Medico‐legal aspects of introducing sialendoscopy: A minimally invasive treatment for salivary gland obstruction

Felton, Mark; Mamais, Constantinos; Kumar, B. Nirmal; Izzat, Mohammad Bashar

doi:10.1111/j.1749-4486.2012.02485.x

Cited by 12 publications

(23 citation statements)

References 17 publications

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“…MRI and ultrasound often fail to detect stones under 2 mm in diameter and are limited in their ability to diagnose strictures and other intraluminal pathologies. 9,10 With direct visualization and the ability to extract stones or dilate strictures within the ductal system, sialendoscopy is thought to be a safer alternative to excisional approaches with an overall complication rate in the range of 5%. 9,11 Sialendoscopy is largely considered the gold standard in sialolithiasis treatment, but is not without disadvantages.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 With direct visualization and the ability to extract stones or dilate strictures within the ductal system, sialendoscopy is thought to be a safer alternative to excisional approaches with an overall complication rate in the range of 5%. 9,11 Sialendoscopy is largely considered the gold standard in sialolithiasis treatment, but is not without disadvantages. The cost of adopting sialendoscopy into practice is not insignificant, 9 and surgeons training in this technique typically require at least 30 consecutive observed procedures and a sufficient volume of cases in practice to gain and maintain technical proficiency.…”

Section: Introductionmentioning

confidence: 99%

“…9,11 Sialendoscopy is largely considered the gold standard in sialolithiasis treatment, but is not without disadvantages. The cost of adopting sialendoscopy into practice is not insignificant, 9 and surgeons training in this technique typically require at least 30 consecutive observed procedures and a sufficient volume of cases in practice to gain and maintain technical proficiency. 12 Although infrequent, sialendoscopy may be complicated by duct avulsion, strictures, fistulas, and perforations; and the likelihood of these events are influenced by surgeon experience.…”

Section: Introductionmentioning

confidence: 99%

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Gland‐preserving surgery for salivary stones and the utility of sialendoscopes

et al. 2018

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Background Sialoendoscopy is the standard treatment for sialolithiasis; however, some patients may be unlikely to benefit from an endoscopic approach. This study assesses predictors of failure in the endoscopic management of sialoliths. Methods Patients treated for sialolithiasis from 2012 to 2017 at two centers were stratified into 3 groups: successful interventional sialendoscopy, incisional sialolithotomy, and gland excision. Patient, disease, and surgical factors were compared. Results Interventional sialendoscopy was attempted in 156 of 206 cases and successful for 42 (27%). Endoscopically retrieved calculi were smaller (4.96 mm) compared to incisional sialolithotomy (7.90 mm). Nonendoscopic approaches were required more often in submandibular cases 87% (P ≤ .005). Palpable stones were present in 74% of incisional sialolithotomies (P < .001). Submandibular location (OR 3.50, 1.53‐7.98), palpability (OR 2.74, 1.21‐6.18), CT localization (OR 3.05, 1.32‐7.10, P = .010), and increased diameter (OR 1.25, 1.09‐1.44) were predictive of incisional management. Conclusion Stone size/location, CT‐localization, and palpability were predictive of calculi that require an incisional approach. If these factors are recognized, the surgeon can consider proceeding directly to incisional sialolithotomy. Level of evidence III

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gland‐preserving surgery for salivary stones and the utility of sialendoscopes

et al. 2018

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“…The initial investment on specific instruments is mainly on a set of endoscopes and dilators, as other equipment (like light cables, monitor and light source) are already available in units doing endoscopic surgery. In a previous publication, Felton et al [11] mentioned a figure of £15,000 (or €21,000) as a starting cost, with consumables per case costing approximately £150 or €200. Nevertheless, it is difficult to exactly estimate the cost since there are large variations among different nations depending in the taxation policy and differences in the ''packages'' offered by the manufacturers.…”

Section: Discussionmentioning

confidence: 98%

Sialendoscopy: what is it and what is its awareness?

Prasad¹,

Pézier²,

Faure

et al. 2015

Eur Arch Otorhinolaryngol

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In expanding the scope of sialendoscopy across the globe and assessing the impact of training activities at the European Sialendoscopy Training Centre, this study was conducted to find out the knowledge and attitude among respondents as well as identify potential obstacles to the initiation of the procedure. Delegates attending the 2011 International Federation of Otorhinolaryngological Societies meeting received a set of five questions. There were a total of 257 responses from 57 countries. Nearly all (238/257) were practising in the academic setting. A significant number of respondents had heard about sialendoscopy (231/257). An equal number found it interesting and were keen to learn more about the procedure (233/257). More than 85 % (219/257) respondents expressed their desire to start sialendoscopy. Hurdles to overcome included financial limitations (110) and "not enough knowledge" (100). Awareness about the existence of the procedure was rather high although the knowledge was limited. Several of the responders seemed keen on starting it, but had not done so due to financial limitations. However, there was a high rate of bias owing to the limited number of responders per country precluding a country-wise inference of awareness. Moreover, meetings of this nature tend to be attended by academics who in general seem to be more aware of new developments than their non-academic peers. Future surveys can address these issues as part of ensuring the universal adoption of sialendoscopy.

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“…The usual setting of a diagnostic and/or interventional sialendoscopy demands specific instrumentation, an endoscopic tower and an assistant for continuous administration of rinsing solution by syringe through the endoscope's irrigation channel that enables/enhances visualisation. In the case of an interventional sialendoscopy, the assistant also participates to the handling of micro‐instruments …”

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confidence: 99%