ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain.
ENT and Cervicofacial Surgery Department, Villalba General University Hospital, Collado Villalba, Spain.
Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5813-5820. doi: 10.1007/s00405-022-07473-w. Epub 2022 Jun 9.
Chronic obstructive sialadenitis (COS) is a recurring inflammation of the salivary gland. To date, there are no known predisposing factors for COS. Given the advances seen in radiology and sialendoscopy, we must update our knowledge of COS, analyzing factors that can favor its development.
We prospectively analyzed 333 patients who underwent sialendoscopy between 2012 and 2021. Epidemiologic, radiologic, and sialendoscopy-related factors were correlated. Suspected diagnosis was established based on the clinical and radiologic data. The final diagnosis was determined on the basis of sialendoscopic findings.
The most common etiology of COS was stricture (40.8%). Lack of papilla distensibility (LPD) was also described as an etiology. COS was related to patient gender and age. Submandibular gland involvement was significantly more associated with lithiasis and LPD, while COS of the parotid gland was most frequently caused by stricture. Radioiodine sialadenitis and Sjögren's syndrome were significantly associated with stricture. MR sialography (MR-Si) showed the best overall sensitivity and specificity.
In our series, stricture was the most common cause of COS. We describe LPD as a frequent cause of COS in this series; ours is the first study to report this finding. There was a significant association between the salivary gland involved, patient sex and age, and the cause of COS. MR-Si showed the greatest diagnostic yield.
慢性阻塞性唾液腺炎(COS)是唾液腺的复发性炎症。迄今为止,COS 尚无已知的诱发因素。鉴于放射学和唾液内镜检查的进步,我们必须更新对 COS 的认识,分析可能有利于其发展的因素。
我们前瞻性分析了 2012 年至 2021 年间进行唾液内镜检查的 333 例患者。对流行病学、放射学和唾液内镜相关因素进行了相关性分析。根据临床和放射学资料建立可疑诊断。最终诊断基于唾液内镜检查结果确定。
COS 最常见的病因是狭窄(40.8%)。乳头可扩展性差(LPD)也被描述为一种病因。COS 与患者性别和年龄有关。下颌下腺受累与结石和 LPD 显著相关,而腮腺的 COS 最常由狭窄引起。放射性碘唾液腺炎和干燥综合征与狭窄显著相关。MR 唾液造影(MR-Si)显示出最佳的整体敏感性和特异性。
在我们的系列研究中,狭窄是 COS 最常见的原因。我们描述了 LPD 是本系列中 COS 的常见病因;这是首次报道这一发现的研究。受累唾液腺、患者性别和年龄以及 COS 的病因之间存在显著相关性。MR-Si 显示出最大的诊断效果。