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1.
J Otolaryngol Head Neck Surg ; 52(1): 53, 2023 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-37598195

RESUMO

BACKGROUND: Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling in children. The purpose of this systematic review was to determine the diagnostic and therapeutic effectiveness of sialendoscopy in children affected by JRP. METHODS: A systematic literature search was performed in PubMed, EMBASE, Scopus and the Cochrane Library until April 2022, without language restrictions or specified start date. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS). RESULTS: Our review included 524 patients and 646 sialendoscopies. The sample sizes of the different studies ranged from 3 to 77 subjects. Most authors performed sialendoscopy under general anesthesia. The mean percentage of recurrences observed was 25.1% (95% confidence intervals) (CI 23.6-26.6). There was a statistically significant relationship between the number of attacks/year and recurrences (p < 0.05). The percentage of recurrences according to the type of irrigation/flushing used ranged from 22.2% to 25.2%, with no significant differences between the use of corticosteroids alone (25.2% of recurrences), corticosteroids plus antibiotics (25% of recurrences) or saline alone (22.2% of recurrences). Sialoendoscopy has proved in all cases to be a valid method for the diagnosis of JRP, but it does not allow a reliable differential diagnosis with other autoimmune parotitis such as Sjögren's syndrome. CONCLUSION: According to our results, parotid sialoendoscopy was 74.9% effective as a primary treatment in the prevention of recurrent symptoms in JRP. The type of ductal irrigation used did not significantly influence the prognostic outcome.


Assuntos
Parotidite , Criança , Humanos , Parotidite/diagnóstico , Parotidite/cirurgia , Glândula Parótida , Anestesia Geral , Recidiva
2.
Laryngoscope ; 133(6): 1495-1500, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37158262

RESUMO

OBJECTIVES: To investigate long-term outcomes, imaging, and pathologic findings in pediatric patients who underwent superficial parotidectomy for recalcitrant juvenile recurrent parotitis (JRP). METHODS: Records for 20 children (23 parotidectomies; 9 females, 11 males; age at surgery of 8.6 ± 3.7 years) collected over a 10-year period (2012-2021) were reviewed. Parents were contacted via telephone to obtain extended follow-up. A simplified scoring system was used to assess imaging findings and an additional pathologic review was conducted to further clarify the underlying disease process. RESULTS: All but one patient experienced resolution of their recurrent symptoms after superficial parotidectomy. Three of the patients studied required surgery on the contralateral side, and this could be predicted based on their imaging at the time of the initial surgery. Pathologic findings included ductal fibrosis, metaplasia, and dilatation as well as parenchymal atrophy and fatty deposition. There were no major surgical complications, however, the incidence of Frey's syndrome in this sample was 43.5% of surgical sites. CONCLUSION: For patients with frequent recalcitrant symptoms or significant quality of life impairment related to JRP, superficial parotidectomy represents a potential treatment option with the noted reduction in symptom burden following surgery. Further longitudinal studies are needed. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:1495-1500, 2023.


Assuntos
Parotidite , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Glândula Parótida/cirurgia , Parotidite/cirurgia , Qualidade de Vida , Estudos Retrospectivos
3.
J Stomatol Oral Maxillofac Surg ; 124(1S): 101355, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36513275

RESUMO

We report the case of a 75-year-old diabetic man who developed a bilateral abscess of the parotid gland. Although a bacterial parotitis was first suspected, cultures of fine-needle aspiration identified Candida albicans as the causal agent. Failure of medical treatment led us to perform a surgical drainage of the right abscess. The patient was then treated with oral fluconazole for 6 weeks, with complete recovery during follow-up. Of interest, the patient had a history of right superficial parotidectomy for a benign tumor 30 years ago. Despite the high prevalence of oral carriage, fungal abscesses of the parotid gland are extremely rare and have only been reported in a few cases. This might be due to the fungal toxicity of the salivary proteins, like histatins. To our knowledge, this is the first report of a Candida albicans abscess of the parotid gland developed bilaterally.


