Symptom Outcomes After Sialendoscopy‐Assisted Salivary Duct Surgery: A Prospective 6‐Year Study

Callander, Jacquelyn K; Plonowska-Hirschfeld, Karolina A.; Gulati, Arushi; Chang, Jolie L.; Ryan, William R.

doi:10.1002/lary.30294

Cited by 4 publications

(9 citation statements)

References 30 publications

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“…Patients with sialadenitis from autoimmune conditions are prone to more persistently elevated symptom scores or recurrent disease. Patients with distal duct stenosis may also have greater clinical improvement than those with proximal duct stenosis 9,18 …”

Section: Discussionmentioning

confidence: 99%

“…For example, patients with COSS scores less than 10 points postoperatively were associated with complete resolution of symptoms 7 . Using this cutoff, studies utilizing the COSS were able to demonstrate that patients with stenosis continue to have elevated symptom scores up to a year postoperatively 9,19 . The disease process involved in ductal stenosis contributes to the high likelihood of recurrent or persistent symptoms even after endoscopic intervention and dilation 9,10,19 …”

Section: Discussionmentioning

confidence: 99%

“…Sialadenitis from sialolithiasis is a different disease process than sialadenitis from stenosis (nonsialolithiasis) in presentation and outcomes. Prior studies utilizing the MSGS and COSS questionnaires have demonstrated differences in preoperative scores and improvement after sialendoscopy‐assisted intervention between patients with sialolithiasis versus those with stenosis 5,9,10 . For instance, patients with sialolithiasis have significantly lower mean postoperative COSS scores compared to those with disease related to ductal stenosis, demonstrating sialolithiasis is associated with greater rates of symptom resolution 9 .…”

mentioning

confidence: 99%

“…Prior studies utilizing the MSGS and COSS questionnaires have demonstrated differences in preoperative scores and improvement after sialendoscopy-assisted intervention between patients with sialolithiasis versus those with stenosis. 5,9,10 For instance, patients with sialolithiasis have significantly lower mean postoperative COSS scores compared to those with disease related to ductal stenosis, demonstrating sialolithiasis is associated with greater rates of symptom resolution. 9 Though these PROMs have shown that patients with stenosis tend to have higher symptom scores after treatment, none have shown baseline domainspecific differences between patients with sialolithiasis versus those with stenosis.…”

mentioning

confidence: 99%

“…5,9,10 For instance, patients with sialolithiasis have significantly lower mean postoperative COSS scores compared to those with disease related to ductal stenosis, demonstrating sialolithiasis is associated with greater rates of symptom resolution. 9 Though these PROMs have shown that patients with stenosis tend to have higher symptom scores after treatment, none have shown baseline domainspecific differences between patients with sialolithiasis versus those with stenosis.…”

mentioning

confidence: 99%

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Comparison of Chronic Sialadenitis Symptom Burden in Patients With Sialolithiasis Versus Stenosis Before and After Sialendoscopy

Bhat,

Gulati,

Ryan

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo define symptomatology and responses to treatment in chronic sialadenitis from sialolithiasis versus duct stenosis and establish a minimal clinically significant difference (MCID) in the validated Obstructive Salivary Problem Impact Test (SPIT).Study DesignProspective, cohort.SettingTertiary‐care center.MethodsPatients completed the SPIT questionnaire at presentation and 3 to 6 months after surgery. SPIT scores and domains were compared between patients with symptomatic sialolithiasis and those with stenosis of a major salivary gland.ResultsSeventy‐nine patients completed the SPIT, including 43 (54%) with sialolithiasis and 36 (46%) with stenosis. Stenosis patients displayed greater baseline scores compared to sialolithiasis patients (45.4 ± 19.9 vs 33.3 ± 18.5, P < .013). Frequency and severity of gland swelling and pain (21.9 ± 8.9 vs 17.1 ± 9.6, P = .02) and functional/psychosocial impact subscores were greater in the stenosis versus sialolithiasis groups (18.0 ± 10.9 vs 11.3 ± 9.4, P < .01). For 43 patients who underwent surgical intervention, SPIT scores improved at 3 to 6 months postoperatively in all domains (−18.6 ± 19.4, P < .01). Degree of improvement did not differ between sialolithiasis versus stenosis groups (−22.0 ± 20.9 vs −13.3 ± 15.8, P = .13). The MCID in SPIT score was found to be −13 points. A postoperative SPIT score of less than 10 suggested symptom resolution.ConclusionWhen compared to sialolithiasis, chronic salivary obstruction from stenosis is associated with greater baseline SPIT scores, indicating poorer sialadenitis‐related quality of life due to greater symptom frequency and functional impact. Based on SPIT survey outcomes, a score decrease of 13 points or SPIT score <10 represent significant symptom improvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of Chronic Sialadenitis Symptom Burden in Patients With Sialolithiasis Versus Stenosis Before and After Sialendoscopy

Bhat,

Gulati,

Ryan

et al. 2024

Otolaryngol.--head neck surg.

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Parotid sialolithiasis – Long term follow‐up analyzing surgical approaches

Tanenbaum,

Wenzel,

Molotkova

et al. 2024

Laryngoscope Investig Oto

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ObjectivesPresent follow‐up data comparing transoral and transfacial parotid gland procedures for stone removal to offer insight addressing technical considerations and complications.MethodsRetrospective study of a consecutive series of surgical treatments for parotid sialolithiasis from 2013 to 2018 at an academic institution by one surgeon provided review of 16 transoral and 10 transfacial procedures supplemented by long‐term follow‐up through telephone or mail. Clinical and radiographic parameters, additional treatment, and persistence of symptoms were evaluated.ResultsFour of 10 patients treated with the transfacial approach had parotid‐cutaneous fistulas addressed with transdermal scopolamine patches and pressure dressings (one also with intraductal steroid infusion) with closure at a median of 12.5 days. A fifth fistula failed to resolve at 23 days and was addressed with parotidectomy. All 8 patients who were contacted (median: 106 months) reported complete resolution of symptoms. None had facial weakness.Six of 16 patients treated by a transoral approach had persistent stone fragments at the conclusion of operation. Four of these 6 patients underwent subsequent procedures (two transoral, one transfacial, one parotidectomy). Among the 11 patients who responded to long‐term follow‐up (median: 107 months), one reported mild symptoms insufficient to request treatment. Larger stone size coupled with proximal location correlated with the conversion from transoral to include transfacial approach.ConclusionPatients with retained stone remnants at the conclusion of transoral stone removal are more likely to require additional procedures that result in long‐term favorable results. The transfacial approach to stone removal offers long‐term favorable results following the common short‐term complication of salivary fistula.Level of EvidenceOCEBM Level 4.

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