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Sialendoscopy approach in treating juvenile recurrent parotitis: a systematic review
D Soriano-Martín1, L García-Consuegra2, L Junquera3
1Department Maxillofacial Surgery, Central University Hospital of Asturias, Avenida de Roma, 33011, Oviedo, Spain. soriano.martin.david@gmail.com.
Insights
Sialendoscopy is 74.9% effective for treating juvenile recurrent parotitis (JRP) by preventing symptom recurrence. Different irrigation methods did not significantly impact treatment outcomes for JRP patients.
Area of Science:
- Pediatric Otolaryngology
- Minimally Invasive Surgery
- Diagnostic Imaging
Background:
- Juvenile recurrent parotitis (JRP) causes painful parotid swelling in children.
- Sialendoscopy is a minimally invasive procedure for diagnosing and treating salivary gland conditions.
- This review evaluates sialendoscopy's effectiveness in managing JRP in pediatric patients.
Approach:
- A systematic literature search was conducted across major databases (PubMed, EMBASE, Scopus, Cochrane Library) up to April 2022.
- Studies were assessed for quality using the Newcastle-Ottawa Scale (NOS).
- The review included data from 524 patients who underwent 646 sialendoscopies.
Key Points:
- Sialendoscopy is a valid diagnostic tool for JRP but cannot reliably differentiate from autoimmune parotitis like Sjögren's syndrome.
- The overall recurrence rate after sialendoscopy was 25.1%, with a significant relationship between attacks per year and recurrence.
- Irrigation methods (corticosteroids, antibiotics, saline) showed no significant difference in recurrence rates, ranging from 22.2% to 25.2%.
Conclusions:
- Parotid sialendoscopy demonstrated a 74.9% effectiveness as a primary treatment for preventing recurrent symptoms in JRP.
- The choice of ductal irrigation did not significantly influence the long-term prognosis for JRP patients undergoing sialendoscopy.
Background:
Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling in children. The purpose of this systematic review was to determine the diagnostic and therapeutic effectiveness of sialendoscopy in children affected by JRP.
Methods:
A systematic literature search was performed in PubMed, EMBASE, Scopus and the Cochrane Library until April 2022, without language restrictions or specified start date. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS).
Results:
Our review included 524 patients and 646 sialendoscopies. The sample sizes of the different studies ranged from 3 to 77 subjects. Most authors performed sialendoscopy under general anesthesia. The mean percentage of recurrences observed was 25.1% (95% confidence intervals) (CI 23.6-26.6). There was a statistically significant relationship between the number of attacks/year and recurrences (p < 0.05). The percentage of recurrences according to the type of irrigation/flushing used ranged from 22.2% to 25.2%, with no significant differences between the use of corticosteroids alone (25.2% of recurrences), corticosteroids plus antibiotics (25% of recurrences) or saline alone (22.2% of recurrences). Sialoendoscopy has proved in all cases to be a valid method for the diagnosis of JRP, but it does not allow a reliable differential diagnosis with other autoimmune parotitis such as Sjögren's syndrome.
Conclusion:
According to our results, parotid sialoendoscopy was 74.9% effective as a primary treatment in the prevention of recurrent symptoms in JRP. The type of ductal irrigation used did not significantly influence the prognostic outcome.
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