Assuntos
Glândula Parótida , Parotidite , Masculino , Humanos , Idoso , Glândula Parótida/cirurgia , Abscesso/diagnóstico , Parotidite/diagnóstico , Parotidite/microbiologia , Parotidite/cirurgia
4.
Am J Otolaryngol ; 43(3): 103398, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35256205

RESUMO

OBJECTIVE: To study whether irrigating the parotid gland with saline solution through the parotid duct reduces the number of inflammatory episodes in patients with juvenile recurrent parotitis (JRP) over a 1-year period. METHODS: This was a retrospective cohort study using the electronic clinical history data of patients with JRP that were treated with parotid irrigation under general anaesthesia at the Paediatric Surgery units of Consorci Sanitari Alt Penedès-Garraf and Hospital Universitari Mútua de Terrassa. The number of inflammation episodes in the year before and the year after treatment was analysed. RESULTS: A total of 15 patients with JRP were evaluated, of whom 10 met the criteria for irrigation. Data from 9 patients were available. The procedure was performed without incident in all of the patients. There was no difficulty with probing the duct and no need for orifice dilation. No post-lavage complications were observed. Four patients had complete resolution of inflammation events (44.4%), and the remaining 5 patients had a decrease in the number of events. The Wilcoxon signed-rank test showed a statistically significant difference between the number of inflammation events before and after the intervention (p = 0.009). CONCLUSIONS: Parotid irrigation with saline solution could be a safe and effective first-line technique for the treatment of JRP. LEVEL-OF-EVIDENCE: IV.


Assuntos
Parotidite , Criança , Humanos , Inflamação , Glândula Parótida , Parotidite/cirurgia , Recidiva , Estudos Retrospectivos , Solução Salina , Irrigação Terapêutica
5.
Ann Otol Rhinol Laryngol ; 130(9): 1036-1043, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33554618

RESUMO

BACKGROUND: Frey's syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. METHODS: We conducted a 20-year retrospective study including the patients who had undergone "formal" (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. RESULTS: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey's syndrome was found after the use of dermal collagen interpositional barrier (P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor's test was positive at an incidence of 59.09% in Group A and 21.87% in Group B (P = .004, 95% CI). Severe Frey's syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B (P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey's syndrome in the compared groups. CONCLUSION: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey's syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.


Assuntos
Colágeno/uso terapêutico , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Doenças Parotídeas/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Sudorese Gustativa/prevenção & controle , Adenolinfoma/cirurgia , Adenoma/cirurgia , Adenoma Pleomorfo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/cirurgia , Parotidite/cirurgia , Estudos Retrospectivos , Sialadenite/cirurgia , Teratoma/cirurgia , Adulto Jovem
6.
Laryngoscope ; 131(6): 1404-1409, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33098313

RESUMO

OBJECTIVE/HYPOTHESIS: Current literature has confirmed the benefits of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). However, this procedure is often performed unilaterally, although the disease can affect both sides. This article investigated the clinical course of the contralateral parotid (CL) gland in children requiring unilateral sialendoscopy with the goal of clarifying the necessity of primary bilateral sialendoscopy. STUDY DESIGN: Prospective cohort study in a tertiary center. METHODS: Over an eight-year period, 77 children with JRP underwent unilateral sialendoscopy. We observed the clinical course of the CL parotid over a minimum follow-up period of 24 months. New episodes of sialadenitis were recorded on both sides along with the need for a second sialendoscopy. These data were correlated with the preoperative symptoms of the contralateral side as well as ultrasound (U/S) findings at baseline assessment. RESULTS: In total, six children required sialendoscopy on the CL side (7.8%), 62 children remained asymptomatic or with scarce swellings (80.5%), and nine children improved (11.7%). The preoperative U/S findings on the CL side positively correlated with the number of postoperative swellings. The proportion of children needing CL sialendoscopy was higher (21.4%) among children needing a second sialendoscopy on the operated side. CONCLUSIONS: In the long term, the vast majority of children needing unilateral sialendoscopy do not require similar treatment of the CL parotid gland. However, a history of bilateral swellings along with U/S findings of parenchymal disorganization on the CL side significantly increases the risk of needing further sialendoscopy at a later time. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1404-1409, 2021.


