[Learning curve in sialendoscopy: Our first 101 procedures]. / Courbe d'apprentissage en sialendoscopie : nos 101 premières procédures.

ABSTRACT

OBJECTIVE: To present our learning curve in diagnostic and interventional sialendoscopy for obstructive salivary diseases. MATERIALS AND METHODS: Monocentric descriptive retrospective study from March 2009 to July 2011. Clinical and demographic data were collected. We are particularly interested in arising technical issues, the use of combined approach, operative time, functional improvement as well as parameter changes over time. RESULTS: 92 operations were performed to explore 101 glands (63 parotid glands against 38 submandibular). We found 39.6% of stones and as many stenosis. The rate of complete stone removal was 65% and dilation was effective in 75% of stenosis. The median of the visual analog scale for pain was 1/10 and functional improvement was effective in 77%. The removal of the gland did not exceed 3.3%. No major complication was noted. Since the initiation of this activity, the median operative time was steady while procedures were more complex, with increased interventional sialendoscopy procedure often requiring combined approach. In about 25% of cases, we have been faced with technical issues. These have evolved over time initially failure to enter the papilla, difficulty of removing large stones today. CONCLUSION: The learning curve in sialendoscopy allows rapid empowerment and acquisition of expertise in security. Mastery of this technique allows for innovative approaches, complementary to conventional procedure, without compromising neither the operative time nor the functional benefit.