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Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
Aleksandar Aničin1,2, Anže Jerman3, Jure Urbančič1,2
1Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia.
Journal of Clinical Medicine
|February 11, 2023
Summary
The appearance of Wharton
Area of Science:
- Otolaryngology
- Surgical Anatomy
Background:
- Identifying the submandibular (Wharton's) duct punctum can be challenging during sialendoscopy.
- Limited evidence exists on how Wharton's duct papilla appearance affects sialendoscopic procedures.
Purpose of the Study:
- To propose and evaluate a classification system for Wharton's duct papillae.
- To assess the impact of papilla type on sialendoscope introduction and intraoperative complications.
Main Methods:
- A prospective evaluation of a novel classification system for Wharton's duct papillae (Types A, B, C, D).
- Analysis of 351 papillae in 315 patients, examining demographic data, complications, and introduction time.
- Correlation of papilla type with macroscopic appearance, probe size, and sialendoscopic approach.
Main Results:
- Type A (estuary-like) papillae were associated with shorter introduction times and no complications.
- Type B (normal) papillae were most common (48.1%).
- Type D (substantially closed) papillae showed the highest complication rate (perforation) and longest introduction times.
Conclusions:
- Wharton's duct papilla appearance is influenced by underlying pathology.
- The proposed classification effectively predicts sialendoscope introduction duration and intraoperative complication risk.
- Papilla typology is a significant factor in sialendoscopy success.