Assuntos
Endoscopia/métodos , Glândula Parótida/cirurgia , Parotidite/cirurgia , Reoperação/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Glândula Parótida/diagnóstico por imagem , Parotidite/diagnóstico por imagem , Estudos Prospectivos , Sialografia/métodos , Resultado do Tratamento , Ultrassonografia/métodos
7.
S Afr J Surg ; 58(1): 45, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32243117

RESUMO

SUMMARY: A 36-year-old patient presented with an 18-month history of intermittent right parotid swelling accompanied by otorrhoea. The symptoms started subsequent to a palm leaf injury to the right ear. At right parotidectomy, a fistula connecting the right external auditory canal and the right parotid was demonstrated. A small fibrotic mass probably due to a remnant of the palm leaf was found intraoperatively. The symptoms resolved completely after the mass was excised by superficial parotidectomy, and the fistula closed spontaneously.


Assuntos
Otopatias/cirurgia , Edema/etiologia , Fístula/cirurgia , Traumatismos Ocupacionais/complicações , Parotidite/cirurgia , Adulto , Orelha/lesões , Otopatias/etiologia , Edema/cirurgia , Fístula/etiologia , Humanos , Masculino , Parotidite/etiologia
8.
Int J Pediatr Otorhinolaryngol ; 124: 179-184, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31202035

RESUMO

INTRODUCTION: Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling, generally associated with non-obstructive sialectasia of the parotid gland. The aim of this study was to evaluate the diagnostic and therapeutic effectiveness of sialography in children affected by JRP. METHODS: Clinical records of 110 outpatients with a diagnosis of JRP followed up from 2008 to 2017 at the Unit of Paediatric Otorhinolaryngology, Surgery Department of the Bambino Gesù Children's Hospital of Rome, were retrospectively reviewed. Data on demographics, number of acute episodes/year, course of disease, site of symptoms and duration of follow up were collected. The inclusion criteria were: at least two or more episodes of intermittent swelling of the parotid glands on one side or both sides during the last 6 months, age <16 years. Exclusion criteria were: obstructive lesions, dental malocclusion, Sjogren syndrome, congenital IgA immunodeficiency, and relevant systemic diseases. Outcome of the procedure was measured by evaluating number and degree of episodes of parotid swelling before and after sialography. RESULTS: Sialography has been shown in all cases to be a valid method in the diagnosis of JRP. Following the execution of the sialography, in 98 patients (89% of cases) there was a statistically significant improvement of disease with a mean reduction of 67.4% of episodes of parotid swelling (p < 0.05). In 75 patients there was marked improvement of the symptomatology (p < 0.05). In 23 patients partial resolution occurred (p < 0.05); in 12 patients there was no resolution or a reduction less than 30% of episodes (p > 0.05). There was a statistically significant relationship between the number of attacks/year and the degree of glandular function, pre and post-sialography in 2-way ANOVA test (p < 0.05). CONCLUSION: Sialography is effective method not only as a diagnostic procedure but also as a therapeutic procedure in treatment of JRP. It is a method that can be carried out in ambulatory setting, without anaesthesia, with a minimum cost and with a very low rate of complications. In a disease with tendency to spontaneous resolution like JRP, sialography represent a therapeutic option alternative to more invasive treatment.


Assuntos
Parotidite/diagnóstico por imagem , Parotidite/cirurgia , Sialografia , Criança , Pré-Escolar , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Estudos Retrospectivos
9.
Int. arch. otorhinolaryngol. (Impr.) ; 23(1): 83-87, Jan.-Mar. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1002182

