title: A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders.
abstract: OBJECTIVE
  To examine how preoperative imaging characteristics correlate with sialendoscopic findings and operative outcomes in patients with obstructive parotid symptoms.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  We identified 112 consecutive patients who underwent 134 unilateral or bilateral parotid gland sialendoscopies between December 2005 and August 2013. We reviewed clinical history, radiographic imaging and reports, operative reports, and clinical outcomes. Available preoperative computed tomography (CT) or magnetic resonance imaging (MRI) were analyzed for parotid stone size and location relative to the masseter muscle.
  
  
  RESULTS
  For patients with parotid stone on preoperative imaging, at least one stone was found on sialendoscopy in 63% of cases. In contrast, for all cases with preoperative imaging negative for stone, no stone was found on sialendoscopy suggesting that parotid stones are not radiolucent on CT imaging. Furthermore, stones located anterior to the masseter were more successfully visualized on sialendoscopy compared to stones located posterior to the masseter. Anteriorly located stones were also more accessible for endoscopic management, whereas posterior stones required combined approaches for management.
  
  
  CONCLUSIONS
  Preoperative imaging characteristics such as stone presence, size, and location provide essential information that can guide surgical planning and clinical outcome expectations for obstructive parotid disease management. All parotid CT scans that failed to demonstrate stones on imaging had no stone found on sialendoscopy. Stones posterior to the masseter muscle are the most difficult to access with sialendoscopy, and in these cases, patients should be counseled about the potential need for a transfacial approach to remove symptomatic stones.
  
  
  METHODS
  2b.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A.
authors.forename: Ruwan
authors.initials: R
authors.lastname: Kiringoda
authors.forename: David W
authors.initials: DW
authors.lastname: Eisele
authors.forename: Jolie L
authors.initials: JL
authors.lastname: Chang
mesh_terms: D003251:Constriction, Pathologic / Q000175:diagnosis; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010305:Parotid Diseases / Q000175:diagnosis* / Q000601:surgery; D010306:Parotid Gland / Q000000981:diagnostic imaging* / Q000473:pathology*; D057234:Preoperative Period; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Sialendoscopy; computed tomography; parotid sialolithiasis