Combined endoscopic–transcutaneous surgery in parotid gland sialolithiasis and other ductal diseases: reporting medium- to long-term objective and patients′ subjective outcomes

Objective was to assess the medium to long-term results and patients′ perceive of success after combined sialoendoscopic and transcutaneous access in salivary gland diseases. A retrospective analysis was performed in a tertiary referral centre. A total of 19 patients have been treated with a combine...

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Bibliographic Details
Published in:European archives of oto-rhino-laryngology 2013-05, Vol.270 (6), p.1933-1940
Main Authors: Koch, M., Iro, H., Zenk, J.
Format: Article
Language:English
Subjects:
Adult
Aged
Endoscopy - methods
Female
Head and Neck
Head and Neck Surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neurosurgery
Otorhinolaryngology
Parotid Diseases - diagnostic imaging
Parotid Diseases - surgery
Parotid Gland - diagnostic imaging
Parotid Gland - surgery
Recovery of Function
Retrospective Studies
Salivary Gland Calculi - diagnostic imaging
Salivary Gland Calculi - surgery
Stents
Surveys and Questionnaires
Treatment Outcome
Ultrasonography
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Summary:Objective was to assess the medium to long-term results and patients′ perceive of success after combined sialoendoscopic and transcutaneous access in salivary gland diseases. A retrospective analysis was performed in a tertiary referral centre. A total of 19 patients have been treated with a combined sialoendoscopic and transcutaneous access. The main indication was sialolithiasis in 89.5 % of cases ( n  = 17), in 2 of these cases simultaneous complications were treated. Other indications included treatment-resistant stenosis and traumatic transection of the parotid duct. Intraductal stents were placed in 52.6 % of the cases. Patients were evaluated by clinical investigation, ultrasound examination and by a questionnaire to assess patients perceive of success. As a result the treatment was successful in 89.5 % of all cases, and in 94.1 % of the patients with sialolithiasis. Parotidectomy was required in two patients, as reconstruction of the ductal system was not possible intraoperatively (sialolithiasis, n  = 1) or was unsuccessful (stenosis, n  = 1). Prerequisites for successful treatment were the endoscopic access to the pathology, the possibility to reconstruct the duct and recovery of gland function postoperatively. A mean follow-up time for successfully treated patients was 40.67 months. All patients were satisfied with the results and reported a significant reduction in symptoms and improvement of their perceived quality of life ( p  = 0.001 each). As conclusion the combined access is a valuable alternative treatment in patients with sialolithiasis. Additional indications may include treatment-resistant stenosis and injuries to the parotid duct. However, the indication in stenosis needs to be carefully weighed up.
ISSN:0937-4477
1434-4726
DOI:10.1007/s00405-012-2286-y