RESUMO

Abstract Introduction chronic parotitis (CP) is a hindering, recurring inflammatory ailment that eventually leads to the destruction of the parotid gland. When conservative measures and sialendoscopy fail, parotidectomy can be indicated. Objective to evaluate the efficacy and safety of parotidectomy as a treatment for CP unresponsive to conservative therapy, and to compare superficial and near-total parotidectomy (SP and NTP). Methods retrospective consecutive case series of patients who underwent parotidectomy for CP between January 1999 and May 2012. The primary outcome variables were recurrence, patient contentment, transient and permanent facial nerve palsy and Frey syndrome. The categorical variables were analyzed using the two-sided Fisher exact test. Alongside, an elaborate review of the current literature was conducted. Results a total of 46 parotidectomies were performed on 37 patients with CP. Neartotal parotidectomy was performed in 41 and SP in 5 cases. Eighty-four percent of patients was available for the telephone questionnaire (31 patients, 40 parotidectomies) with a mean follow-up period of 6,2 years. Treatment was successful in 40/46 parotidectomies (87%) and 95% of the patients were content with the result. The incidence of permanent and transient facial nerve palsy was 0 (0%) and 12 (26.1%), respectively. Frey syndrome manifested in 20 (43.5%) patients. Neither this study nor careful review of the current literature resulted in evident difference between SP and NTP regarding the primary outcome variables. Conclusion parotidectomy is a safe and effective treatment for CP in case conservative therapy fails. There is no evidence of a distinct difference between SP and NTP regarding efficiency, facial nerve palsy or Frey syndrome. (AU)


Assuntos
Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Parotidite/cirurgia , Glândula Parótida/cirurgia , Glândula Parótida/fisiopatologia , Parotidite/fisiopatologia , Sialadenite/cirurgia , Sialadenite/fisiopatologia , Procedimentos Cirúrgicos Otorrinolaringológicos , Doença Crônica , Resultado do Tratamento
10.
Stomatologiia (Mosk) ; 97(2): 49-51, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29795107

RESUMO

The authors with the goal of postoperative dynamic control over the results of surgical treatment of patients previously operated for salivary stone disease and various ducts deformations of the parotid salivary glands examined 16 patients with an observation period up to 8 years. It was found that recurrent acute parotitis or recurrence of stone formation was observed in 100% of cases. The authors developed methods of surgical treatment leads to long-term clinical success with no recurrence of the disease.


Assuntos
Glândula Parótida , Parotidite , Cálculos das Glândulas Salivares , Humanos , Glândula Parótida/patologia , Glândula Parótida/cirurgia , Parotidite/cirurgia , Recidiva , Ductos Salivares , Cálculos das Glândulas Salivares/cirurgia , Glândulas Salivares
11.
Int J Pediatr Otorhinolaryngol ; 105: 163-166, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29447807

RESUMO

OBJECTIVE: To evaluate the role of sialoendoscopy associated with steroid irrigation for juvenile recurrent parotitis (JRP) at a tertiary referral hospital. METHODS: Clinical records of patients affected by JRP and treated with operative sialoendoscopy between June 2011 and April 2017 were retrospectively reviewed. Data on demographics, number of acute episodes per year before and after surgery, characteristics of the surgical procedure, hospitalization time, and rate of complications were collected. The outcome of the procedure was measured by comparing the number of episodes of parotid swelling before and after salivary endoscopic treatment. RESULTS: Twenty-three patients for a total of 34 operative sialoendoscopies were included in the study. Before the surgical endoscopic procedure, the mean number of parotid swelling was 10 episodes per year. At sialoendoscopy, typical endoscopic findings such as mucous plugs, stenosis of the duct, intraductal debris, and pale ductal appearance were evident. All patients were discharged on the first postoperative day. A significant decrease in the number of swelling episodes per year was observed compared to the preoperative rate (p = .0004). Complete resolution of the disorder was obtained in 35% of patients. CONCLUSIONS: Operative sialoendoscopy with steroid irrigation can be considered a valid therapeutic treatment for JRP. The technique is conservative, effective, safe, and, potentially repeatable. Short hospitalization time, rapid recovery, absence of peri-operative complications, and a high rate of good outcomes are the main advantages of this treatment.


Assuntos
Endoscopia/métodos , Parotidite/cirurgia , Ductos Salivares/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Estudos Retrospectivos
12.
Auris Nasus Larynx ; 45(4): 880-884, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29217121

RESUMO

Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjögren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen's duct stenosis and may similarly have limitation in the treatment of Sjögren's syndrome and recurrent parotitis.


