Pediatric sialendoscopy: a 5-year experience at a single institution.

OBJECTIVES: To evaluate the outcome of our experience in the treatment of salivary gland disorders in children undergoing sialendoscopy and to assess the evolution of the technique. DESIGN: Retrospective medical record review. SETTING: Tertiary care university hospital. PATIENTS: Thirty-eight children with salivary gland disorders undergoing diagnostic and interventional sialendoscopy between January 1, 2003, and November 30, 2008. INTERVENTION: Diagnostic and interventional sialendoscopy using general anesthesia. MAIN OUTCOME MEASURES: Demographic, clinical, and surgical variables, including age, sex, date of first symptoms, parotid or submandibular location of disease, preoperative ultrasonographic results, sialendoscopy technique, sialendoscopy observations, and complications. RESULTS: Pediatric sialendoscopy was performed on the parotid gland in 23 patients (61%) and on the submandibular gland in 15 patients (39%). The most frequent indication for sialendoscopy was recurrent salivary gland swelling. Thirty-two of 38 procedures (84%) were performed endoscopically, whereas a combined intervention was necessary for 3 patients and a submandibular gland excision for another 3 patients. Sialendoscopy allowed the diagnosis of 12 patients with salivary duct lithiasis, 21 with salivary duct stenosis, and 2 with both submandibular lithiasis and stenosis, and findings from 3 sialendoscopies were normal. Preoperative ultrasonographic results were confirmed by sialendoscopy in only 7 patients. Of the 10 patients with lithiasis found using sialendoscopy, only 4 had been detected using preoperative ultrasonography. CONCLUSIONS: Sialendoscopy is a pertinent technique for the diagnosis and treatment of salivary gland disorders in children. It also allows the most conservative treatment of sialolithiasis and juvenile recurrent parotitis.

Juvenile recurrent parotitis: sialendoscopic approach.

OBJECTIVE: To assess the relevance of sialendoscopy as a diagnostic and interventional procedure in juvenile recurrent parotitis (JRP). DESIGN: Prospective case series study. SETTING: Tertiary care teaching hospital. PATIENTS: Sialendoscopy was used to examine 10 children (age range, 1.8-13.0 years) with symptomatic JRP for recurrent swelling of the parotid glands between January 2003 and January 2005. Diagnostic sialendoscopy allowed classification of ductal lesions, and interventional sialendoscopy was used to treat the lesions. Initial data analyzed included the type of endoscope used as well as the size and form of the main duct of the parotid gland. Outcome variables were resolution of symptoms and endoscopic enlargement of the ductal tree. RESULTS: Initial ultrasound evaluation of the diseased gland revealed a white Stensen duct without the natural proliferation of blood vessels in all 10 cases. This finding was associated with a true stenosis of the Stensen duct. Two cases of suspected stones according to ultrasonography were subsequently diagnosed as localized stenoses. The sialendoscope was used to dilate the duct with pressurized saline solution in all cases as well as to dilate the 2 cases of stenoses. There were no major complications. The average length of follow-up was 11 months (range, 2-24 months). Seventeen parotid glands were dilated in all 10 patients, with a success rate of 89%. One patient needed repeated sialendoscopies for recurrent symptoms. Two patients presented with a second episode of JRP contralateral to the side initially treated. CONCLUSIONS: Diagnostic sialendoscopy is a new procedure that can be used in children for reliable evaluation of salivary ductal disorders, with low morbidity. Sialendoscopic dilation of the main parotid ducts appears to be a safe and effective method for treating JRP.