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One‐year outcomes of sialendoscopic‐assisted salivary duct surgery for sialadenitis without sialolithiasis
Author(s) -
Plonowska Karolina A.,
Gurman Zev R.,
Humphrey Amanda,
Chang Jolie L.,
Ryan William R.
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.27433
Subject(s) - sialadenitis , medicine , stenosis , prospective cohort study , surgery , gastroenterology , salivary gland
Objectives To prospectively examine durability of long‐term outcomes in sialendoscopy‐assisted salivary duct surgery (SASDS) in chronic obstructive sialadenitis without sialolithiasis (COSWS). Methods A prospective cohort study of adult patients with COSWS who completed Chronic Obstructive Sialadenitis Symptoms (COSS) Questionnaire prior to and at 3 months and 1 year following SASDS. COSS scores scaled to 0 to 100 were analyzed by statistically significant improvements and previously published ranges corresponding to complete, partial, and nonresolution of symptoms. Results Twenty‐nine patients with COSWS affecting 41 glands had statistically significant improvements in COSS scores at 3 months following SASDS. These improvements usually were sustained at 1 year, supporting durability of treatment effect over time. A majority of cases (30 of 41, 73%) achieved at least a partial resolution of sialadenitis symptoms (COSS score ≤ 25) at 1‐year follow‐up. Symptom improvement after SASDS was noted in 14 of 18 (78%) glands with radioiodine‐induced sialadenitis (RAI‐IS). The highest proportion of persistent or recurrent disease at 1‐year post‐SASDS was found in autoimmune sialadenitis (2 of 4, 50%) and glands with proximal or multifocal stenoses (6 of 12, 50%). At 1 year, distal duct stenoses achieved a significantly higher proportion of partial or complete symptom resolution (18 of 21, 86%) than cases with proximal or multifocal stenoses (6 of 12, 50%; P = 0.044). Conclusions SASDS is effective in reducing symptoms in duct stenosis and RAI‐IS, usually with durable treatment benefits at long‐term follow‐up. Distal stenoses appear to be more amenable to sialendoscopic treatment, achieving greater symptom reduction than proximal/multifocal stenoses. Additional larger multi‐center studies are needed to further characterize risk factors for COSWS refractory to SASDS. Level of Evidence 2 Laryngoscope , 129:890–896, 2019