Assuntos
Edema/cirurgia , Doenças Parotídeas/cirurgia , Glândula Parótida/cirurgia , Cálculos das Glândulas Salivares/cirurgia , Adulto , Idoso , Constrição Patológica , Edema/diagnóstico por imagem , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Doenças Parotídeas/diagnóstico por imagem , Glândula Parótida/diagnóstico por imagem , Parotidite/diagnóstico , Parotidite/cirurgia , Estudos Retrospectivos , Ductos Salivares/diagnóstico por imagem , Ductos Salivares/cirurgia , Cálculos das Glândulas Salivares/diagnóstico por imagem , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
13.
Eur Ann Otorhinolaryngol Head Neck Dis ; 134(6): 405-407, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28669808

RESUMO

Juvenile recurrent parotitis (JRP) is a rare disease of childhood occurring between the ages of 3 and 5 years, characterized by recurrent non-suppurative parotitis, spontaneously evolving towards parotid gland dysfunction. Clinically, JRP presents in the form of unilateral or bilateral, usually asynchronous, swelling of the parotid gland. The diagnosis is based on ultrasound characteristics. Widespread use of sialendoscopy has opened up new prospects for the management of this disease. This review of the literature evaluates the role of sialendoscopy in the management of JRP. A Medline search retrieved 68 articles, 18 of which concerned JRP. Standard treatment consists of antibiotics for at least 10 days at the acute phase of the disease. All studies demonstrated the diagnostic value of sialendoscopy by visualizing strictures, hypovascularization and whitish intraductal debris. Sialendoscopy is also useful for treatment, by allowing intraductal lavage and, when possible, dilatation of strictures. Lavage is performed with saline solution, hydrocortisone, antibiotics or a combination of these solutions, with no significant differences in terms of efficacy. The mode of administration with or without sialendoscopy also appears to provide similar results. Sialendoscopy appears to be a diagnostic and therapeutic option, although it has not been shown to be more effective than simple lavage. All lavage solutions appear to be effective.


Assuntos
Endoscópios , Endoscopia do Sistema Digestório , Parotidite/diagnóstico por imagem , Parotidite/cirurgia , Satisfação do Paciente , Endoscopia do Sistema Digestório/instrumentação , Endoscopia do Sistema Digestório/métodos , Medicina Baseada em Evidências , Humanos , Resultado do Tratamento
15.
Int J Oral Maxillofac Surg ; 46(7): 877-882, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28279602

RESUMO

Chronic obstructive parotitis (COP) is a common disease of the parotid gland. A total of 104 patients with COP were identified and randomized into a treatment group (52 cases) and a control group (52 cases). All patients underwent sialography and salivary gland scintigraphy (SGS) examinations before surgery. The patients in the treatment group received chymotrypsin combined with gentamicin via interventional sialendoscopy to irrigate the duct, and the control group received gentamicin alone. All patients were asked to record their pain on a visual analogue scale (VAS) before treatment and at 1 week, 2 weeks, 1 month, 3 months, and 6 months after surgery. The VAS score for pain intensity was decreased at 1 week post-treatment in both groups (P<0.05). Compared to the control group, the VAS score was lower in the treatment group at 1 week, 2 weeks, and 1 month post-treatment (P<0.05). The 6-month postoperative SGS results showed improved uptake and excretion in both groups (P<0.05). The treatment group exhibited higher scores for postoperative SGS excretion than the control group (P<0.05). The administration of chymotrypsin combined with gentamicin by sialendoscopy is effective for the treatment of non-stone-related COP and specifically improves the excretion function of the parotid gland.


Assuntos
Antibacterianos/uso terapêutico , Quimotripsina/uso terapêutico , Endoscopia/métodos , Gentamicinas/uso terapêutico , Parotidite/cirurgia , Adulto , Idoso , Doença Crônica , Terapia Combinada , Humanos , Pessoa de Meia-Idade , Medição da Dor , Parotidite/diagnóstico por imagem , Sialografia , Resultado do Tratamento
16.
Artigo em Inglês | MEDLINE | ID: mdl-28049607

