoid cells. FNA has a valuable role in triaging lymphoid lesions of the salivary glands.

Diagnostic Findings and Surgical Management of Three Dogs Affected by Osseous Metaplasia Secondary to a Salivary Mucocele.

Saliva is an irritant of the subcutaneous tissue, thus causing the development of a non-epithelial reactive pseudocapsule. Metaplastic ossification of the pseudocapsule is a condition rarely described in the veterinary literature. The main causes of calcification are trauma, tumours, various chronic inflammatory conditions and fibrodysplasia ossificans progressiva. The aim of the present case series was to describe three dogs affected by a calcified salivary mucocele. The medical records of dogs affected by a cervical sialocele were retrospectively evaluated, and three cases met the inclusion criteria. All the dogs in this study were referred to the Veterinary Teaching Hospital (VTH) of the Department of Veterinary Sciences of the University of Turin (Turin, Italy) for a large solid mass in the intermandibular region. The diagnosis of a mucocele was confirmed clinically by centesis and by radiography or CT. Complete excision of both the pseudocyst and the ipsilateral mandibular/monostomatic sublingual salivary gland was performed in all cases. The histological report showed large areas of bone metaplasia within the pseudocapsule and chronic sialadenitis. Based on this limited case series, complete excision of the pseudocyst and a concurrent sialoadenectomy provided an effective treatment for this rare salivary mucocele disorder.

A CLINICOPATHOLOGICAL STUDY OF 100 CASES OF SALIVARY GLAND LESIONS AT A TERTIARY CARE CENTRE.

Background: Salivary gland shows varied types of pathological lesions ranging from inammatory lesions to neoplasms. We have studied the salivary gland lesions with correlation to clinical and histopathologic features. Objective: Aim of this study was – 1. To study the epidemiology of salivary gland lesions in a tertiary care centre with respect to the age, sex and site distribution. 2. To study the histomorphological aspect of these lesions. 3. To correlate between ne needle aspiration cytology and histopathology of these lesions. Materials and Methods: The present observational study was conducted in the department of pathology in Dr. VPMCH&amp;RC, Nashik. Total 100 cases were studied over a period of two years with particular reference to age, sex, site, cytological details &amp; histological types as per WHO classication. Detailed FNAC &amp; histopathological examination was done in all the cases. Correlation between the cytological &amp; histopathological diagnoses was assessed. A total of 100 cases were studied, comprising of 62 Results: male &amp; 38 female and 16 cases were malignant. The parotid gland was the most commonly involved site (70% of cases). Of the 46 non-neoplastic cases, 38 were of chronic sialadenitis and 8 cases of mucous retention cyst. Among the 38 benign neoplastic lesions, 32 were Pleomorphic adenoma and 6 were Warthin's tumour. Mucoepidermoid carcinoma (8 cases) was the most common malignant neoplastic lesions. Correlated in 95% of instances. Salivary gland lesions, are most Conclusion: nd th commonly seen in 2 to 6 decade of life with more male predominance. Parotid gland is the most common site. Lesions have more frequent occurrences compared to neoplastic lesions, with chronic sialadenitis having highest incidence. Histopathologic examination is fairly accurate in making a diagnosis especially in non-neoplastic &amp; benign neoplasms.

Radiomics-based sialadenitis staging in contrast-enhanced computed tomography and ultrasonography: a preliminary rat model study

The aim of this study was to measure the ability of radiomics analysis to diagnose different stages of sialadenitis, compare the diagnostic accuracy of computed tomography (CT) and ultrasonography (US), and suggest radiomics features selected through 3 machine learning algorithms that would be helpful in discriminating between stages of sialadenitis with both imaging systems. Wistar rats were treated to induce acute and chronic sialadenitis in the left and right submandibular glands, respectively. Contrast-enhanced CT and US of the glands were performed, followed by extirpation and histopathologic confirmation. Radiomics feature values of the glands were obtained from all images. Based on 3 feature selection methods, an optimal feature set was defined after a comparison of the receiver operating characteristic area under the curve (AUC) of each combination of 3 deep learning algorithms and 3 classification models. The attribute features for the CT model were 2 gray-level run length matrices and 2 gray-level zone length matrices. In the US model, there were 2 gray-level co-occurrence matrices and 2 gray-level zone length matrices. The most accurate diagnostic models of CT and US yielded outstanding (AUC=1.000) and excellent (AUC=0.879) discrimination, respectively. The radiomics diagnostic model using gray-level zone length matrices-based features conferred clinically outstanding discriminating ability among stages of sialadenitis using CT and excellent discrimination with US in almost all combinations of machine learning feature selections and classification models.

