First evaluation of an ovine training model for sialendoscopy.

Objective: Sialendoscopy is a minimally invasive diagnostic and therapeutic technique used in the treatment of various salivary gland diseases. To date, there are very few suitable training models other than the pig's head, which has been used at the European Sialendoscopy Training Center for 22 years. The goal of this study was to describe an ovine model for sialendoscopy training and compare the ovine model's to the human anatomy. We propose a step-by-step approach for sialendoscopy training using this ex-vivo model. Methods: The anatomy of the ovine salivary ducts and glands was assessed by magnetic resonance imaging using one fresh ovine head. Thereafter, the model was designed during dissection by an experienced sialendoscopist. The various steps were then validated during consecutive dissections using a Likert-scale questionnaire. Results: The full model was described in the form of a dissection guide and allowed reliable diagnostic sialendoscopy in 10/10 Stenson's and in 5/10 Wharton's ducts. Moreover, interventional sialendoscopy was simulated to provide a training model for the removal of sialoliths in the Stenson's duct. The human and ovine anatomy are quite similar allowing a training experience close to reality. Conclusion: We developed and evaluated an ovine model with the goal of improving training in diagnostic and interventional sialendoscopy. In particular, the Stenson's duct can be successfully prepared, probed and subjected to sialendoscopy. The realistic anatomical environment and excellent tissue quality created a life-like training experience for an experienced sialendoscopist. Further studies with beginners are necessary to validate this model as a training model. Level of Evidence: 4.

[Sjögren's syndrom: clinical, diagnostic and therapeutic innovations]. / Syndrome de Sjögren : nouveautés cliniques, diagnostiques et thérapeutiques.

Sjögren's syndrome (SS) is a systemic autoimmune disease affecting the lacrimal and salivary glands. In up to one third of patients, SS may be complicated by potentially severe extra-glandular visceral involvement, which can be life-threatening. Diagnosis is often difficult based on a combination of clinical and biological evidence. The development of new imaging techniques can now help the clinician in his diagnostic approach. Long considered incurable, new medical and surgical treatments are being studied and are potentially promising. Paramedical management and regular physical activity are also essential and contribute to the improvement of patients' fatigue. The objective of this article is to review the main clinical manifestations as well as the diagnostic and therapeutic novelties developed in recent years.

Le syndrome de Sjögren (SS) est une maladie autoimmune systémique touchant les glandes lacrymales et salivaires. Chez près d'un tiers des patients, il peut se compliquer d'atteintes extraglandulaires potentiellement sévères. Le diagnostic, reposant sur un faisceau d'arguments clinicobiologiques, est souvent difficile. Le développement des nouvelles techniques d'imagerie peut aujourd'hui aider le clinicien dans sa démarche diagnostique. Longtemps considéré comme incurable, de nouveaux traitements médicochirurgicaux sont en cours d'étude et potentiellement prometteurs. Une prise en charge paramédicale avec une activité physique régulière est également essentielle. L'objectif de cet article est de revoir les manifestations cliniques ainsi que les nouveautés diagnostiques et thérapeutiques développées ces dernières années.

Novel Multidisciplinary Salivary Gland Society (MSGS) Questionnaire: An International Consensus.

