Sialendoscopy in treatment of adult chronic recurrent parotitis without sialolithiasis

Jokela, Johanna; Haapaniemi, Aaro; Mäkitie, Antti; Saarinen, Riitta

doi:10.1007/s00405-017-4854-7

Cited by 13 publications

(7 citation statements)

References 26 publications

(38 reference statements)

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“…Another study showed that retroductal application of corticosteroids was effective in patients with chronic recurrent sialadenitis and Sjögren syndrome. 15 16 17 In contrast, Jokela et al 16 reported that steroid irrigation did not provide additional benefit compared to saline irrigation; however, they conducted single-dose steroid injections, which were not sufficient to determine the efficacy of the drug. 16 Another variable to consider would be the timing of the intervention, since inflammatory gland changes vary widely depending on the duration or severity of disease.…”

Section: Discussionmentioning

confidence: 97%

Efficacy of corticosteroid ductal irrigation in acute salivary gland inflammation induced in a rat model

Lee

Kim

et al. 2022

Imaging Sci Dent

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Purpose This study aimed to compare the therapeutic effects of corticosteroid irrigations and normal saline irrigations in the early inflammatory state of the salivary gland. Materials and Methods Adult male Wistar rats were divided into experimental (n=6) and control (n=3) groups. Inflammation was induced in the experimental subjects on both sides of the submandibular gland with ligation. After 14 days, both sides of the glands were de-ligated and retroductal irrigation using saline (n=3) and a corticosteroid (n=3) was performed on the left sides only. The controls (n=3) were used to normalize the gland state for the effects of diet and aging. Magnetic resonance imaging was performed to confirm inflammation and post-irrigation gland recovery by measuring relative signal intensity (SI). The glands were excised for histological examination. Results All experimental animals showed inflamed glands with increased SI and subsequent recovery of the gland with decreased SI to varying degrees. The SI of the controls showed no significant changes during the overall period. The mean SI change of the irrigated gland was higher than that of the non-irrigated side, without a significant difference. The corticosteroid-irrigated glands showed a greater change in SI than that of the saline-irrigated glands. Histology revealed that inflammation was not observed in most of the irrigated glands, while mild to moderate quantities inflammatory cells were found in non-irrigated glands. Conclusion Corticosteroid irrigation mitigated the early stages of salivary gland inflammation more effectively than normal saline.

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Section: Discussionmentioning

confidence: 97%

Efficacy of corticosteroid ductal irrigation in acute salivary gland inflammation induced in a rat model

Lee

Kim

et al. 2022

Imaging Sci Dent

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“…During sialoendoscopy, saline and anti-inflammatory corticosteroids were used as irrigating solutions. The administration of irrigating solutions, such as corticosteroids, antibiotics, and saline 11 , is intended to remove debris and dilate the duct by hydrostatic pressure to facilitate visualisation 9 , in addition to having therapeutic properties, such as anti-inflammatory and antibiotic actions 9 . Corticosteroids have anti-inflammatory and antiproliferative effects, significantly reducing the formation of primary strictures or their recurrence 1,13 .…”

Section: Discussionmentioning

confidence: 99%

“…This heteroplasia may have a congenital 6,7 or acquired origin, characterised by dilation of the salivary duct, which frequently occurs secondary to obstruction caused mainly by sialolithiasis and strictures of the duct 8 . They can cause an increase in recurrent swelling in the affected duct region 9 , sometimes followed by painful symptoms not associated with eating 6 , making the differential diagnosis with other diseases is essential. 8 Hereditary factors were considered a central element in the development of ectasia 7 .…”

Section: Introductionmentioning

confidence: 99%

“…Only 5-10% of salivary duct obstructions occur due to chronic inflammatory processes, 60-70% due to sialolithiasis, and 15-25% due to strictures 2 . The other causes correspond to a rate of 1-3% and include allergic processes (granulomatous and autoimmune conditions, radiotherapy) 9 , presence of anatomical abnormalities of the parotid duct 5 , trauma 10 , juvenile chronic parotitis 7 , autoimmune disease 4 , among others.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and management of multiple salivary gland anomalies