Specific inhibitor of Smad3 (SIS3) alleviated submandibular gland fibrosis and dysfunction after dominant duct ligation in mice

Background/purposeChronic obstructive sialadenitis (COS) is a condition that severely reduced patients’ quality of life. This study aimed to analyze the effects of SIS3, a specific inhibitor of small mothers against decapentaplegic 3 (SMAD3), on the submandibular gland (SMG) dysfunction, fibrosis, and inflammation. Materials and methodsThe dominant duct in the SMG was ligated in mice, followed by intraperitoneal injection of SIS3 (2 mg/kg/day) or Dimethyl sulfoxide (DMSO) saline for 7 days. In the sham group, this duct was surgically identified but not ligated. Saliva flow, histological structure, fibrosis, Transforming growth factor-β1 (TGF-β)/SMAD3 signaling, and inflammatory cytokines, were analyzed. ResultsSIS3 rescued ligation-induced SMG dysfunction and improved the saliva flow rate compared to DMSO. SIS3 alleviated acinar atrophy and ductal dilation and maintained the morphology of the basal membrane. SIS3 reduces interlobular and intralobular fibrosis and collagen deposition. We observed reduced SMAD3 phosphorylation and TGF-β expression. The SIS3 group showed downregulation of np_5318 and miR-21 and upregulation of miR-29 b compared to the DMSO group. Moreover, SIS3 controlled the inflammatory cytokine release, including interleukin-6 and interleukin-1β. ConclusionSIS3 protected duct-ligated SMGs against fibrosis and dysfunction by inhibiting the TGF-β/SMAD3 signaling and inflammatory cytokine expression. SIS3 may serve as a promising treatment for chronic obstructive sialadenitis.

A Prospective Study of Recovery of Salivary Gland Function After Calculus Removal by Sialendoscopy.

Sialendoscopy is gaining popularity in treating obstructive sialolithiasis as a gland preserving procedure. The study aimed to determine if the salivary glands recovered apart from symptomatic improvement after interventional sialendoscopy for calculus removal. A prospective comparative study was conducted in a tertiary care center on 24 patients diagnosed with sialolithiasis. The eligibility criterion was patients who underwent calculus removal through interventional sialendoscopy. All patients underwent objective and subjective methods of assessments of function of the salivary glands with the help of salivary Technetium (Tc) 99 Scintigraphy, measurement of salivary flow rate, Chronic obstructive sialadenitis symptoms (COSS), and xerostomia index (XI) questionnaires. Assessments were done before the procedure and repeated after 3months. Categorical variables were expressed using frequency and percentage. Numerical variables were represented using mean and standard deviation. To test the statistical significance of the difference in the mean of the four parameters Wilcoxen sign ranked test was used. According to our study improvement in functionality was noted in all of the subjective and objective parameters assessed namely Tc scintigraphy, salivary flow rate, COSS questionnaire, and XI questionnaire, with a statistically significant p value (< 0.001). Functionality of salivary gland showed improvement within 3months of calculus removal through sialendoscopy. There was a marked improvement in the symptoms after sialendoscopy. This study demonstrates that removal of obstructing calculus results in rapid recovery of glandular function thereby emphasizing the need for salivary gland preservation. Level of evidence: Level III.

Sialoadenitis crónica recurrente de glándula submandibular, reporte de caso y revisión de la literatura

Sialadenitis is defined as an inflammation of the major salivary glands and has multiple etiologies. this article reported the case of a 17-year-old girl treated in the Maxillofacial Surgery service of the “Hospital General la Perla”. The patient presents an increase in volume in the right submandibular region, she reports 5 months of evolution, 12 days of antibiotic/analgesic treatment, and persistent symptoms. The requested tomographic study shows an isodense that suggests increased volume at the right submandibular gland. Due to the correlation between clinical and imaging presentation, chronic sialadenitis is diagnosticated. The patient is prepared to go to the operating room to remove the affected gland. Under general anesthesia, submandibular access, and dissection the submandibulectomy was achieved. The suture by planes is with Vicryl 3-0 and Nylon 5-0. The controls conducted at 7 and 30 days indicate normal healing and evolution, without nervous alterations. That is why is important for the clinician to have complete knowledge of the anatomy and pathology so that he will perform this procedure successfully, reducing the possibility of post-treatment complications.