OBJECTIVES: First, establishment and validation of a novel questionnaire documenting the burden of xerostomia and sialadenitis symptoms, including quality of life. Second, to compare two versions regarding the answering scale (proposed developed answers Q3 vs. 0-10 visual analogue scale Q10) of our newly developed questionnaire, in order to evaluate their comprehension by patients and their reproducibility in time. STUDY DESIGN: The study is a systematic review regarding the evaluation of the existing questionnaire and a cohort study regarding the validation of our new MSGS questionnaire. MATERIALS AND METHODS: A Multidisciplinary Salivary Gland Society (MSGS) questionnaire consisting of 20 questions and two scoring systems was developed to quantify symptoms of dry mouth and sialadenitis. Validation of the questionnaire was carried out on 199 patients with salivary pathologies (digestive, nasal, or age-related xerostomia, post radiation therapy, post radioiodine therapy, Sjögren's syndrome, IgG4 disease, recurrent juvenile parotitis, stones, and strictures) and a control group of 66 healthy volunteers. The coherence of the questionnaire's items, its reliability to distinguish patients from healthy volunteers, its comparison with unstimulated sialometry, and the time to fill both versions were assessed. RESULTS: The novel MSGS questionnaire showed good internal coherence of the items, indicating its pertinence: the scale reliability coefficients amounted to a Cronbach's alpha of 0.92 for Q10 and 0.90 for Q3. The time to complete Q3 and Q10 amounted, respectively, to 5.23 min (±2.3 min) and 5.65 min (±2.64 min) for patients and to 3.94 min (±3.94 min) and 3.75 min (±2.11 min) for healthy volunteers. The difference between Q3 and Q10 was not significant. CONCLUSION: We present a novel self-administered questionnaire quantifying xerostomia and non-tumoral salivary gland pathologies. We recommend the use of the Q10 version, as its scale type is well known in the literature and it translation for international use will be more accurate. Laryngoscope, 132:322-331, 2022.

The RAI-6 Questionnaire: A New Screening Questionnaire to Monitor Complications of Radioiodine Treatment.

Objective: The aim of this study is to develop a simple and efficient screening questionnaire to be able to routinely monitor potential radioiodine therapy-induced complications. Materials and Methods: A new radioiodine 6 (RAI-6) questionnaire containing six questions adressing salivary, ocular, and nasal symptoms as well as quality of life was developed. Validation of the RAI-6 questionnaire was assessed with a group of fifty-four patients diagnosed with differentiated thyroid carcinoma treated post-operatively with radioiodine therapy, and in a group of fifty healthy volunteers. The patient's group was subdivided into subgroups according to the radioiodine dose received: 23 patients received less or 30 mCi, 28 patients received 100 mCi, and three patients received between 200 and 300 mCi. We asked the patients to complete the RAI-6 questionnaire in a retrospective manner, regarding their situation before radioiodine therapy and regarding their actual symptoms after radioiodine therapy. The time needed to complete the RAI-6 was also assessed both in patients and in healthy volunteers. Results: The mean post radioiodine treatment RAI-6 score were significantly higher than the mean pre radioiodine RAI-6 scores (p < 0.001) and the scores of healthy participants (p < 0.001). The mean total RAI-6 scores increased significantly with increasing radioiodine dose. A total mean RAI-6 score of each question was also analysed and revealed that ocular and nasal discomfort as well as quality of life were the items which affected the patients most after radioiodine treatment. The mean time to fill the RAI-6 questionnaire was 2 min for patients and 49 s for healthy volunteers. Conclusion: The RAI-6 represents a new questionnaire which is easy and quick to complete. This simple screening tool can be recommended for general clinical practise and further epidemiological research.

Do Postoperative Oral Corticosteroids Improve Results After Sialendoscopy for Ductal Stenosis?

OBJECTIVES: This study aims to review the effects of short- and long-term oral administration of postoperative corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis due to ductal stenosis. STUDY DESIGN: Prospective comparative study. METHODS: A prospective observational study was conducted at Manukau Surgical Center in Auckland, New Zealand, where patients undergoing sialendoscopic surgery for recurrent obstructive sialadenitis due to ductal stenoses were reviewed. Univariable and multivariable analysis, and also logistic regression were performed to identify variables correlated with the likelihood of the need for revision surgery for persistent or recurrent symptoms. RESULTS: In this study, sialendoscopy was performed in 142 patients: 162 parotid glands (86.6%) and 25 submandibular glands (13.4%). Postoperative oral steroids were prescribed for 48 patients (34%); 19 (13%) were prescribed for less than 7 days and 29 (20%) for more than 7 days. In total, 33 patients (23.2%) required a revision sialendoscopy during follow-up due to recurrence of symptoms. Oral steroids prescribed for more than 7 days after a sialendoscopy reduced the likelihood of a revision procedure by 93% when compared with patients who did not receive this medication, and by 96% when compared with patients who received steroids for less than 7 days. CONCLUSION: The results showed that in our population oral administration of corticosteroids for more than 7 days after sialendoscopy for the treatment of recurrent obstructive sialadenitis due to ductal stenosis markedly reduced the need for later revision surgery. Routine use of corticosteroids for more than 7 days is recommended after sialendoscopy in patients with ductal stenosis. LEVEL OF EVIDENCE: II Laryngoscope, 131:E1503-E1509, 2021.

