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 treatment of large sialoliths by sialendoscopic combined approach.

PURPOSE: To investigate the advantages, disadvantages, and complications of the combined surgical technique for removing large sialoliths from the salivary glands. MATERIALS AND METHODS: This retrospective study analyzed 37 patients with obstructive sialadenitis caused by sialolithiasis who could not undergo surgery using a purely sialendoscopic technique because of the stone size or because of a tight distal stricture obstructing the passage of stone removal by an endoscope. RESULTS: Six patients had parotid gland obstruction, and the other 31 patients had submandibular gland obstruction. The calculi varied in size from 5 to 45 mm (average, 10.4 mm). Twenty-three stones were located at the hilar part of the gland or in the proximal part of the duct close to the hilum. The other 14 stones were located in the middle third of the duct. Thirty patients had no complications and were free of symptoms, with normal saliva secretion checked by milking the gland. Five patients developed minor complications that were treated under local anesthesia. Only 2 patients developed severe ductal restenosis and required further sialadenectomy. CONCLUSIONS: The combined technique showed good results for removing large sialoliths or proximally located sialoliths that could not have been removed by sialendoscopy alone. The use of an endoscope enables further exploration of the remaining duct, allowing for the removal of further sialolith and reconstruction of the duct after sialolith removal. The technique is not limited to stone size or location along the duct.

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.