title: Sialadenitis without sialolithiasis: Prospective outcomes after sialendoscopy-assisted salivary duct surgery.
abstract: To prospectively assess symptoms before and after sialendoscopy-assisted salivary duct surgery (SASDS) in patients with symptomatic sialadenitis without sialolithiasis.
  
  
  
  Prospective cohort study.
  
  
  
  Patients with chronic obstructive sialadenitis without sialolithiasis (COSWS) completed the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire prior to SASDS and 3 months postoperatively.
  
  
  
  Of 80 consecutive patients in a 20-month period, 20 surveyed patients underwent SASDS for COSWS in 37 symptomatic glands. Major symptom improvement (> 10 COSS score reduction) was reported in 24 of 37 (65%) of all glands, including 14 of 21 (67%) of radioactive iodine (RAI)-induced cases and 10 of 13 (77%) of idiopathic sialadenitis cases. A significant reduction in postoperative mean COSS scores was seen overall (12.6 points, standard deviation [SD] 19.3, P < 0.05 to a post-SASDS mean score of 26.6). However, 19 of 37 (51%) glands demonstrated postoperative COSS scores above 25, denoting persistent disease. Mean COSS score reductions in RAI-induced sialadenitis (12.4 points, SD 22.7, P < 0.05) and idiopathic sialadenitis (16.3 points, SD 13.7, P < 0.005) groups were significant, with post-SASDS COSS mean scores of 30.6 (SD 19.8) and 20.8 (SD 13.8), respectively. Ducts with stenoses treated with dilation or sialodochoplasty showed significant COSS improvements of 21.1 (SD 17.9) and 12.4 points (SD 10.7), respectively (P < 0.05). In a multivariate analysis, both the presence of stenosis and sialodochoplasty were independent predictors of complete or partial resolution (post-COSS score < 25) and major symptom improvement (P < 0.05).
  
  
  
  SASDS provides short-term symptom reduction in patients with COSWS; particularly in RAI-induced and idiopathic sialadenitis, and in duct stenosis amenable to dilation or sialodochoplasty. However, approximately half of the glands did not achieve meaningful symptom resolution.
  
  
  
  4 Laryngoscope, 127:1073-1079, 2017.
authors.affiliation: School of Medicine, University of California-San Francisco, San Francisco, California, U.S.A.
authors.forename: Elise A
authors.initials: EA
authors.lastname: Delagnes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A.
authors.forename: Annick
authors.initials: A
authors.lastname: Aubin-Pouliot
authors.affiliation: School of Medicine, University of California-San Francisco, San Francisco, California, U.S.A.
authors.forename: Melissa
authors.initials: M
authors.lastname: Zheng
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A.
authors.forename: Jolie L
authors.initials: JL
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Oncologic and Endocrine Surgery, University of California-San Francisco, San Francisco, California, U.S.A.
authors.forename: William R
authors.initials: WR
authors.lastname: Ryan
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018987:Salivary Ducts / Q000601:surgery; D012793:Sialadenitis / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Sialendoscopy; chronic obstructive sialadenitis; outcomes; parotid; radioactive iodine-induced sialadenitis; salivary duct surgery; stenosis; submandibular