Sialoendoscopy

Lüers, Jan Christoffer; Grosheva, Maria; Stenner, Markus; Beutner, Dirk

doi:10.1001/archoto.2010.238

Cited by 49 publications

(24 citation statements)

References 18 publications

(17 reference statements)

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“…The stones, which were all clinically and ultrasonographically classified as intra-parenchymal, were successfully retrieved from all but seven patients, in whom the failure was due to the fact that the stone could not be separated from the gland tissue despite the use of dedicated elevators. This good result is in line with our initial experience 1 and what has been reported by other authors 4 6 16 , and demonstrate that the procedure is effective in removing deep submandibular stones. Most of these can be removed without using a sialendoscope but, in 9% of cases, the bright guidance of the sialendoscopic unit facilitated the search for residual parenchymal microliths that had cracked during removal of the main stone or migrated backwards to the peri-hilar region.…”

Section: Discussionsupporting

confidence: 92%

Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Capaccio

Gaffuri

Rossi

et al. 2017

Acta Otorhinolaryngol Ital

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Come si evince dallanalisi della letteratura, lapproccio transorale ai calcoli prossimali e ilo-parenchimali della ghiandola sottomandibolare rappresenta una valida alternativa alla scialoadenectomia tradizionale. Lo scopo di questo studio è quello di valutare i risultati chirurgici, ecografici e soggettivi di questa tecnica conservativa. Tra Gennaio 2003 e Settembre 2015 sono stati trattati con lapproccio transorale scialoendoscopico-assistito 479 pazienti affetti da calcoli ilo-parenchimali sottomandibolari palpabili, non mobili, di dimensioni superiori ai 7 mm. Tutti i pazienti sono stati sottoposti ad un follow-up clinico, ecografico e ad una valutazione soggettiva delloutcome chirurgico per mezzo di un apposito questionario somministrato attraverso unintervista telefonica. Il successo chirurgico definito come completa asportazione del calcolo ilo-parenchimale è stato ottenuto in 472 pazienti (98.5%); in sette casi (1.5%) si è verificato un insuccesso chirurgico, riguardante esclusivamente calcoli parenchimali puri. Un anno dopo lintervento chirurgico, 408 pazienti (85.1%) non riferivano più sintomi ostruttivi, 59 pazienti (12.3%) riferivano sintomi ostruttivi ricorrenti e 12 (2.6%) infezioni ricorrenti. Dei 54 pazienti (11.2%) affetti da litiasi sottomandibolare ricorrente, 52 sono stati sottoposti ad una seconda procedura terapeutica, nello specifico in 29 casi a scialoendoscopia, in 2 casi a litotrissia pneumatica intracorporea, in 8 casi a chirurgia transorale, in 6 casi ad un ciclo di litotrissia extracorporea, in 7 casi a scialoadenectomia sottomandibolare. La maggior parte dei pazienti (75.2%) ha riferito un dolore post-chirurgico di grado lieve. Al termine del follow-up, i sintomi riferiti da 454 pazienti (94.8%) erano migliorati dopo il secondo trattamento e la ghiandola sottomandibolare affetta era stata preservata nel 98.5% dei casi. La chirurgia transorale scialoendoscopico-assistita dei calcoli ilo-parenchimali della ghiandola sottomandibolare rappresenta unopzione terapeutica sicura, efficace e conservativa e la preservazione del dotto e del parenchima ghiandolare permette di esplorare il sistema duttale attraverso lostio naturale in caso di ricorrenza della patologia. Lutilizzo combinato dellapproccio transorale e delle altre tecniche mini-invasive permette di trattare con successo la maggior parte dei pazienti affetti da litiasi ilo-parenchimale sottomandibolare.

