Acute Sialadenitis After Skull Base Surgery: Systematic Review and Summative Practice Recommendations

Area of Science:

• Neurosurgery
• Otolaryngology
• Critical Care Medicine

Background:

• Sialadenitis is a rare but serious complication following skull base neurosurgery.
• It involves acute inflammation and edema of the submandibular gland, potentially causing airway obstruction.
• Current understanding of risk factors and management guidelines is limited.

Purpose of the Study:

• To systematically review the literature on sialadenitis after skull base neurosurgery.
• To characterize associated risk factors, treatment considerations, and patient outcomes.
• To identify trends in this rare complication.

Main Methods:

• A systematic literature search was conducted using PRISMA guidelines.
• Databases searched included Ovid EMBASE, SCOPUS, and PubMed up to August 2020.
• Analysis focused on reported cases of sialadenitis post-skull base surgery.

Main Results:

• The review identified 13 publications detailing 18 cases, with one additional case described.
• Aggressive respiratory support, including intubation or tracheostomy, is almost universally required.
• Potential risk factors include extreme head and neck flexion/rotation; outcomes are generally favorable despite secondary complications.

Conclusions:

• Sialadenitis is a rare yet potentially fatal complication of skull base neurosurgery.
• Acute airway compromise and secondary complications are significant concerns.
• Further research into risk factors and management is warranted.