Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population
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ORIGINAL ARTICLE
Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population Megha Goyal1
•
P. P. Singh1 • Ankur Batra1
Received: 6 August 2020 / Accepted: 14 October 2020 Ó The Association of Oral and Maxillofacial Surgeons of India 2020
Abstract Objectives To assess the role of sialendoscopy as a diagnostic modality and in managing cases of non-neoplastic parotid gland diseases. Secondly, to provide descriptive analysis of intraoperative findings. Methods The patients of chronic parotid sialadenitis who presented with complaints of recurrent unilateral or bilateral parotid swelling and pain were included in the study. All patients underwent sialendoscopy, and the findings were noted. Intervention was carried out in the same sitting like dilatation of stenosis, stone removal by basket, combined approach, flushing of mucoid flakes, etc. Failed cases were worked up with radiological investigation and managed accordingly. Results Two hundred and forty-one cases of parotid sialadenitis who underwent sialendoscopy between 2012 and 2018 were included. Diagnostic sialendoscopy was achieved in 100% cases, while intervention was successful in 96.7% (233/241) cases after the first procedure. On diagnostic sialendoscopy, ductal stenosis was the most common pathology present in 177 (73.4%) patients followed by stones (12%) and debris (11.6%). All cases of stenosis were serially dilated with increasing sizes of sialendoscopes followed by stenting in 75% of the cases. The diagnosis of juvenile recurrent parotitis was confirmed in 17 children (mean age 5.6 years) with consistent clinical history and sialendoscopic findings of stenosis along with pale ductal mucosa. There were 18 cases where ductal
& Megha Goyal [email protected] 1
Department of Otorhinolaryngology and Head and Neck Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
perforation was seen. One case showed multiple hyperdense foci in bilateral parotid gland along with multiple strictures that underwent repeat sialendoscopy, but the symptoms did not resolve, and finally the patient underwent bilateral superficial parotidectomy. Conclusion Sialendoscopy is a safe and highly effective modality in managing non-neoplastic parotid gland disorders with low complication rates and resulted in gland preservation in the vast majority of patients. Therefore, it can be concluded that sialendoscopy is the diagnostic and therapeutic modality of choice for parotid obstructive sialadenitis. Keywords Sialendoscopy Parotid Sialadenitis Salivary stone Stenosis Sialolithiasis JRP
Introduction Obstructive sialadenitis is the most frequent cause of major salivary gland dysfunction and represents approximately 50% of benign salivary gland disease. Submandibular gland obstruction accounts for 80–90% of cases followed by parotid (5–10%) and sublingual (\1%) glands [1]. The common causes are stones in 60–70%, stenosis in about 15–25%, inflammatory (5–10%) and other
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