Tympanic neurectomy in the management of parotid sialectasis

Abstract

The term sialectasis refers to dilatation of the salivary ducts. Parotid sialectasis presents itself as recurrent painful swellings during mastication and/or swallowing. Our results with 10 cases treated by tympanic neurectomy over a period of nine years, from 1983 to 1992, were encouraging as seven cases had improvement of their symptoms.Anatomy of the tympanic plexus and surgical procedure are discussed as well as a review of the literature.We recommend extensive interruption of the secreto-motor nerve fibres by thoroughly drilling into the hypotympanum and below the basal turn of the cochlea. We also recommend that this be carried out by an experienced otologist to avoid possible complications.

Management of chronic parotitis: a review

“…22 These branches may run in a bony canal, which may, or may not, be partially or completely dehiscent. 20 In 40-50 per cent of patients there may be a hypotympanic branch that arises from the main trunk while still in the hypotympanic cells and runs anteriorly below the promontory to reach the eustachian tube recess. 23 Division of these bres in the hypotympanum is said to be necessary for the achievement of 'good long term results'.…”

Recurrent parotitis

“…Recurrent parotitis presents as a recurrent painful swelling during mastication and/or swallowing 22. The disease usually starts in a child between 3 and 6 years of age,1 3 13 23 but earlier and later occurrence has been observed 2…”

Current Management of Juvenile Recurrent Parotitis

“…Neurectomy of the tympanic nerve, described by Daud in 1995 [27], has to be mentioned as a possible surgical procedure in recurrent parotitis. Division of the secretory fibers of the tympanic nerve should reduce the gland's secretion.…”

“…Division of the secretory fibers of the tympanic nerve should reduce the gland's secretion. Seven out of ten adults had a clear improvement in their symptoms [27]. The method remains controversial because of its general lack of success and relative invasiveness [28,29]; in particular, it is not recommended for children.…”