Capaccio P, Torretta S, Di Pasquale D, Rossi V, Pignataro L
Department of Biomedical, Surgical and Dental Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Clin Otolaryngol. 2017 Feb;42(1):148-155. doi: 10.1111/coa.12681. Epub 2016 Jun 6.
To verify the role of interventional sialendoscopy and steroidal ductal irrigation in patients with recurrent sialadenitis.
A prospective, cross-sectional pilot study.
University of Milan.
Fifty-four patients with sine causa recurrent sialadenitis who underwent interventional sialendoscopy (group A, 36 patients) or interventional sialendoscopy followed by a intraductal steroidal irrigations (group B, 18 patients).
The number of episodes of sialadenitis three and 6 months before and after sialendoscopy, and their severity assessed by means of a 0-10 pain visual analogue scale.
In the population as a whole, a significant post-treatment reduction in the number of episodes of 30.7 ± 5.5 after 3 months and 34.6 ± 10.2 after 6 months (P < 0.001) and a significant reduction in pain visual analogue scale values of 4.7 ± 0.4 after 6 months (P < 0.001) occurred. There was a statistically significant reduction in both parameters at the same time points in both treatment groups (P ≥ 0.001), with no significant between-group difference in pain visual analogue scale values, an albeit non-significant trend in favour of group B in terms of the number of episodes 3 months after therapy that became significant after 6 months (11.0 ± 9.9 versus 20.5 ± 9.5; P = 0.05).
Interventional sialendoscopy is effective for the treatment of recurrent sialadenitis; the addition of intraductal steroidal irrigations seems to increase its value in the medium term. Further studies of larger case series with longer follow-up are needed to establish the possibly primary role of steroid therapy in blocking inflammation.
验证介入性涎腺内镜检查及类固醇导管冲洗在复发性涎腺炎患者中的作用。
一项前瞻性横断面试点研究。
米兰大学。
54例无明确病因的复发性涎腺炎患者,其中36例接受介入性涎腺内镜检查(A组),18例接受介入性涎腺内镜检查后进行导管内类固醇冲洗(B组)。
涎腺内镜检查前后3个月和6个月时涎腺炎发作次数,以及通过0-10疼痛视觉模拟量表评估的严重程度。
总体而言,治疗后3个月发作次数显著减少,为30.7±5.5,6个月时为34.6±10.2(P<0.001),6个月时疼痛视觉模拟量表值显著降低,为4.7±0.4(P<0.001)。两个治疗组在相同时间点的两个参数均有统计学显著降低(P≥0.001),疼痛视觉模拟量表值在组间无显著差异,尽管在治疗后3个月发作次数方面B组有非显著的优势趋势,6个月后变得显著(11.0±9.9对20.5±9.5;P=0.05)。
介入性涎腺内镜检查对复发性涎腺炎有效;导管内类固醇冲洗的加入似乎在中期增加了其价值。需要进一步对更大病例系列进行更长时间随访的研究,以确定类固醇治疗在阻断炎症中可能的主要作用。