Sialendoscopy in Chronic Obstructive Sialadenitis Without Sialolithiasis: A Prospective Cohort Study

Area of Science:

• Otolaryngology
• Surgical Innovation
• Salivary Gland Disorders

Background:

• Chronic sialadenitis, characterized by recurrent salivary gland inflammation, significantly impacts patient quality of life.
• Sialolithiasis (salivary stones) is a common cause of sialadenitis, but non-obstructive causes also contribute to chronic symptoms.
• Conservative management for chronic sialadenitis without sialolithiasis often yields suboptimal long-term results.

Purpose of the Study:

• To compare the long-term effectiveness of sialendoscopy-assisted salivary duct surgery (SASDS) versus conservative management for chronic sialadenitis in patients without sialolithiasis.
• To evaluate changes in symptom severity and patient-reported outcomes following SASDS.

Main Methods:

• A prospective cohort study was conducted at a tertiary care center.
• Thirty-six patients with chronic sialadenitis (without sialolithiasis) were assessed using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire over one year.
• Outcomes were compared between 27 patients undergoing SASDS and 9 patients receiving conservative management.

Main Results:

• Both SASDS-treated and control groups had similar baseline COSS scores.
• At 6-12 months post-intervention, the SASDS group showed significantly lower COSS scores and a greater reduction in symptom severity compared to controls (P=.04).
• 72% of SASDS patients reported symptom resolution versus 22% of controls (P<.05).

Conclusions:

• SASDS provides superior symptom improvement and greater symptom severity reduction for chronic sialadenitis without sialolithiasis compared to conservative management.
• SASDS is associated with higher rates of significant overall symptom improvement in affected patients.
• Evaluating chronic sialadenitis requires longitudinal assessment due to the intermittent nature of obstructive symptoms.