Comparison of Clinical Characteristics and Magnetic Resonance Imaging of Salivary Glands With Magnetic Resonance Sialography in Sjögren's Syndrome.

OBJECTIVES/HYPOTHESIS: To compare the results of magnetic resonance imaging with magnetic resonance sialography (MRSIAL) and the clinical and laboratory characteristics in a well-characterized cohort of patients with primary or secondary Sjögren's syndrome (SS) meeting the American-European Consensus Group criteria. STUDY DESIGN: Retrospective, observational, monocentric study. METHODS: Thirty-six patients (81% female, mean age = 48 ± 35 years) with primary or secondary SS who underwent MRSIAL were included in the study. RESULTS: MRSIAL revealed characteristic radiological signs in the parotid, sublingual, and submandibular salivary glands in 35/36 patients (97%). Patients presenting with anti-Sjögren's syndrome-related antigen A (SSA) autoantibodies showed more often fatty infiltration, a "pepper-and-salt" appearance, ductal stenosis, and/or ductal dilation of the parotid gland (88%, 88%, and 72% respectively) than patients negative for anti-SSA (12%, 4%, and 28% respectively). MRSIAL demonstrated signs characteristic of SS in all 11 patients with negative minor salivary gland biopsy. For 15 patients undergoing ultrasound examination only, 11 (73%) had SS findings, but all 15 had SS findings on MRSIAL. Two cases of parotid lymphoma were detected by MRSIAL (6%). CONCLUSIONS: MRSIAL is a reliable technique to detect glandular anomalies in patients with SS, and seems to provide a valuable aid in the diagnosis of SS. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E83-E89, 2021.

Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology.

BACKGROUND: Postoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement. METHODS: A multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations. RESULTS: Consensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management. CONCLUSION: Salivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.

[ENT news 2018]. / ORL.

The articles have been again selected among more than 15 000 abstracts and the review aims to be generalist. Interest of honey in head and neck pathologies, apnea syndrome, tonsillectomy and immunotherapy. In otology, middle ear infections and mastoiditis, cochlear implant in the elderly, deafness in children, auto-evaluation of audition and new perspectives regarding ciliar cell cultures. In rhinology the interest of different treatments including Xylitol, new technologies and nasal bleeding. In laryngology and thyroid surgery, guidelines for dysphonia, the interest of ultrasound in vocal cord evaluation and relation between thyroid surgery outcomes and training. HPV will be largely discussed as well as immunotherapy, interest of cannabis in cancer patients. Regarding salivary glands sialendoscopy, rerouting of salivary ducts and multiple detection of diseases in saliva.

Les actualités thérapeutiques en ORL 2018, établies à partir de plus de 15 000 abstracts, se veulent une fois de plus généralistes. En ORL générale, les sujets seront le miel, les apnées du sommeil, l'adénotonsillectomie et l'immunothérapie. En otologie, l'otite moyenne aiguë et la mastoïdite, les nouvelles technologies, l'implant cochléaire chez le patient âgé, la surdité et l'intérêt des cultures de cellules ciliées. En rhinologie, la rhinosinusite et ses traitements dont le xylitol, l'apport de nouvelles technologies et l'épistaxis. En laryngologie et chirurgie thyroïdienne, les guidelines pour la dysphonie, l'intérêt de l'ultrason en préopératoire et les résultats en chirurgie thyroïdienne selon la formation. En chirurgie cervico-faciale, le VPH, l'immunothérapie, l'intérêt du cannabis et la possibilité de diagnostics tumoraux précoces dans la salive. En glandes salivaires, la sialendoscopie, la transposition de canaux salivaires et la détection de maladies à l'aide de biomarqueurs dans la salive.

