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Sialendoscopic Approach

Stephanie Quenin, MD; Isabelle Plouin-Gaudon, MD; Francis Marchal, MD; Patrick Froehlich, MD, PhD; Francois Disant, MD, PhD; Frederic Faure, MD

Arch Otolaryngol Head Neck Surg. 2008;134(7):715-719.

Objective  To assess the relevance of sialendoscopy as a diagnostic and interventional procedure in juvenile recurrent parotitis (JRP).

Design  Prospective case series study.

Setting  Tertiary care teaching hospital.

Patients  Sialendoscopy was used to examine 10 children (age range, 1.8-13.0 years) with symptomatic JRP for recurrent swelling of the parotid glands between January 2003 and January 2005. Diagnostic sialendoscopy allowed classification of ductal lesions, and interventional sialendoscopy was used to treat the lesions. Initial data analyzed included the type of endoscope used as well as the size and form of the main duct of the parotid gland. Outcome variables were resolution of symptoms and endoscopic enlargement of the ductal tree.

Results  Initial ultrasound evaluation of the diseased gland revealed a white Stensen duct without the natural proliferation of blood vessels in all 10 cases. This finding was associated with a true stenosis of the Stensen duct. Two cases of suspected stones according to ultrasonography were subsequently diagnosed as localized stenoses. The sialendoscope was used to dilate the duct with pressurized saline solution in all cases as well as to dilate the 2 cases of stenoses. There were no major complications. The average length of follow-up was 11 months (range, 2-24 months). Seventeen parotid glands were dilated in all 10 patients, with a success rate of 89%. One patient needed repeated sialendoscopies for recurrent symptoms. Two patients presented with a second episode of JRP contralateral to the side initially treated.

Conclusions  Diagnostic sialendoscopy is a new procedure that can be used in children for reliable evaluation of salivary ductal disorders, with low morbidity. Sialendoscopic dilation of the main parotid ducts appears to be a safe and effective method for treating JRP.

Author Affiliations: Edouard Herriot University Hospital, Lyon, France (Drs Quenin, Plouin-Gaudon, Froehlich, Disant, and Faure); and Geneva University Hospital, Geneva, Switzerland (Dr Marchal).