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Section: Discussionsupporting

confidence: 92%

Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Capaccio

Gaffuri

Rossi

et al. 2017

Acta Otorhinolaryngol Ital

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“…In all forms of intra-corporeal lithotripsy, the effectiveness and duration of treatment depends first on the endoscopic accessibility, second on the size, shape and location of the stone and third on the anatomic relationships within the salivary duct system 20 41 42 . Regarding submandibular stones located near the mylohyoid bend, transoral duct surgery or ESWL are valid treatment alternatives and the use of intraductal lithotripsy must be weighed in every individual case or can be applied in combination with these 20 41 43 .…”

Section: Endoscopically Controlled Intra-corporeal Lithotripsymentioning

confidence: 99%

“…Like all of the other forms of intra-corporeal lithotripsy, the effectiveness and duration of treatment depend on the size, shape and location of the stone, and the anatomic relationships of the salivary duct system 20 41 42 .…”

Section: Endoscopically Controlled Intra-corporeal Lithotripsymentioning

confidence: 99%

Salivary lithotripsy in the era of sialendoscopy

Capaccio

Torretta

Koch

2017

Acta Otorhinolaryngol Ital

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Negli ultimi decenni i tradizionali approcci terapeutici alla patologia ostruttiva salivare sono stati gradualmente sostituiti da trattamenti conservativi e mini-invasivi tra cui la litotrissia salivare, la scialoendoscopia, le tecniche di radiologia interventistica e la rimozione vidoendoscopica di calcoli per via trans-orale o trans-cervicale. Tra queste tecniche la scialoendoscopia è attualmente considerata il trattamento di scelta, tuttavia la sola scialoendoscopia interventistica non preceduta da tecniche di frammentazione garantisce una completa rimozione dei calcoli salivari allincirca nel 15-20% dei casi. Inoltre il 10-20% dei calcoli non è raggiungibile endoscopicamente o con altri approcci chirurgici. In questi casi la litotrissia salivare extracorporea rappresenta il trattamento di scelta. Nonostante ciò negli ultimi anni la litotrissia salivare extracorporea è stata gradualmente sostituita dalle tecniche di frammentazione intracorporee eseguite sotto controllo endoscopico tra cui la litotrissia salivare intracorporea laser e pneumatica video-assistita. In questo articolo verranno descritte le tecniche e le indicazioni residue alla litotrissia salivare, comprendente la litotrissia extracorporea e la litotrissia salivare intracorporea laser, elettroidraulica, elettrocinetica e pneumatica video-assistite. Verranno inoltre fornite le indicazioni residue di tali trattamenti.

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“…The most common obstructive salivary gland disease is sialolith, while other etiologies include strictures, mucoid plug, and anatomic ductal abnormalities [2]. Mobile stones of size \5 mm, especially those located at the distal duct position, are generally considered to be removable by simple sialendoscopy without the interference of the original salivary duct structures [3]. In some difficult conditions like in larger stones ([5 mm), a combined sialendoscopic approach that includes ductal incision, may be necessary to remove the stone [4].…”

Section: Introductionmentioning

confidence: 99%

Post-sialendoscopy ductoplasty by salivary duct stent placements

Lee

Tseng

et al. 2015

Eur Arch Otorhinolaryngol

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With damage to a duct or papilla after sialendoscopy, a stent may be necessary to prevent re-stenosis and for maintaining the salivary duct open after complete sialendoscopy. However factors affecting outcomes and complications after stent placement remain unclear. This study aimed to report preliminary experiences in salivary duct stent placement after sialendoscopy. Data from 35 procedures in 33 patients who received sialendoscopy with salivary duct stent placements at Mackay Memorial Hospital between October 2013 and June 2014 were recorded and compared for clinical data, as well as procedural techniques, findings, and outcomes. In the 35 stent placement procedures, the hypospadias silastic stent tubes were used in 27 and the Fr. 5 pediatric feeding tubes were used in the remaining eight. When the hypospadias silastic stent tubes were used for stenting, the stent obstruction and irritation rates were higher compared to those who used the Fr. 5 pediatric feeding tube (100 vs. 0 % and 67 vs. 33 %, respectively). None of the stents secured by a 5-0 nylon suture were complicated by dislocation but when the stents were secured by 6-0 nylon sutures, the dislocation rate went as high as 47.4 %. The duration needed for salivary duct stent placement might be potentially shortened to only 2 weeks. If a salivary duct stent is intended to be placed for a certain period before its scheduled removal, a suture strength equivalent or stronger than the 5-0 nylon suture should be considered for stent fixation.

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Sialoendoscopy

Abstract: Small size, good mobility, round or oval, and distal location of a salivary stone in the main duct predict significantly greater probability of endoscopic removal and consequently are positive prognostic factors.

Cited by 49 publications

References 18 publications

Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Salivary lithotripsy in the era of sialendoscopy

Post-sialendoscopy ductoplasty by salivary duct stent placements

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