Long-term Follow-up of the Effect of Tympanic Neurectomy on Sialadenosis and Recurrent Parotitis

Abstract

We examined the effect of tympanic neurectomy on the clinical symptoms and secretory function of the parotids in 13 patients with chronic parotitis or sialadenosis for 3 years. Each patient had significantly fewer complaints immediately after the surgery. In quite a few patients the improvement was transient only. Three years after neurectomy 3 of the 10 examined patients were free from complaints and 4 further patients had less severe complaints than before the surgery. Neurectomy was followed by a significant decrease in parotid flow rate and an increase in the sodium concentration of parotid saliva, while potassium concentration showed a slight decrease. Three years after the surgery the flow rate and the sodium concentration were moderately higher than before that. There was a significant, long-lasting change in the amylase activity of parotid saliva; 3 years after neurectomy it attained one-third of the preoperative value. A pharmacological test, carried out 3 years after neurectomy in 2 patients, suggested parasympathetic reinnervation of the parotid.

Inflammatory diseases of the salivary glands in infants and adolescents

“…Its pathogenesis is not fully elucidated. There are conflicting opinions in the literature as to a possible connection with congenital [9,21], acquired or multifactorial inflammationinduced stenosis and ectasia of the duct system [20], congenital duct anomalies [22] and post-infectious factors [13]. In addition, the involvement of autoimmune processes has been suggested [23,24].…”

Diseases of the salivary glands in infants and adolescents

“…Its pathogenesis is not fully elucidated. There are conflicting opinions in the literature as to a possible connection with congenital [9,27], acquired or multifactorial inflammation-induced stenosis and ectasia of the duct system [26], congenital duct anomalies [27,28], and post-infectious factors [19]. In addition, the involvement of autoimmune processes has been suggested [29].…”

“…In two patients, the disease had healed spontaneously by the onset of puberty. Instillation of a fibrin-glue/gentamycin mixture into the Stenon's duct was eventually found to be unsuitable [31], and long-term results after tympanic neurectomy were unsatisfactory [28]. Consequently, both procedures were abandoned.…”

Valproic acid-associated sialadenosis of the parotid and submandibular glands: diagnostic and therapeutic aspects

“…Tympanic neurectomy transects these parasympathetic fibres of the glossopharyngeal nerve which play a decisive role in the physiological stimulation of the secretion of saliva. Using this method only a transient improvement was observed, most probably due to cholinergic reinnervation of the gland [17]. The treatment of choice for chronic recurrent sialadenosis of the major salivary glands that does not respond to conservative therapy, especially when the cosmetic deformity is unacceptable to the patient, is to perform lateral parotidectomy under neuromonitoring control and partial resection of the submandibular glands.…”