Interventional sialendoscopy for treatment of juvenile recurrent parotitis

Abstract

Objective:To evaluate our preliminary experience with interventional sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis (JRP).Materials and Methods:Three consecutive pediatric patients with JRP who underwent interventional sialendoscopy were identified. Interventional sialendoscopy consisted of serial dilation of the Stenson's duct, endoscopy of the ductal system and saline irrigation followed by instillation of triamcinolone acetate. Clinical, demographic, procedure-related data and complications were documented. End points of the study were technical success, defined as completion of the procedure, subjective improvement in symptoms as indicated by the patients or their parents and assessment of safety in terms of complications.Results:Three male patients with a mean age of 9 years (range 6–11 years) underwent interventional sialendoscopy for JRP. Endoscopic findings included a blanched stenotic duct with intraductal debris in those who were symptomatic. Technical success was 100%. The mean number of episodes of JRP in the year prior to presenting to our service among the three patients was 5 (range 4–6 per year). There were no new episodes of JRP reported at the last follow-up. There were no major complications.Conclusion:Our preliminary experience concurs with the current literature and suggests that interventional sialendoscopy is effective for the management of JRP and can be considered for patients who fail conservative medical management.

Complications of traditional and modern therapeutic salivary approaches

“…Salivary fistulas, sialoceles, minor ductal tears, minor haemorrhage and acute masseteric bend, while reported, should be considered as extremely rare complications 52 61 67 68 . Large or recalcitrant parotid stones can leave a persistent stone fragment or produce obstructive symptoms due to a fibrous stricture that is also very rare.…”

Sialendoscopy approach in treating juvenile recurrent parotitis: A systematic review

“…Morbidity related to sialoendoscopy is low, being reported in 4.4% of patients. The complications described are: swelling and pain [ 15 , 25 , 30 , 35 ], duct perforation [ 7 , 20 ], proximal duct stenosis [ 24 ], rare cases of upper airway obstruction [ 20 , 26 ], and the usual risks of general anesthesia [ 11 ]. In 95.6% of the patients there were no complications or this data was not available [ 1 , 17 , 18 , 22 , 23 , 28 , 29 , 32 , 36 ].…”

Response to "Interventional sialendoscopy for treatment of juvenile recurrent parotitis"

“…The article by Gary et al . [ 1 ] aroused our interest and simultaneously raised some areas of discussion on which we would like to expand.…”

“…First, the authors understated that “Sialendoscopy is a relatively new procedure introduced by Marchal et al [ 1 ]” and a book of Dr. Marchal (2003) was cited. [ 2 ] Indeed, sialendoscopy is not new and is not invented by Dr. Marchal.…”

“…Third, the authors mentioned in their surgical technique that “The oral cavity can be kept open using splints.”[ 1 ] This seems to be a misnomer because the term “ splint ” means material or a device used to protect or immobilize a body part, usually for fracture treatment, rehabilitation, or physiotherapy. [ 17 ] Commonly used intraoral splints include a wire-composite splint for traumatized teeth and/or alveolar bone [ Figure 1 ], an occlusal splint for temporomandibular disorders, and a surgical splint for orthognathic surgery [ Figure 2 ].…”