Interventional sialendoscopy in parotidomegaly related to eating disorders

Abstract

Background To evaluate the viability and efficacy of sialendoscopy for the management of parotidomegaly related to eating disorders, 6 patients suffering from eating disorders and recurring symptoms of glandular swelling were followed up at the Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU University of Campania “Luigi Vanvitelli”. After the detection of the impaired gland through clinical and radiographical analysis, the diagnostic unit was introduced into the duct and was advanced in, reaching the ductal system. Plaques were washed out, any strictures were dilated both by hydrostatic pressure application and steroid solution injection directly in the fibrotic area. Results Both glands resulted affected in 83% of patients. 11 parotid glands were explored and treated. Strictures were found in 2 glands (33%), sialectasis in 3 glands (50%), strictures and sialectasis together in 1 glands (17%). In 3 parotid glands (50%) Stenon’s duct was affected, in two (33%) only secondary ducts, in 1 (17%) both. We reached symptomatic improvement in 5 patients (83%), reporting the spherical volume of the parotid region and pain reduction. Conclusions Our results demonstrate that sialendoscopy is a safe and effective therapeutic method to treat EDs salivary symptoms. Treating the underlining psychiatric pathology should be the primary goal in patient care to lower the possible recurrence rate and increase the successful outcome of this technique.

Use of Irrigation Device for Duct Dilatation during Sialendoscopy

“…Sialendoscopy is a procedure for the diagnosis and treatment of salivary obstructive and inflammatory diseases [ 5 , 6 , 7 , 8 ]. It can be performed under local or general anesthesia depending on the level of difficulty of the individual case.…”

Efficacy and safety of intraglandular botulinum toxin injections for treatment of sialadenosis

“…This study was a single cohort case series without comparative group and was conducted based on the patients’ subjective reports and subjective measurement of parotid size. Objective studies, such as ultrasound or magnetic resonance imaging, can be used to assess salivary gland size and spherical volume of the salivary glands 6,10 . Also, long‐term effects of repetitive BoNTA injection still need to be confirmed.…”

“…Partial parotidectomy was the mainstay of treatment in the 1990s, but any remaining salivary tissue may continue to enlarge, and functional impairment is another problem 5 . Recently, interventional sialendoscopy has been proposed as another surgical option, although their efficacy remains to be further determined 6 . Alternative treatment options, such as intraglandular botulinum toxin or triamcinolone injections, have been conducted, but their efficacy has yet to be examined.…”

Salivary Gland Disorders in Pediatric Patients: A 20 Years’ Experience

“…Sialogogues, the direct massage of distal stones out of the duct, and techniques involving interventional sialography, lithotripsy, sialoendoscopy and various surgeries were proposed as treatment choices for sialolithiasis [14]. Our patients were predominantly treated through intraoral surgical excision of the calculi (72.7%), but also through sialoendoscopy, a minimally invasive and versatile procedure that can preserve the gland with the recovery of its functions and without the risk of nerve damage [15]. When sialoendoscopy was carried out, after the dilation and the lavage of the duct, cortisone was injected; the post-operative phase was managed by administering antibiotics along with the gland massages.…”