RESUMO

OBJECTIVES: Chronic obstructive parotitis related to Sjogren syndrome is not uncommon, but it is rarely reported in the literature. The aim of this study was to describe our experience in the treatment of chronic obstructive parotitis related to Sjogren syndrome. STUDY DESIGN: Seventeen cases of chronic obstructive parotitis related to Sjogren syndrome treated with sialendoscopy from June 2014 to June 2015 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, were retrospectively reviewed. The cohort underwent ultrasonography, salivary gland scintigraphy, and sialography before sialendoscopy. All patients were asked to complete a visual analogue scale (VAS) evaluation before and 6 months after surgery. A paired t test was conducted, and P < .05 was considered statistically significant. RESULTS: The 17 study patients (27 parotid glands) successfully underwent interventional sialendoscopy under local anesthesia. The mean preoperative VAS score was 6, and the mean VAS score 6 months after sialendoscopy was significantly lower at 4.5 (P < .05). CONCLUSIONS: Interventional sialendoscopy plays a significant role in the treatment of chronic obstructive parotitis related to Sjogren syndrome.


Assuntos
Endoscopia/métodos , Parotidite/etiologia , Parotidite/cirurgia , Síndrome de Sjogren/complicações , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Parotidite/diagnóstico por imagem , Estudos Retrospectivos , Sialografia , Síndrome de Sjogren/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia
17.
Laryngoscope ; 127(7): 1565-1570, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-27861944

RESUMO

OBJECTIVES/HYPOTHESIS: To characterize clinical, imaging, and sialendoscopy findings in patients with chronic parotitis and multiple parotid calcifications. STUDY DESIGN: Retrospective review. METHODS: Clinical history, radiographic images and reports, lab tests, and operative reports were reviewed for adult patients with chronic parotitis and multiple parotid calcifications who underwent parotid sialendoscopy. RESULTS: Thirteen of 133 (10%) patients undergoing parotid sialendoscopy for chronic sialadenitis had more than one calcification in the region of the parotid gland. Seven patients (54%) were diagnosed with immune-mediated disease from autoimmune parotitis (positive Sjögren's antibodies or antinuclear antibodies) or human immunodeficiency virus (HIV) disease. The six patients (46%) who did not have an immune-mediated disorder had most calcifications located anterior or along the masseter muscle. Eight of 13 patients (61%) had at least one calculus found in the parotid duct on sialendoscopy. Four patients (38%) had multiple punctate calcifications within the parotid gland, all of whom had either autoimmune parotitis or HIV. None of the proximal or punctate parotid calcifications posterior to the masseter were visualized on sialendoscopy. CONCLUSIONS: Chronic parotitis in conjunction with multiple parotid calcifications is uncommon and was identified in 10% of our cohort. We contrast two classifications of parotid calcifications: 1) intraductal stones that cause recurrent duct obstruction and are often located within the main parotid duct along or anterior to the masseter and 2) punctate intraparenchymal parotid gland calcifications that are not visualized on sialendoscopy and may represent underlying inflammatory disease. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1565-1570, 2017.


Assuntos
Endoscopia , Parotidite/diagnóstico , Cálculos dos Ductos Salivares/diagnóstico , Adulto , Doença Crônica , Feminino , Seguimentos , Soropositividade para HIV/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Parotidite/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Cálculos dos Ductos Salivares/cirurgia , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/cirurgia , Tomografia Computadorizada por Raios X
18.
Biomed Res Int ; 2016: 1354202, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27882318

RESUMO

Sialendoscopy (SE) represents nowadays one of the standard diagnostic and therapeutic procedures in the treatment of major salivary glands lithiasis. We know from experience that it is successful only in small percentage of patients, when used in monotherapy. However, it represents an indispensable part of all of the combined minimally invasive gland-preserving treatment techniques, the success rate of which is around 90%. In this work, we focused on the role of sialendoscopy in the treatment of patients with larger inflamed fixed stones in glandula parotis. We conducted a total of 364 sialendoscopy procedures in 332 patients on our site. We have confirmed lithiasis as a cause of salivary gland obstruction in 246 (74%) patients. In 9 patients there was larger, single, or multiple inflamed fixed lithiasis of glandula parotis. In this subgroup of patients endoscopically assisted sialolithectomy from external mini-incision has become the method of choice. In 9 of the 9 (100%) cases we have achieved complete elimination of stones, and in 8 of the 9 (89%) cases we have achieved complete elimination of complaints. Sialoendoscopically assisted sialolithectomy of glandula parotis from external mini-incision has proved to be highly effective technique to eliminate stones with minimal complications.