Study of fine needle aspiration cytology of salivary gland according to the Milan system

Abstract Background: Fine-needle aspiration cytology (FNAC) of salivary gland lesions is the initial screening test. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) classifies FNAC into six categories, which is a simple, convenient and standardized diagnostic method of reporting and also provides management guidelines. The study was encountered in our tertiary care hospital. Aims and Objectives: To study the cytology of salivary gland lesions by Fine Needle Aspiration Cytology and to classify lesions according to The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Materials and Methods: This is a prospective study of 100 patients with clinically enlarged salivary gland presented at the G.K. General Hospital, Bhuj, during April 2019 to March 2020. Results: Of 100 cases, 40 cases were nonneoplastic, 52 cases were neoplastic, and 8 cases were unsatisfactory for evaluation. The category II had 40 cases, out of which chronic sialadenitis was the most common cytological diagnosis (20 cases). There were two case in each category IVb and category V. Category IV had 41 cases on cytology. Category VI had eight cases. Conclusions: It is of particular relevance in the head and neck area because of easy accessibility of the target site minimally invasive procedure, excellent patient compliance and thereby help to avoid surgery in nonneoplastic, inflammatory conditions.

Cytopathological Evaluation of Paediatric Non-Thyroidal Neck Swelling–Experience in a Tertiary Care Children Hospital

Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. However, until recently, few reports have been obtained regarding the role of FNAC in non-thyroidal neck masses in children. Therefore, the objective of our study was to determine the diagnostic value of fine needle aspiration cytology in the diagnosis of pediatric non-thyroidal neck masses. Methods: This descriptive study was conducted at the Department of Pathology of Bangladesh Shishu (Children) Hospital &amp; Institute January 2019 to December 2021. Hundred patients with non-thyroidal neck masses fulfilling the inclusion criteria were included in the study. Fine needle aspirations were performed, smears prepared and stained by Hematoxylin and Eosin stain. Results: The most common non-neoplastic neck swelling seen in children were an enlarged lymph node due to inflammation 38(42.2%), i.e., reactive lymphadenitis. Others were TB lymphadenitis 25 (27.8%), non-TB granulomatous lymphadenitis 2(2.22%), chronic sialadenitis 2(2.22%), branchial cyst 4(4.44%) and epidermal cyst 3(3.33%) cases. Overall sensitivity, specificity, positive predictive value and negative predictive value of FNAC in our cases are 93.06%, 72.22%, 93.06% and 72.22%. Conclusion: FNA is an important diagnostic tool in the management of childhood neck lesion with the clinical presentation. The procedure decreases the requirement for more invasive and costly procedures like surgical biopsy.

Drain-Less Submandibular Gland Excision With Preserved Facial Artery.

To describe our experience in excision of the submandibular gland (SMG) without drain insertion and with preservation of the facial artery as a day case surgery as well as evaluation of the surgical outcomes of this procedure. Prospective case series study of 42 cases of chronic calcular submandibular sialadenitis that underwent SMG excision by the same surgical team during the period from 2017 to 2021. The initial surgical plan in all cases was to excise the SMG with preservation of the facial artery and without drain insertion. SMG excision without drain insertion was successfully achieved in 28 patients who were discharged on the same day. In the remaining 14 patients, the surgical dissection was difficult and a suction drain was inserted at the end of the surgery; consequently, they were discharged on the next day. In all cases, facial vessels were preserved, and complete gland excision was achieved. Among the 28 patients who had no drain insertion, 1 patient had a postoperative seroma and no patient had wound related complications. Among the 14 patients who had drain insertion, 2 patients had postoperative seroma and 3 patients had wound related complications in the form of obvious scar formation. There were no other significant complications in all patients. Submandibular gland (SMG) excision with facial artery preservation and without drain insertion as a day case surgery could be safely done in cases of chronic calcular inflammation provided that meticulous surgical dissection and complete hemostasis were achieved.

Ultrasonographic Features of Salivary Glands after Radioiodine Therapy in Patients with Thyroid Cancer.

Chronic sialadenitis is the most common complication of radioactive iodine (RAI) treatment. The aim of the study was to ascertain sonographic features of the major salivary glands in patients with papillary thyroid cancer (PTC) treated with RAI. The database of a tertiary medical center was retrospectively searched for consecutive patients who underwent total thyroidectomy for PTC in 2011-2020 with ultrasound follow-up after 1 year. Changes in ultrasound features of the major salivary glands were compared between patients treated or not treated with RAI postoperatively. The cohort included 158 patients, of whom 109 (69%) were treated postoperatively with RAI (mean dose, 131 mCi) and 49 were not (control group). Sonographic changes were observed in the major salivary glands in 43% of the study group and 18% of the control group (p= 0.002), including coarse echotexture, decreased echogenicity, fibrosis, and atrophy. Higher RAI doses were significantly correlated with the prevalence and severity of glandular changes (p< 0.0001). RAI treatment following thyroidectomy is associated with a dose-response effect and adverse changes in the major salivary glands and should be prescribed carefully. 4 Laryngoscope, 133:1271-1275, 2023.