[Novelties in ENT - 2017]. / ORL.

Rhinology : balloon sinuplasty and its potential commercial links ; factors of recurrence of sinunasal polyposis ; olfactory dysfunction and biofilms. Otology : effect of music and headphones on children ; vaccination and otitis media. Pharyngo-laryngology : interest of DISE (Drug Induce Sleep Endoscopy) in case of Sleep Apnea Syndrome; adenotonsillectomy and interest of robotic surgery.Salivary glands : presence of Helicobacter pylori in buccal cavity ; pepsin testing in saliva in case of reflux ; antibacterial effect of xylitol ; interest of propolis in treating candidosis. Thyroid : incidence and screening.

Rhinologie : intérêt de la sinuplastie au ballon et potentielles dérives commerciales ; facteurs de récidives de polypose naso-sinusienne ; biofilms et sinusite chronique. Otologie : effets de la musique et des écouteurs sur l'audition ; vaccination et otite moyenne. Pharyngo-laryngologie : intérêt de l'endoscopie sous sédation et apnées ; intérêt du robot. Glandes salivaires : Helicobacter dans la cavité buccale ; dosage de la pepsine salivaire en cas reflux ; effet bactéricide du xylitol et antimycotique de la propolis. Thyroïde : incidence et screening du cancer thyroïdien.

[Novelties in ENT - 2016]. / ORL.

These novelties in ENT were selected among more than 15'000 abstracts in the 2016 literature, and dedicated to the practioner Guidelines of the American Academy of ORL will resume the attitude towards chronic otitis media, and reviews of hearing impairment and tinnitus are presented, as well as impact of the pneumoccal vaccine on otitis media. In rhinology, the flora of chronic rhinosinusitis and its non surgical treatments will be discussed, as well as epistaxis and malignant tumor series. 17 Diseases dignanosed only with exhaled air will be also reported. The importance of HPV in head and neck cancer will be again discussed, with the increasing incidence of oropharyngeal cancer. Peritonsillar abcesses, and indications for tonsillectomy, as well as progresses in salivary glands, including sialendoscopy will be finaly presented.

Les actualités thérapeutiques ORL 2016 sont, comme à l'accoutumée, établies à partir de la revue de plus de 15 000 abstracts parus pendant l'année, à l'attention du pratitien. En otologie, la prise en charge de l'otite moyenne chronique, l'impact du vaccin antipneumococcique sur l'otite, la malentendance et le tinnitus seront abordés. En rhinologie, la rhinosinusite chronique, allergique ou aiguë et leurs traitements, l'épistaxis et l'importance diagnostique des tumeurs malignes du nez et des sinus seront abordés. Une étude remarquable évoquant de nouvelles perspectives diagnostiques à partir de l'air exhalé a également été retenue. En chirurgie cervico-faciale, une revue des indications à tonsillectomies, les abcès péri-amygdaliens, les tumeurs ORL liées au HPV, et les glandes salivaires complèteront cette sélection non exhaustive.

Sialendoscopy: what is it and what is its awareness?

In expanding the scope of sialendoscopy across the globe and assessing the impact of training activities at the European Sialendoscopy Training Centre, this study was conducted to find out the knowledge and attitude among respondents as well as identify potential obstacles to the initiation of the procedure. Delegates attending the 2011 International Federation of Otorhinolaryngological Societies meeting received a set of five questions. There were a total of 257 responses from 57 countries. Nearly all (238/257) were practising in the academic setting. A significant number of respondents had heard about sialendoscopy (231/257). An equal number found it interesting and were keen to learn more about the procedure (233/257). More than 85 % (219/257) respondents expressed their desire to start sialendoscopy. Hurdles to overcome included financial limitations (110) and "not enough knowledge" (100). Awareness about the existence of the procedure was rather high although the knowledge was limited. Several of the responders seemed keen on starting it, but had not done so due to financial limitations. However, there was a high rate of bias owing to the limited number of responders per country precluding a country-wise inference of awareness. Moreover, meetings of this nature tend to be attended by academics who in general seem to be more aware of new developments than their non-academic peers. Future surveys can address these issues as part of ensuring the universal adoption of sialendoscopy.

