Endoscopic-assisted management of chronic sialadenitis.
BACKGROUND
Chronic sialadenitis is a relatively common disorder that is frequently referred to head and neck surgeons for diagnosis and management. The management of the disorder is rapidly evolving with the introduction of salivary endoscopy. The purpose of the present study was a review of the indications and techniques of endoscopic-assisted management of chronic sialadenitis at a single U.S. institution.


METHODS
This study is a retrospective case series of patients undergoing salivary endoscopy for chronic sialadenitis. Patient clinical information was reviewed to determine endoscopic findings, associated procedures, complications, rate of gland preservation, and early symptom control.


RESULTS
A total of 51 patients underwent endoscopic-assisted salivary surgery over a 24-month period. Treatment indications included sialadenitis of unclear etiology (49%), sialadenitis with sialolithiasis (47%), and Sjögren syndrome (4%). Findings included obstructive stricture formation in 22 patients (43%). Associated procedures included sialodochoplasty (41%), steroid infusion (39%), and ductal stenting (8%). Gland preservation was achieved in 40 patients (78%). Of those who were treated with endoscopic-assisted techniques alone, 38 patients (84%) had symptomatic improvement whereas 7 patients (16%) did not improve. Minor complications were observed in 12% of the patients.


CONCLUSIONS
Endoscopic-assisted management of chronic sialadenitis is both safe and effective and allows gland preservation with symptom control in the majority of patients.
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA. gillesmb@musc.edu
M Boyd
MB
Gillespie
Jared
J
Intaphan
Shaun A
SA
Nguyen
D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002908:Chronic Disease; D003952:Diagnostic Imaging; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000150:complications / Q000628:therapy; D012469:Salivary Glands / Q000473:pathology / Q000601:surgery; D012793:Sialadenitis / Q000209:etiology / Q000628:therapy*; D012859:Sjogren's Syndrome / Q000150:complications; D015607:Stents; D013256:Steroids / Q000627:therapeutic use; D055815:Young Adult
D009465:Neuromuscular Agents; D013256:Steroids; D019274:Botulinum Toxins, Type A