Clinical outcomes and prognostic factors of sialendoscopy in salivary duct stenosis

Abstract

4. Laryngoscope, 128:878-884, 2018.

One‐year outcomes of sialendoscopic‐assisted salivary duct surgery for sialadenitis without sialolithiasis

“…In this study, we present a prospective analysis of etiology‐specific responses to SASDS in patients with COSWS using the COSS questionnaire. Previous studies have shown that symptomatic response to SASDS varies in an etiology‐dependent manner, most likely reflecting different drivers of inflammation and obstruction in chronic sialadenitis . Although evidence for efficacy of SASDS in the treatment of sialolithiasis is robust, the limited power and generalizability of SASDS outcomes for COSWS can be attributed to predominantly retrospective design of most published studies, small sample sizes given the rare incidence of COSWS, short duration of postoperative follow‐up, and heterogeneous cohorts with an emphasis on sialolith‐based disorders.…”

“…Preoperative localization of stenosis with ultrasound may help inform perioperative planning and help set expectations for treatment efficacy during patient discussions . Other studies show variable success rates for duct stenosis, with a substantial proportion having symptom persistence . Proximal and parenchymal stenoses are often not endoscopically accessible for the delivery of treatment given ductal branching and the limited maneuverability of the semirigid sialendoscopes.…”

“…Previous studies have shown that symptomatic response to SASDS varies in an etiology-dependent manner, most likely reflecting different drivers of inflammation and obstruction in chronic sialadenitis. [4][5][6][7][8][9][10][11][12][13][14][15][16] Although evidence for efficacy of SASDS in the treatment of sialolithiasis is robust, the limited power and generalizability of SASDS outcomes for COSWS can be attributed to predominantly retrospective design of most published studies, small sample sizes given the rare incidence of COSWS, short duration of postoperative follow-up, and heterogeneous cohorts with an emphasis on sialolith-based disorders. As a result, the role of surgical management in COSWS requires further assessment, especially with respect to long-term outcomes, to better define prognostic factors that help improve preoperative patient counseling.…”

“…The efficacy of sialendoscopy‐assisted salivary duct surgery (SASDS) in treating chronic obstructive sialadenitis due to sialolithiasis has been well documented . The role of SASDS in the treatment of COSWS due to stenosis, inflammation from autoimmune disease, and radioactive iodine‐induced sialadenitis (RAI‐IS) has been previously explored, although primarily through retrospective analyses . Recently, our group used the 20‐item Chronic Obstructive Sialadenitis Symptoms (COSS) Questionnaire to quantify short‐term (3‐month) symptom improvements in patients with COSWS, showing at least partial symptom alleviation in a majority of patients with stenoses and RAI‐IS .…”

“…[4][5][6][7][8][9] The role of SASDS in the treatment of COSWS due to stenosis, inflammation from autoimmune disease, and radioactive iodine-induced sialadenitis (RAI-IS) has been previously explored, although primarily through retrospective analyses. [10][11][12][13][14][15][16] Recently, our group used the 20-item Chronic Obstructive Sialadenitis Symptoms (COSS) Questionnaire to quantify short-term (3-month) symptom improvements in patients with COSWS, showing at least partial symptom alleviation in a majority of patients with stenoses and RAI-IS. 17,18 However, given the systemic or locally inflammatory processes often present in chronic sialadenitis, the longer term durability of symptomatic relief following SASDS remains unclear.…”