Pediatric Sialadenitis

I disordini ostruttivi salivari sono infrequenti nelletà pediatrica. I recenti progressi tecnologici nel distretto della testa e del collo hanno modificato la strategia diagnostica e terapeutica dei disordini salivari. La diagnosi è oggi basata sulleco color Doppler, sulla scialo-RMN, sulla cone beam 3D TC, mentre la litotrissia extracorporea ed intracorporea, la scialoendoscopia interventistica, la chirurgia scialoendoscopico- assistita, sono attualmente utilizzati come procedure conservative e mininvasive per la preservazione funzionale della ghiandola affetta. Abbiamo analizzato i risultati dellesperienza clinica a lungo termine nel trattamento dei disordini ostruttivi delletà pediatrica. Un gruppo consecutivo di 66 pazienti pediatrici (38 femmine) con sintomi salivari ostruttivi causati da parotite ricorrente pediatrica (32 pazienti), calcoli (20), stenosi duttali (5), e ranule (9) è stato incluso nello studio. 45 pazienti sono stati sottoposti a scialoendoscopia interventistica per parotite ricorrente, calcoli e stenosi, 12 pazienti sono stati sottoposti ad un ciclo di litotrissia extracorporea (ESWL), tre pazienti a chirurgia transorale scialoendoscopico-assistita, un paziente a drenaggio, sei a marsupializzazione e due a sutura della ranula. Nel 90,9% è stato raggiunto un risultato favorevole. Lapproccio combinato di litotrissia salivare extracorporea e di scialoendoscopia interventistica è stato utilizzato in tre pazienti ed una procedura secondaria è stata eseguita in sette pazienti. Nessun paziente è stato sottoposto a scialoadenectomia nonostante la persistenza di modesti sintomi ostruttivi in sei pazienti. Non è stata osservata alcuna complicanza maggiore. Adottando un adeguato iter diagnostico mediante eco color Doppler delle ghiandole salivari, scialo-RMN e cone beam 3D TC, i pazienti pediatrici con disordini ostruttivi salivari possono essere efficacemente trattati con un approccio moderno mini-invasivo mediante tecniche di litotrissia extracorporea ed intracorporea, scialoendoscopia interventistica, e chirurgia transorale scialoendoscopico-assistita; questo approccio garantisce un risultato favorevole nella maggior parte dei pazienti evitando così il ricorso alla scialoadenectomia invasiva e mantenendo così la preservazione funzionale della ghiandola coinvolta.

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“…In line with previous reports 20 , the most common cause of recurrent paediatric sialadenitis in our experience was JRP .…”

Section: Discussionsupporting

confidence: 93%

Modern management of paediatric obstructive salivary disorders: long-term clinical experience

Capaccio

Canzi

Gaffuri

et al. 2017

Acta Otorhinolaryngol Ital

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“…Cases of recurrent juvenile parotitis cause atrophy of glandular tissue acini and the formation of fibrosis. Collagen is attracted to calcium ions, which initiates its deposition on the protein matrix and may result in dystrophic calcifications in the affected gland (12-14). Recurrent juvenile parotitis may develop because of a parasitic infection, specifically in the case of cysticercosis.…”

Section: Discussionmentioning

confidence: 99%

Dystrophic calcification vs sialolithiasis in a pediactric parotid gland: A case report

et al. 2019

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Calcinosis is a connective tissue disorder characterized by ectopic calcification in soft tissues. It is subdivided into: dystrophic, metastatic, idiopathic and iatrogenic calcification. The formation of mineralized material in the salivary glands is a common finding in the daily practice of dentists and other specialists. In most cases, this calcification is a sialolith. However, a type of ectopic calcification termed dystrophic calcification is characterized by inappropriate biomineralization in soft tissues and may be associated with trauma, chronic and localized infection or inflammatory diseases. We report a case of a 9-year-old female patient who complained of small nodules in the left parotid region, which begun two years before. Her main complaint was of recurring periods of worsened symptoms characterized by the exacerbation and symptomatic remission of the gland volume with occasional otolaryngologic infections. This study aims to discuss ectopic dystrophic calcification in the parotid gland associated with recurrent infection in children. Key words: Dystrophic calcification, salivary gland, pediatric pathology.

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“…However, practitioners should be aware of the clinical presentation of sialadenitis since it may mimic other orofacial infections. Viral sialadenitis and juvenile recurrent parotitis represent the most common salivary gland diseases in children and adolescents [ 74 ]. The literature revealed a few types that can be described as suppurative sialadenitis.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing for Oro-Facial Infections in the Paediatric Outpatient: A Review

et al. 2018

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There are many reports on the complications associated with antibiotics abuse during the treatment of paediatric patients, particularly those related to antimicrobial resistance. The dental profession is no exception; there is growing evidence that dental practitioners are misusing antibiotics in the treatment of their paediatric patients. This review is directed to dental practitioners who provide oral healthcare to children. It is also directed to medical practitioners, particularly those working in emergency departments and encountering children with acute orofacial infections. A systematic search of literature was conducted to explore the clinical indications and recommended antibiotic regimens for orofacial infections in paediatric outpatients. The main indications included cellulitis, aggressive periodontitis, necrotizing ulcerative gingivitis, and pericoronitis. Amoxicillin was found to be the most commonly recommended antibiotic for short durations of 3–5 days, with metronidazole or azithromycin being the alternative antibiotics in penicillin-sensitive patients.

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Pediatric Sialadenitis

Cited by 63 publications

References 52 publications

Modern management of paediatric obstructive salivary disorders: long-term clinical experience

Modern management of paediatric obstructive salivary disorders: long-term clinical experience

Dystrophic calcification vs sialolithiasis in a pediactric parotid gland: A case report

Antibiotic Prescribing for Oro-Facial Infections in the Paediatric Outpatient: A Review

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