Correction of LAMP3-associated salivary gland hypofunction by aquaporin gene therapy

Sjögren’s disease (SjD) is a chronic autoimmune sialadenitis resulting in salivary gland hypofunction with dry mouth symptom. Previous studies showed that lysosome-associated membrane protein 3 (LAMP3) overexpression is involved in the development of salivary gland hypofunction associated with SjD. However, the molecular mechanisms are still unclear, and no effective treatment exists to reverse gland function in SjD. Analysis on salivary gland samples from SjD patients showed that salivary gland hypofunction was associated with decreased expression of sodium–potassium-chloride cotransporter-1 (NKCC1) and aquaporin 5 (AQP5), which are membrane proteins involved in salivation. Further studies revealed that LAMP3 overexpression decreased their expression levels by promoting endolysosomal degradation. Additionally, we found that LAMP3 overexpression enhanced gene transfer by increasing internalization of adeno-associated virus serotype 2 (AAV2) via the promoted endolysosomal pathway. Retrograde cannulation of AAV2 vectors encoding AQP1 gene (AAV2-AQP1) into salivary glands induced glandular AQP1 expression sufficient to restore salivary flow in LAMP3-overexpressing mice. LAMP3 could play a critical role in the development of salivary gland hypofunction in SjD by promoting endolysosomal degradation of NKCC1 and AQP5. But it also could enhance AAV2-mediated gene transfer to restore fluid movement through induction of AQP1 expression. These findings suggested that AAV2-AQP1 gene therapy is useful in reversing salivary gland function in SjD patients.

NOR-1 (NR4A3) immunostaining on cytologic preparations for the preoperative diagnosis of acinic cell carcinoma of the salivary gland.

Acinic cell carcinoma of the salivary gland (ACC-SG) is characterized by recurrent rearrangements in the nuclear receptor subfamily 4 group A member 3 (NR4A3). Immunostaining using an antibody targeting this rearrangement, neuron-derived orphan receptor 1 (NOR-1), has been recently studied on surgical specimens and cell block material of fine-needle aspirates for the diagnosis of ACC-SG. Our goal was to evaluate whether NOR-1 immunostaining could reliably be performed on destained cytologic preparations. This was a retrospective multi-institutional study. Immunostaining with the NOR-1 antibody (sc-393902 [H-7], Santa Cruz Biotechnology Inc.) was performed at a titer of 1:30 on destained cytologic preparations. ACC-SG cases (n = 17) were represented by twelve cases with alcohol-fixed preparations (n = 12), including direct smears and SurePath preparations, as well as 5 cases with air-dried preparations (n = 5). These were compared to 27 mimicker lesions (n = 27): normal acini (4), chronic sialadenitis (3), oncocytoma (2), pleomorphic adenoma (6), Warthin tumor (8), mucoepidermoid carcinoma (1), secretory carcinoma (2), and salivary duct carcinoma (1). The positivity of NOR-1 in ACC-SG cases was 100% on destained alcohol-fixed preparations (12/12) and 60% on air-dried preparations (3/5). All 27 mimicker lesions were negative for NOR-1 (0/27). Evaluation of 2 ACC-SG cases with both types of cytologic preparations showed that NOR-1 was positive on the alcohol-fixed slides but negative on the air-dried slides. NOR-1 immunostaining can reliably be performed on alcohol-fixed direct smears and liquid-based preparations for the diagnosis of ACC-SG. Air-dried preparations show a lower positivity rate and may be less suitable for diagnostic immunostaining.

Validation of a Spanish chronic obstructive sialadenitis quality of life questionnaire (CSOC)

Background and objectivesInterest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility. Material and methodsA prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. ResultsAll the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94 respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31. ConclusionsThe CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis.

Validación de un cuestionario específico de calidad de vida en sialoadenitis obstructiva crónica (CSOC)

Background and objectivesInterest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility. Material and methodsA prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. ResultsAll the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94, respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31. ConclusionsThe CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis.

Warthin Tumor - Diagnostic Dilemma- Case Report

Warthin Tumor is also known as Papillary Cystadenoma lymphomatosum, is a fairly common tumor. Cytologically, it simulates many other lesions of salivary glands like chronic sialadenitis, low grade mucoepidermoid carcinoma, acinic cell carcinoma, squamous cell carcinoma, oncocytic carcinoma, lymphoepithelial cyst etc which poses a diagnostic dilemma.