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One‐Year symptom outcomes after sialolithiasis treatment with sialendoscopy‐assisted salivary duct surgery
Author(s) -
Ryan William R.,
Plonowska Karolina A.,
Gurman Zev R.,
AubinPouliot Annick,
Chang Jolie L.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27398
Subject(s) - medicine , interquartile range , prospective cohort study , sialadenitis , surgery , stenosis , cohort , salivary gland
Objectives For chronic obstructive sialadenitis, there is a paucity of long‐term prospective evidence of disease‐specific symptom outcomes after sialendoscopy‐assisted salivary duct surgery (SASDS). We prospectively assessed patients with sialolithiasis before and at 3 months and 1 year after SASDS using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. Methods A prospective cohort study of adult patients with sialolithiasis who underwent SASDS and completed the COSS questionnaire over a 1‐year follow‐up period. The COSS questionnaire consists of 20 disease‐specific symptom questions. COSS score outcomes were classified by complete, partial, and nonresolution, as well as by clinically significant improvement. Results Ninety‐six patients underwent SASDS in 110 glands, of which 69 glands (63%) had findings of sialolithiasis. The following median COSS scores were reported for sialolithiasis glands: preoperative, 27.5 (interquartile range [IQR]: 12.5–44); 3 months, 1 (IQR: 0–5); and 1 year, 1 (IQR: 0–5.5). Patients with sialolithiasis reported statistically significant improvements in COSS scores from preoperative to 3 months post‐SASDS ( P > 0.05). A vast majority of patients maintained this improvement from 3 months to 1 year, indicating durability. Complete resolution of symptoms was attained in 95% and 85% of glands at 3 months and 1 year, respectively. Open/hybrid compared to endoscopic‐only sialolithiasis extraction achieved similar 3‐month and 1‐year COSS outcomes. Potential risk factors for symptom persistence after SASDS included nonreachable parenchymal sialoliths and concurrent inflammatory disease and/or stenosis. Conclusion SASDS for sialolithiasis extraction is associated with durable, long‐term benefit regardless of endoscopic or open technique or sialolith location, suggesting that subsequent ductal stenosis from iatrogenic or sialolithiasis‐related inflammation fibrosis is unlikely. Level of Evidence 4 Laryngoscope , 129:396–402, 2019