Assuntos
Endoscopia/métodos , Glândula Parótida/cirurgia , Cálculos das Glândulas Salivares/cirurgia , Cálculos das Glândulas Salivares/terapia , Feminino , Humanos , Litíase/cirurgia , Litíase/terapia , Masculino , Pessoa de Meia-Idade , Parotidite/cirurgia , Parotidite/terapia , Estudos Prospectivos , Estudos Retrospectivos
19.
J Oral Maxillofac Surg ; 73(8): 1524-31, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25970512

RESUMO

PURPOSE: Chronic obstructive parotitis (COP) is the most common non-neoplastic salivary disorder. The aim of this study was to describe the authors' experience using sialendoscopy for diagnosing and treating COP. MATERIALS AND METHODS: Thirty-one patients with COP who were treated with sialendoscopy from January 2013 through June 2014 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University (Shenyang, China) were retrospectively reviewed. The cohort underwent ultrasonography and salivary gland scintigraphy examinations before sialendoscopy. Patients without stones underwent sialography before surgery. All patients were asked to report visual analog scale (VAS) scores before and 6 months after surgery to evaluate their condition. A paired t test was conducted and differences with a P value less than .05 were considered statistically significant. RESULTS: Thirty patients (44 parotid glands) successfully underwent interventional sialendoscopy under local anesthesia; 1 patient (1 parotid gland) received general anesthesia. The mean preoperative VAS score was 6, and the mean VAS score 6 months after sialendoscopy was 4.9. The postoperative VAS score was significantly lower than the preoperative VAS score (P < .05). CONCLUSIONS: Interventional sialendoscopy plays an important role in the treatment of COP.


Assuntos
Constrição Patológica/cirurgia , Endoscopia/métodos , Parotidite/cirurgia , Adulto , Idoso , Doença Crônica , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
J Oral Maxillofac Surg ; 73(3): 475-81, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25544300

RESUMO

PURPOSE: Chronic sialadenitis is a common complication of radioactive iodine for the treatment of thyroid disease. The aim of this study was to describe the authors' experience with interventional sialendoscopy for the management of radioiodine-induced sialadenitis. MATERIALS AND METHODS: Twelve patients with radioiodine-induced sialadenitis treated with sialendoscopy from January 2013 through December 2013 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University were retrospectively reviewed. Age, gender, and time to development of radioiodine-induced sialadenitis were obtained from the hospital database. All patients were asked to undergo visual analog scale (VAS) and salivary gland scintigraphy (SGS) examinations before and 6 months after surgery. A paired t test was conducted, and a P value less than .05 was considered statistically significant. RESULTS: Twelve patients (15 parotid glands and 4 submandibular glands) successfully underwent interventional sialendoscopy under local anesthesia. Ductal stenosis was the most common feature identified by endoscopy. Among the 12 patients, swelling occurred in 91.7%. Compared with the preoperative score of 6, the mean VAS score 6 months after sialendoscopy was 3; 15 glands (78.9%) showed improved uptake and excretion by SGS. The postoperative VAS score was significantly lower than the preoperative VAS score (P < .05), and the postoperative SGS result was significantly higher than the preoperative SGS result (P < .05). CONCLUSIONS: Interventional sialendoscopy could be an effective technique for the treatment of sialadenitis caused by radioactive iodine.


Assuntos
Endoscopia/métodos , Radioisótopos do Iodo/efeitos adversos , Compostos Radiofarmacêuticos/efeitos adversos , Sialadenite/cirurgia , Adenocarcinoma Folicular/radioterapia , Adulto , Carcinoma/radioterapia , Carcinoma Papilar , Estudos de Coortes , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Dilatação/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Parotidite/etiologia , Parotidite/cirurgia , Cintilografia , Estudos Retrospectivos , Ductos Salivares/efeitos da radiação , Ductos Salivares/cirurgia , Sialadenite/diagnóstico por imagem , Sialadenite/etiologia , Doenças da Glândula Submandibular/etiologia , Doenças da Glândula Submandibular/cirurgia , Irrigação Terapêutica/métodos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/radioterapia , Escala Visual Analógica , Adulto Jovem
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