Hamasaki¹,

Trentin²,

Pascoto³

et al. 2022

J Oral Diag

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Anatomical anomalies in the salivary glands, such as ductal ectasia and stenosis, are rare and can be idiopathic, congenital, or acquired. The diagnosis of these anomalies is based on imaging examinations and is sometimes challenging. A 65-year-old female patient complained of a recurrent volume increase in the right preauricular region for 43 years. The swelling was exacerbated during the periprandial period. Physical examination with palpation revealed a flaccid swelling. Aspiration showed clear liquid compatible with saliva. Ultrasonography and magnetic resonance (MR) sialography showed changes in ductal anatomy and sialocele. MR sialography allowed the diagnosis of sialocele secondary to idiopathic duct anomalies, ectasia, and strictures in the parotid ducts. The treatment was sialoendoscopy. The patient presented a good clinical evolution with a significant reduction in swelling in the preauricular region due to less saliva accumulation. Sialoendoscopy is an effective method for the diagnosis and treatment of major salivary gland anomalies.

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“…Another prospective study by Jokela et al [ 29 ], has shown no significant difference observed in a group of patients receiving 1 mL of hydrocortisone 125 mg/mL and the group receiving 1 mL of isotonic saline solution intraductally, concluding that no additional benefit in symptom relief were found from a single-dose intraductal steroid.…”

Section: Discussionmentioning

confidence: 99%

A conservative treatment for chronic obstructive sialoadenitis by intraductal instillation of mucolytic, steroids and antibiotic solution

Martines

Immordino

Sireci

et al. 2021

Eur Arch Otorhinolaryngol

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Purposes Reporting our experience in treating chronic obstructive sialadenitis with a protocol consisting of sialoendoscopy and intraductal instillation of antibiotics, steroids and n-acetyl-cysteine (NAC) solution. Methods Prospective study of patients with chronic obstructive sialadenitis with no apparent lithiasic obstructions, with recurrent non-lithiasic sialoadenitis and patients with lithiasic sialoadenitis not solved with sialoendoscopy. In all cases, a sialoendoscopy was performed. All the patients affected by lithiasic sialoadenitis where the chronic inflammation was resolved with sialoendoscopy were excluded from the study. The mid-term follow-up was performed at 12 months via phone interview, to understand whether patients had developed any further symptoms after the treatment. Results This study included 26 patients. All the patient without sialolithiasis have not reported any symptoms during the follow-up period. Two of those with sialolithiasis have not shown any signs of recurrence. The remaining three patients with non-resolved sialolithiasis had a recurrence of symptoms which were treated again with 1 intraductal administration of betamethasone, gentamicine and NAC, showing immediately a regression of the symptoms. Conclusions Intraductal administration of gentamicin + NAC + betamethasone seemed effective for the therapy of chronic obstructive sialoadenitis. Our protocol seemed effective also in that cases where it was not possible to remove or detect endoscopically an obstruction. In all these cases we have noticed an increase in the symptom-free time even in cases where it was not possible to remove the stones.

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Sialendoscopy in treatment of adult chronic recurrent parotitis without sialolithiasis

Abstract: Sialendoscopy appears to reduce the symptoms of chronic recurrent parotitis. While total permanent symptom remission is rare, sialendoscopy can be considered a safe and relatively efficacious treatment method for this patient group.

Cited by 13 publications

References 26 publications

Efficacy of corticosteroid ductal irrigation in acute salivary gland inflammation induced in a rat model

Efficacy of corticosteroid ductal irrigation in acute salivary gland inflammation induced in a rat model

Diagnosis and management of multiple salivary gland anomalies

A conservative treatment for chronic obstructive sialoadenitis by intraductal instillation of mucolytic, steroids and antibiotic solution

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