The learning progression of diagnostic sialendoscopy

Abstract

We found better outcomes after the first 50 diagnostic sialendoscopies. Complication rates were statistically the same between early and late groups of experience with sialendoscopy.

Prognostische Einflussfaktoren auf den Erfolg der Sialendoskopie bei Sialolithiasis

“…Die Eingriffe dauerten 30 Minuten länger als in anderen Studien berichtetet [9,32]. Das könnte mit der geringeren Erfahrung der Operateure zusammenhängen [32,33].…”

The evolution of sialendoscopy in clinical practice

“…The complication rates are higher in the first 50 cases than seen in subsequent cases. 5 According to Bowen et al sialendoscopy is a safe and effective alternative to open surgery with low rates of major complications. Experience of options to overcome the tedious steps, like dilation of the ductal meatus and well planned case selection, are key to success.…”

Minimally Invasive Techniques for Management of Salivary Gland Pathology

“…Despite the high reported success rates with sialendoscopy, the procedure is deemed to be technically challenging and correlation between success rates and operator experience has been shown (Walvekar et al, 2008) [14]. In order to achieve the success rates of >90% as reported in literature, completion of 50 cases appears to be the benchmark (Steck, Stabenow, Volpi, & Vasconcelos, 2016) [16]. The most commonly cited difficulties surgeons new to sialendoscopy experience are difficulty canalizing the papilla, creation of false passage and duct lacerations (Steck et al, 2016) [16], (Farneti et al, 2015) [17].…”

“…In order to achieve the success rates of >90% as reported in literature, completion of 50 cases appears to be the benchmark (Steck, Stabenow, Volpi, & Vasconcelos, 2016) [16]. The most commonly cited difficulties surgeons new to sialendoscopy experience are difficulty canalizing the papilla, creation of false passage and duct lacerations (Steck et al, 2016) [16], (Farneti et al, 2015) [17]. Catheterization of the papilla is deemed the rate limiting step, since failure to achieve this step precludes completion of either diagnostic or therapeutic sialendoscopy (Farneti et al, 2015) [17].…”

“…There appears to be a consensus that surgeons experienced with endoscopic sinus surgery or dacryocystorhinostomy have no trouble with this aspect of the procedure. It has been suggested that practicing this skill on fresh cadavers of human or pig heads should be part of standardized training (Steck et al, 2016) [16] (Farneti et al, 2015) [17]. Laceration of the duct is undesirable due to potential of future ductal stenosis thus increasing patient's chance for recurrent obstructive symptoms and possible need for eventual gland removal.…”