Role of sialoscopy in the treatment of Stensen's duct strictures.
OBJECTIVE
The origin of strictures of Stensen's duct often remains unclear, but chronic recurrent parotitis may be one associated disease. Failure of conservative therapy leads to a recommendation of parotidectomy in a high percentage of cases. Nowadays, development of new, minimally invasive methods may lead to a fundamental change in the treatment regimen.


METHODS
We retrospectively evaluated 39 patients who presented with symptomatic strictures of Stensen's duct from 2002 to 2005. Sialoscopy was performed with semirigid endoscopes. Therapy consisted of irrigation and intraductal infusion of cortisone. If possible, interventional sialoscopy was carried out as the first-line procedure. If indicated, operative procedures of the duct were performed.


RESULTS
After irrigation and intraductal medication, 17.9% of the patients were free of symptoms. Interventional sialoscopy was carried out in 74.4%, with a success rate of 75.9%. Operative duct procedures (extended papillotomy or resection of papilla stricture with duct reinsertion) were carried out in 23% of cases. In 5.1% of the total cases, parotidectomy was unavoidable.


CONCLUSIONS
Sialoscopy-based methods play a central role in gland-preserving treatment of strictures of Stensen's duct. Sialoscopy has proven to be a fast, useful, and relatively safe therapeutic tool with a high success rate. Parotidectomy is the last choice in symptomatic cases.
Koch
Michael
M
Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Iro
Heinrich
H
Zenk
Johannes
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003348:Cortisone / Q000008:administration & dosage; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000601:surgery; D011788:Quality of Life; D012189:Retrospective Studies; D018987:Salivary Ducts / Q000000981:diagnostic imaging; D012466:Salivary Gland Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014463:Ultrasonography
D000893:Anti-Inflammatory Agents; D003348:Cortisone