Diagnostic and interventional sialendoscopy: a preliminary experience

Laryngoscope. 2011 Feb;121(2):299-303. doi: 10.1002/lary.21390. Epub 2011 Jan 14.

Abstract

Objectives/hypothesis: To review our preliminary experience with diagnostic and therapeutic sialendoscopy for the management of non-neoplastic disorders of the salivary gland.

Study design: Retrospective chart review.

Methods: Thirty-three consecutive patients undergoing 36 sialendoscopy procedures performed at a tertiary medical center from July 2008 to July 2010 were included.

Results: The mean age of presentation was 43 years (range, 7-74 years), and 61% of patients were male. Indications included sialolithiasis (47%; 17 of 36), recurrent sialadenitis (44%, 16 of 36), and Sjögren's syndrome (8%; three of 36). Successful endoscopy was performed in 97% (35 of 36). A papillotomy for access was necessary in 25% (nine of 36). In patients with sialolithiasis (n = 17), the mean size of the stones was 7.3 mm (range, 1-20 mm). Complete stone removal was achieved in 76% (13 of 17) of cases. Endoscopic stone removal was possible in 29% (five of 17), and a combined approach technique was required in 47% (eight of 17). Seventy-two percent (26 of 36) of patients had complete resolution of symptoms after sialendoscopy, with 19% (seven of 36) having partial resolution of symptoms. Patients with partial improvement of symptoms had a mean duration of improvement of 4.7 months. The overall complication rate was 22% (eight of 36). The major and minor complication rates were 3% (one of 36) and 19% (seven of 36), respectively.

Conclusions: Sialendoscopy is safe and effective in managing non-neoplastic salivary gland disorders with low rates of major complications. Knowledge of options to navigate the rate-limiting steps, like dilation of the papilla and careful case selection, are key to successful outcomes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Endoscopy* / adverse effects
  • Endoscopy* / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Salivary Gland Calculi / pathology
  • Salivary Gland Calculi / surgery
  • Salivary Gland Diseases / diagnosis*
  • Salivary Gland Diseases / surgery*
  • Salivary Glands / pathology*
  • Sialadenitis / pathology
  • Sjogren's Syndrome / pathology
  • Treatment Outcome