The use of sialendoscopy for the treatment of multiple salivary gland stones.

OBJECTIVE: The purpose of this study is to document our experience with sialendoscopy for the treatment of multiple calculi of the salivary ducts, as well as to discuss the technique and indications for the procedure. PATIENTS AND METHODS: In this retrospective non-interventional study, 530 consecutive cases of sialolithiasis were investigated, and the cases with multiple calculi were selected for further analysis. These selected cases were analyzed from clinical and surgical aspects. RESULTS: Multiple calculi were detected in 37 of 530 consecutive investigated sialolithiasis cases. The gender distribution was 15 men and 22 women, with a mean age of 40.4 years. Among these patients, the submandibular gland was affected in 33 cases (right in 13 and left in 20) and the parotid gland was affected in 4 cases (right in 3 and left in 1). As for complications, 1 patient had a postoperative infection and 2 other patients had postoperative ranulas that were considered minor complications. Among all 37 cases, we had 3 cases in which preoperative imaging (sonography in 1 and radiography in 2) showed a single sialolith in the duct, but failed to show further sialoliths that were discovered later by sialendoscopy. CONCLUSIONS: The use of sialendoscopy allows a better diagnosis and minimally invasive treatment for multiple calculi. Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision or surgical removal of the gland even in cases with multiple calculi. Sialendoscopy allows exploration of the ductal system in detail. This technique helps to discover additional stones in the ductal system that could not have been identified with the conventional imaging modalities available.

How reliable is sonography in the assessment of sialolithiasis?

OBJECTIVE: The purpose of this study was to determine the value of sonography for the diagnosis of salivary gland calculi. SUBJECTS AND METHODS: In this study, 82 salivary glands in 79 consecutively registered patients with acute or recurrent parotid or submandibular gland swelling were examined with 7.5-12 MHz linear probes. All sonographic examinations were performed by two experienced radiologists without knowledge of the final diagnosis. The reference standard was digital sialography and sialendoscopy with or without surgery for 54 salivary glands and digital sialography alone for 28 glands. RESULTS: Sialolithiasis was present in 44 glands and was absent in 38 glands as confirmed by the final diagnosis. The overall sensitivity, specificity, accuracy, and positive and negative predictive values of sonography in the detection of calculi were 77%, 95%, 85%, 94%, and 78%, respectively. False-negative sonographic findings were associated with calculi with a diameter less than 3 mm in nondilated or dilated salivary ducts; most calculi with a diameter of 3 mm or greater were correctly identified. False-positive findings were caused by ductal stenosis with wall fibrosis, which was erroneously interpreted as lithiasis. CONCLUSION: Because of its limited sensitivity and limited negative predictive value, sonography does not allow reliable exclusion of small salivary gland calculi. Therefore, further diagnostic investigations are recommended to detect calculi in patients with normal sonographic findings and suspected lithiasis.

[Otorhinolaryngology]. / ORL.

This review is again focussing on novelties in ENT in 2010 for our non ENT colleagues, as we removed on purpose technical and hyperspecialised topics. Interesting subjects include the increasing role of Helicobacter pylori, the epidemiology of otitis media and the efficiency of topical treatment, an MRSA review in US children, the impaired nasal permeability in smokers, the contamination of the "nose bottle" in case of sinusitis, new technologies in adjuvant cancer treatment, and the prevalence of HPV positive tumors, having a better prognosis, and the importance of follow-up, ENT tumor patients being at risk for recurrences. Other subjects will also be covered.

