Results of minimally invasive gland-preserving treatment in different types of parotid duct stenosis.
OBJECTIVE
To assess differences in minimally invasive treatment in various types of Stensen duct stenoses, because sparse data have been published concerning this.


METHODS
Retrospective study.


METHODS
Tertiary reference center, level of evidence: 2b.


METHODS
Ninety-three patients with stenoses.


METHODS
Treatment of 111 parotid duct stenoses was evaluated with particular attention to which treatment strategies were successful in various types of stenoses (type 1, inflammatory; type 2, web-associated fibrous; and type 3, fibrous). Minimally invasive treatment consisted of sialendoscopy-guided rinsing with cortisone (all cases) and interventional sialendoscopy with instrumental dilation alone or combined with transoral ductal surgery.


RESULTS
Sialendoscopy-guided rinsing with cortisone was sufficient in 73.0% of cases of type 1 stenosis (21.5% of all cases). Interventional sialendoscopy with instrumental dilation was successful in 47.1% of cases of type 2 stenosis and 70.5% of cases of type 3 stenosis (59.2% of all patients). Interventional sialendoscopy combined with transoral duct surgery was successful in 72.7% of cases of type 3 stenosis (8.6% of all cases). Glands could be preserved in 96.4% of cases.


CONCLUSIONS
Stenoses that can be differentiated using sialendoscopy seem to require different minimally invasive treatment. Sialendoscopy-guided rinsing with cortisone is an important basic anti-inflammatory treatment, particularly in inflammatory stenoses. Interventional sialendoscopy with instrumental dilation, transoral ductal surgery or a combination of both are the first choice in fibrous stenoses.
Department of Otorhinolaryngology-Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. michael.koch@uk-erlangen.de
Michael
M
Koch
Heinrich
H
Iro
Nils
N
Klintworth
Georgios
G
Psychogios
Johannes
J
Zenk
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D003251:Constriction, Pathologic / Q000473:pathology / Q000628:therapy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011239:Prednisolone / Q000627:therapeutic use*; D012189:Retrospective Studies; D018570:Risk Assessment; D018987:Salivary Ducts / Q000000981:diagnostic imaging / Q000473:pathology*; D012466:Salivary Gland Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D055815:Young Adult
D011239:Prednisolone