Salivary duct stenosis: Short‐term symptom outcomes after sialendoscopy‐assisted salivary duct surgery

Abstract

4. Laryngoscope, 127:2770-2776, 2017.

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

“…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.…”

“…For parotid duct cases, we defined distal obstructions as those found from the buccal mucosa ostium to the anterior border of the masseter muscle. We defined proximal stenoses as those found from the anterior border of the masseter to the first tributary and the parenchyma of the parotid gland . For the degree of stenosis, complete stenosis was defined as a visualized blind pouch preventing proximal passage of sialendoscope.…”

“…The COSS questionnaire was developed to measure severity and frequency of patient‐reported obstructive sialadenitis symptoms across numerous aspects of salivary gland function (Table ). It has been previously employed in both retrospective and 3‐month prospective studies on chronic obstructive sialadenitis . Each questionnaire item is graded on a scale from 0 to 10, with higher scores denoting worse symptom severity or greater symptom frequency.…”

“…COSS questionnaire responses were collected in person, by mail, and via REDCap. We analyzed summative scores per gland, as well as classified scores based on previously published ranges corresponding to complete (COSS < 10), partial (COSS 10–25), or nonresolution (COSS > 25) of obstructive sialadenitis symptoms …”

“…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 . However, given the systemic or locally inflammatory processes often present in chronic sialadenitis, the longer term durability of symptomatic relief following SASDS remains unclear.…”