Percutaneous CT–Guided Cryoablation of the Salivary Glands in a Porcine Model

Buethe, Ji; Abboud, Salim; Brock, Kristie; Nizialek, Greg; Rezaee, Rod; Wasman, Jay; Frankel, Jonathan K.; Nakamoto, Dean A.

doi:10.1016/j.jvir.2016.06.002

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…We hypothesized that ablating the offending salivary gland in addition to draining the ranula would improve the efficacy of percutaneous treatment. Percutaneous ablation of salivary tissue has been validated in animal models as a means of decreasing gland volume and presumably saliva production [20, 21]. Therefore, to address the clinical problem of a ranula with a minimally invasive procedure that treats both the ranula and the offending salivary gland, we combined image-guided percutaneous ranula aspiration with chemical salivary gland ablation.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation

et al. 2019

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Background Ranulas are salivary pseudocysts in the floor of the mouth adjacent to damaged salivary glands. Current surgical management is drainage of the ranula with removal of the offending gland. An analogous percutaneous procedure could potentially offer similar treatment efficacy in a more minimally invasive way. Objective To evaluate the outcomes of a cohort of patients with ranulas treated with percutaneous ranula aspiration and chemical ablation of the source salivary gland to see whether this technique could be proposed as a minimally invasive treatment alternative. Materials and methods This retrospective single-center study evaluated 24 patients treated percutaneously for ranulas between January 2004 and December 2014. All patients were treated with percutaneous ranula aspiration and chemical ablation of the offending salivary gland. Treatment success and any complications were recorded. Results Complete ranula eradication was successfully accomplished in 87.5% of the patients with no complications. Conclusion Initial results suggest that our technique of percutaneous aspiration of ranulas and chemical ablation of the source salivary gland is safe and effective.

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Section: Introductionmentioning

confidence: 99%

Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation

et al. 2019

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“…Scientific support for this contention includes EtOH salivary gland ablation of the submandibular glands in a rat model where decreased acinar density, decreased glandular tissue, and increased fibrous tissue and fat necrosis were seen in treated submandibular glands [17]. Similar histological results are seen following submandibular gland duct ligation in rats and cryoablation of the parotid gland in pigs [28,29]. We extrapolated that successful salivary gland ablation is possible in children and that sclerotherapy-induced acinar destruction would lead to decreased sialorrhea.…”

Section: Discussionmentioning

confidence: 80%

Salivary gland ablation: introducing an interventional radiology treatment alternative in the management of sialorrhea

et al. 2020

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Background Sialorrhea is common in children with neurological disorders and leads to social isolation, aspiration pneumonia and increased caregiver burden. Sialorrhea management includes anticholinergic medications and a variety of surgeries, but these are limited by side effects, recurrence and risks. Objective We present our method of salivary gland ablation, an interventional radiology treatment for sialorrhea, and report safety and efficacy data from pediatric patients who underwent salivary gland ablation. Materials and methods Salivary gland ablation uses image-guided sotradecol and ethanol dual-drug injection into the salivary glands. Submandibular and sublingual glands are injected percutaneously using ultrasound. Parotid glands are injected retrograde through Stensen ducts using fluoroscopy. We conducted a retrospective review of the medical records of patients who underwent salivary gland ablation at our institution between 2005 and 2019. Pre-and post-procedure Drooling Frequency and Drooling Severity (DFDS) scale scores were compared and caregiver satisfaction was assessed. We devised two cohorts, one to study patient safety and a subcohort to study clinical efficacy using DFDS scores. Results One hundred and seventy salivary gland ablation procedures were performed in the 99 patients comprising the safety cohort. Of the procedures, 88.8% resulted in no or minimal complications. Respiratory difficulty, temporary nerve palsy and infection represent the majority of the 11.2% of patients who experienced periprocedural complications. There were no complications resulting in permanent sequelae. Twenty-seven patients met our inclusion criteria for the efficacy subcohort with a mean follow-up time of 5.4 years. DFDS at follow-up decreased from a median score of nine to a seven post-procedure (P=0.000018). The proportion of caregivers who were satisfied with the procedure increased as more glands were ablated, which suggests a causal link between the number of glands ablated and the outcome. Conclusion Salivary gland ablation is a safe and effective procedure with the potential for permanent decrease in symptoms related to sialorrhea.

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Evaluation of Outcomes following Radiofrequency Ablation for Treatment of Parotid Tail Warthin Tumors

Tung

Luo

et al. 2019

Journal of Vascular and Interventional Radiology

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Percutaneous CT–Guided Cryoablation of the Salivary Glands in a Porcine Model

Cited by 3 publications

References 26 publications

Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation

Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation

Salivary gland ablation: introducing an interventional radiology treatment alternative in the management of sialorrhea

Evaluation of Outcomes following Radiofrequency Ablation for Treatment of Parotid Tail Warthin Tumors

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