Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA.
Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
Laryngoscope. 2024 Feb;134(2):614-621. doi: 10.1002/lary.30828. Epub 2023 Jun 20.
Chronic sialadenitis is associated with decreased quality of life and recurrent infections. While sialendoscopy with stenting is effective in relieving symptoms of sialadenitis, currently available stents are rigid and poorly tolerated by patients, leading to early removal and potential for adverse scarring. This study examines whether sutures can be used as a stenting material to improve patient comfort and reduce recurrence risk.
This is a retrospective cohort study of a consecutive series of adult patients with chronic sialadenitis undergoing sialendoscopy with or without suture stenting. Data were collected between 2014 and 2018 with a 3-year follow-up period ending in 2021. The primary outcome measure was recurrence of sialadenitis within 3 years of surgery. Secondary outcomes were stent dislodgement and patient-reported discomfort.
We included 63 patients with parotid sialadenitis of whom 28 underwent suture stenting and 35 did not receive stenting after sialendoscopy. Stents were well tolerated, with a mean duration of 34.5 days, and only 2 of 28 stents (7.1%) accidentally dislodged within the first week. Suture stenting significantly reduced symptom recurrence after sialendoscopy (OR = 0.09, 95% CI 0.02-0.45, p = 0.003; 3-year sialadenitis recurrence rate: 7.1% vs. 45.7%, p = 0.005). Cox multivariate regression for clinicodemographic variables showed an HR of 0.04 (95% CI 0.01-0.19, p < 0.001) for the risk of symptom recurrence.
Suture stenting after sialendoscopy is low cost, available across all institutions, well-tolerated by patients, and highly efficacious in reducing risk of recurrent sialadenitis after sialendoscopy.
3 Laryngoscope, 134:614-621, 2024.
慢性唾液腺炎与生活质量下降和反复感染有关。虽然唾液腺镜下支架置入术可有效缓解唾液腺炎症状，但目前可用的支架为刚性支架，患者耐受性差，导致支架早期取出和潜在不良瘢痕形成。本研究旨在探讨缝线是否可作为支架材料以改善患者舒适度并降低复发风险。
这是一项连续系列的成人慢性唾液腺炎患者行唾液腺镜检查加或不加缝线支架置入术的回顾性队列研究。研究数据收集于 2014 年至 2018 年，随访期至 2021 年结束，随访 3 年。主要结局测量指标为术后 3 年内唾液腺炎复发情况。次要结局测量指标为支架移位和患者报告的不适。
我们纳入了 63 例腮腺唾液腺炎患者，其中 28 例行缝线支架置入术，35 例未行唾液腺镜检查后的支架置入术。支架耐受性良好，平均留置时间为 34.5 天，仅 2 例（7.1%）支架在第 1 周内意外移位。唾液腺镜检查后行缝线支架置入术可显著降低唾液腺炎症状复发率（OR=0.09，95%CI 0.02-0.45，p=0.003；3 年唾液腺炎复发率：7.1% vs. 45.7%，p=0.005）。对临床和人口统计学变量的 Cox 多变量回归分析显示，症状复发的风险比（HR）为 0.04（95%CI 0.01-0.19，p<0.001）。
唾液腺镜检查后行缝线支架置入术成本低、在所有机构均有供应、患者耐受性良好，且可显著降低唾液腺镜检查后唾液腺炎的复发风险。
3 Laryngoscope, 134:614-621, 2024.
