Lele Saudamini J, Hamiter Mickie, Fourrier Torrey Louise, Nathan Cherie-Ann
1 Department of Otolaryngology-Head and Neck Surgery, Louisiana State University of Health Sciences, Shreveport, LA, USA.
2 Department of Otolaryngology, Wake Forest Baptist Health, Winston Salem, NC, USA.
Ear Nose Throat J. 2019 Jun;98(5):291-294. doi: 10.1177/0145561319841207. Epub 2019 Apr 23.
Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.
唾液腺内镜检查已成为一种安全、有效且微创的技术,用于治疗阻塞性和炎性唾液腺疾病。我们研究的目的是分析唾液腺内镜检查和类固醇冲洗治疗无涎石的涎腺炎患者的疗效。我们对2013年至2016年接受介入性唾液腺内镜检查并进行类固醇冲洗以治疗无涎石病的涎腺炎患者进行了回顾性分析。22例患者接受了介入性唾液腺内镜检查,包括导管扩张和类固醇冲洗,以治疗无任何涎石证据的涎腺炎。所有患者保守治疗均失败。11例患者腮腺出现症状,4例患者下颌下腺出现症状,6例患者腮腺和下颌下腺均出现症状。1例患者仅主诉口干,无腺体症状。研究组包括1名男性和21名女性,平均年龄为44.6岁(范围:3 - 86岁)。4例患者患有自身免疫性疾病,7例患者有放射性碘治疗史。其余11例患者未发现可识别的涎腺炎病因。平均随访期为378.9天(范围:16 - 1143天)。所有患者均接受了导管扩张和类固醇冲洗的唾液腺内镜检查。12例患者完全缓解,9例患者部分缓解,1例患者无反应。仅3例患者需要重复唾液腺内镜检查。唾液腺内镜检查联合导管扩张和类固醇冲洗对于保守治疗无效的无涎石涎腺炎患者是一种安全有效的治疗选择。需要进行更大病例系列的前瞻性研究来确定其作为确定性治疗选择的作用。