Introducing Sialendoscopy in a Veteran Population: Effect on Benign Salivary Disease Treatment.

ABSTRACT

OBJECTIVE: To compare rates of sialadenectomy in a veteran population before and after introduction of sialendoscopy. MATERIALS AND METHODS: All Veterans Affair (VA) Northern California Healthcare System (NCHS) encounters from 2006 to 2021 for benign obstructive salivary etiologies were identified using International Classification of Disease 9/10 codes. This cohort was then cross referenced with Current Procedural Terminology codes to identify patients who underwent a procedure for their salivary pathologies. The rates of sialadenectomy and minimally invasive procedures were measured before and after sialendoscopy was introduced to the VA NCHCS in 2016. Data was obtained via chart review and demographic information, diagnosis, and procedure type were extracted. Rates of sialadenectomy, minimally invasive procedures, and other patient and procedural characteristics were compared between the Pre-Sialendoscopy Era (PSE) and Sialendoscopy Era (SE). Statistical analysis was performed using Microsoft Excel (Microsoft, version 16.66). RESULTS: An increasing number of patients per year sought care for benign obstructive salivary pathology in the SE when compared to the PSE cohort and a higher rate of female patients were treated in the SE cohort. A simultaneous reduction in sialadenectomy rates and increase in minimally invasive procedure rates was observed in the SE. Sialendoscopy represented most of the increase in minimally invasive techniques, but there was a slight increase in other procedure types. Submandibular gland obstructive pathologies required the most procedures and resulted in the most gland excisions. CONCLUSION: This retrospective review strongly suggests introducing sialendoscopy reduced the incidence of sialadenectomy for benign non-tumor obstructive pathology in this VA NCHS population. Further prospective studies are needed to evaluate this in a more generalized setting.