Sialoendoscopia: relato dos dois primeiros casos tratados no Brasil, no Hospital Israelita Albert Einstein / Sialoendoscopy: report of the first two cases treated in Brazil, at Albert Einstein Jewish Hospital

Introdução: A sialoendoscopia é um procedimento endoscópico realizado nas glândulas salivares maiores submandibular e parótida, com finalidade diagnóstica e, principalmente, terapêutica. Desenvolvida pelo Prof. Francis Marchal, no final da década de 1990, passou a ser utilizada em diversos países da Europa, da América do Norte e da Ásia. Método: Este é um relato dos dois primeiros pacientes com doença inflamatória calculosa das glândulas salivares maiores submetidos à sialoendoscopia no Brasil, no Hospital Israelita Albert Einstein. Relatos dos Casos: Caso 1 - Paciente do sexo masculino, com 37 anos, com quadro de sialoadenite recidivante de glândula submandibular esquerda, após tentativa malsucedida de papilotomia do ducto de Wharton para retirada do cálculo; Caso 2 - Paciente do sexo masculino, com 57 anos, com sialoadenite calculosa obstrutiva de glândula parótida direita, persistente após parotidectomia subtotal. Em ambos os casos, o diagnóstico de cálculo salivar foi confirmado, seguindo-se a retirada bem sucedida com o uso de um ?basket? acoplado ao sialoendoscópio. O primeiro doente teve alta no mesmo dia e o segundo, no dia seguinte, com resolução completa dos sintomas. Conclusão: Neste relato preliminar, a experiência inicial com estes dois casos operados em nossa Instituição é encorajadora, especialmente no segundo paciente, que havia sido submetido a uma tentativa infrutífera de resolução de seu quadro obstrutivo através de uma parotidectomia convencional. Este procedimento, minimamente invasivo, oferece uma nova opção para a abordagem de doenças não-neoplásicas das glândulas salivar maiores, com baixíssima morbidade operatória e bons resultados funcionais imediatos, com preservação das glândulas afetadas.

Background: Sialoendoscopy is an endoscopic procedure performed in the major salivary glands submandibular and parotid, with diagnostic as well as therapeutic intent. It wasdescribed by Prof. Francis Marchal, at the end of the 1990´s, and was used in several countries of Europe, North America and Asia since thereafter. Method: This is a report of the two first cases with sialolithiasis of the major salivary glands submitted to sialoendoscopy in Brazil, at Albert Einstein Jewish Hospital. Case Reports: Case 1 - 37 year-old male, with recurrent sialolithiasis of the left submandibular gland, after unsuccessful attempt to extract the Stone with a papilotomy of the Wharton?s duct; Case 2 - 57 yearold male, with obstructive sialolithiasis of the right parotid gland, persistent even after a subtotal parotidectomy. In both cases, the diagnosis of sialolithiasis was confirmed by sialoendoscopy, with a subsequent successful endoscopic extraction of the Stones with baskets. The first patient was discharged on the same day of the procedure, whereas the second patient was discharged on the first postoperative Day, with complete resolution of their symptoms. Conclusion: In this preliminary report, the initial experience with these two cases operated on at our Institution is encouraging, especially regarding the second patient, who was previously submitted to a failed attempt to cure his disease with a conventional parotidectomy. This procedure, which is minimally invasive, offers a new option for the management of non-neoplastic diseases of the major salivary glands, with very low morbidity and very good initial results, with preservation of the affected glands.

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.

New era of Endoscopic Approach for Sialolithiasis: Sialendoscopy.

Sialendoscopy is one of the innovations introduced in the last few years in the field of otolaryngology, head and neck surgery. Sialolithiasis and sialadenitis are two of the most frequently presenting disorders of the salivary glands. The diagnosis is most frequently confirmed by radiology and the treatment of sialolithiasis ranges from the use of surgery, intra-oral extraction or external lithotripsy, to the more frequent external excision of the gland. Sialendoscopy uses minimal invasive surgical techniques which allows for optical exploration of the salivary ductal system and extraction of the stones by a basket under endoscopic view. Sialendoscopy incorporates diagnostic with therapeutic procedures, as dictated by the clinical findings. This technique can be performed in most cases as an ambulatory, outpatient procedure under local anaesthesia.