Use Of Sialendoscopy Research Articles

Is sialendoscopy an effective treatment for obstructive salivary gland disease?

BACKGROUND The management of inflammatory salivary gland disease is undergoing a paradigm shift due to the use of sialendoscopy, which facilitates minimally invasive gland-sparing therapeutic procedures. Although salivary gland resection (sialadenectomy) continues to play an important role in the treatment of significant inflammatory salivary gland disorders due to stones, strictures, and chronic sialadenitis, it is not without potential complications including bleeding, infection, nerve injury, sialocele, and cosmetic deformity. Sialendoscopy involves miniaturized semirigid endoscopes that allow for the diagnostic evaluation of the salivary ductal system. The working channel of therapeutic endoscopes allows insertion of wire baskets, microforceps, manual drill burrs, laser fibers, and balloons that can be used to address obstructive disorders such as sialoliths and strictures. Additionally, saline irrigation and steroid instillation help to clear cellular debris, salivary sludge, mucous plugs, and generalized ductal inflammation. As such, sialendoscopy offers both diagnostic and therapeutic benefits for obstructive salivary gland disease. This review will evaluate the diagnostic and therapeutic outcomes of sialendoscopy as a single-treatment modality for obstructive salivary gland disease and also identify factors predictive of treatment success.

Sialendoscopy in children

Background The definitive cause of most cases of recurrent salivary gland inflammation in children remains unknown. Relatively little has been written about the use of sialendoscopy as a diagnostic and therapeutic tool in children. Objective To evaluate the safety and efficacy of sialendoscopy as a diagnostic and therapeutic tool for recurrent salivary gland inflammation in children. Study Design Retrospective case series. Methods Medical records of all patients who underwent sialendoscopy for recurrent salivary gland inflammation from a single tertiary-care pediatric otolaryngology practice were reviewed. Comparison of pre-procedure vs. post-procedure frequency and severity of disease was reviewed. Operative reports, images, and video were analyzed for causes of inflammation. Results Six patients (aged 3–16 years old) underwent sialendoscopy (3/6 bilateral parotid, 2/6 unilateral parotid, 1/6 unilateral submandibular). There were no complications. No post-operative recurrence was noted in 3/6 patients; decreased frequency of recurrence was noted in 2/6 patients; repeat sialendoscopy was required in 1/6. Operative findings from sialendoscopy from 10 parotid glands showed fibrinous debris (7/10), mucoid debris (1/10), purulent debris (1/10), or duct stenosis (1/10). No stones were noted. Conclusions Sialendoscopy is a safe, minimally invasive procedure that may decrease the frequency of recurrences for salivary gland inflammation in children. In contrast to previously published work, the most common cause of salivary gland obstruction in this series was debris, rather than stones. Increased use of sialendoscopy as a diagnostic and therapeutic tool will allow for improved understanding of the causes of and management for recurrent salivary gland inflammation in children.

P.177 A modification in orotracheal intubation using an extra-short, ringed tube

The purpose of this study is to document our experience with sialendoscopy for the treatment of multiple calculi of the salivary ducts, as well as to discuss the technique and indications for the procedure.In this retrospective non-interventional study, 530 consecutive cases of sialolithiasis were investigated, and the cases with multiple calculi were selected for further analysis. These selected cases were analyzed from clinical and surgical aspects.Multiple calculi were detected in 37 of 530 consecutive investigated sialolithiasis cases. The gender distribution was 15 men and 22 women, with a mean age of 40.4 years. Among these patients, the submandibular gland was affected in 33 cases (right in 13 and left in 20) and the parotid gland was affected in 4 cases (right in 3 and left in 1). As for complications, 1 patient had a postoperative infection and 2 other patients had postoperative ranulas that were considered minor complications. Among all 37 cases, we had 3 cases in which preoperative imaging (sonography in 1 and radiography in 2) showed a single sialolith in the duct, but failed to show further sialoliths that were discovered later by sialendoscopy.The use of sialendoscopy allows a better diagnosis and minimally invasive treatment for multiple calculi. Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision or surgical removal of the gland even in cases with multiple calculi. Sialendoscopy allows exploration of the ductal system in detail. This technique helps to discover additional stones in the ductal system that could not have been identified with the conventional imaging modalities available.