title: Combined endoscopic-transcutaneous surgery in parotid gland sialolithiasis and other ductal diseases: reporting medium- to long-term objective and patients' subjective outcomes.
abstract: Objective was to assess the medium to long-term results and patients' perceive of success after combined sialoendoscopic and transcutaneous access in salivary gland diseases. A retrospective analysis was performed in a tertiary referral centre. A total of 19 patients have been treated with a combined sialoendoscopic and transcutaneous access. The main indication was sialolithiasis in 89.5 % of cases (n = 17), in 2 of these cases simultaneous complications were treated. Other indications included treatment-resistant stenosis and traumatic transection of the parotid duct. Intraductal stents were placed in 52.6 % of the cases. Patients were evaluated by clinical investigation, ultrasound examination and by a questionnaire to assess patients perceive of success. As a result the treatment was successful in 89.5 % of all cases, and in 94.1 % of the patients with sialolithiasis. Parotidectomy was required in two patients, as reconstruction of the ductal system was not possible intraoperatively (sialolithiasis, n = 1) or was unsuccessful (stenosis, n = 1). Prerequisites for successful treatment were the endoscopic access to the pathology, the possibility to reconstruct the duct and recovery of gland function postoperatively. A mean follow-up time for successfully treated patients was 40.67 months. All patients were satisfied with the results and reported a significant reduction in symptoms and improvement of their perceived quality of life (p = 0.001 each). As conclusion the combined access is a valuable alternative treatment in patients with sialolithiasis. Additional indications may include treatment-resistant stenosis and injuries to the parotid duct. However, the indication in stenosis needs to be carefully weighed up.
authors.affiliation: Hals-, Nasen-, Ohren-Klinik, Kopf- und Hals-Chirurgie, Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-University of Erlangen-Nuremberg, Waldstrasse 1, 91054 Erlangen, Germany. michael.koch@uk-erlangen.de
authors.forename: M
authors.initials: M
authors.lastname: Koch
authors.forename: H
authors.initials: H
authors.lastname: Iro
authors.forename: J
authors.initials: J
authors.lastname: Zenk
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000601:surgery; D020127:Recovery of Function; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014463:Ultrasonography