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Evaluation of Salivary Function Recovery Following Gland-Sparing Sialolithotomy: A Prospective Cohort Study
Aya A Sakr1, Emad A Magdy2, Sherif S Mohamed3
1Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Background:
Gland-sparing surgical procedures for managing obstructive sialadenitis have significantly reduced the rate of sialoadenectomies with associated morbidities and provided a better alternative for sialolithotomy while successfully restoring gland function.
Purpose:
The study purpose was to evaluate the recovery of salivary gland function and the improvement in patient quality of life (QOL) following gland-sparing sialolithotomy in individuals with sialolithiasis obstructive sialadenitis (SOS).
Study Design, Setting, And Sample:
This is a prospective cohort study comprising patients who presented with SOS at a tertiary referral center between January 2021 and February 2023. Patients were excluded if they had acute sialadenitis, a history of salivary gland excision, or radiographic signs of gland atrophy.
Predictor Variable:
The predictor variable was the time of assessing therapeutic effect after sialolithotomy which was measured at 3, 6, and 12 months postoperatively.
Main Outcome Variables:
The outcome variable was the therapeutic effect on salivary gland function (primary outcome) as measured by sialometry and QOL (secondary outcome), measured using the Multidisciplinary Salivary Gland Society questionnaire.
Covariates:
The covariates were age, sex, salivary stone characteristics (size, number, and location), gland affected, and surgical approach used. Data were collected and analyzed.
Analyses:
The Mann-Whitney test was used to compare 2 categories of different covariates. The Friedman test was used to compare repeated measures across follow-up periods. Pairwise comparisons were performed with Bonferroni correction. The adjusted P values were calculated automatically using SPSS. Statistical significance was set at P < .05 for all tests.
Results:
The studied sample included 41 subjects (56.1% males) with mean age 37.88 ± 12.79 years. Primary outcome showed mean overall sialometry score improvement from 2.21 ± 1.02 g preoperatively to 3.42 ± 1.23 for submandibular and from 1.87 ± 1.48 g to 2.92 ± 1.28 for parotid at 12 months postoperatively (P < .001). Similarly, secondary outcome showed significant subjective improvement, from total Multidisciplinary Salivary Gland Society score 65.92 ± 28.63 to 3.84 ± 9.59 for submandibular and 72.42 ± 38.27 to 7.11 ± 12.13 for parotid (P < .001).
Conclusion And Relevance:
Gland-sparing surgical procedures represent an excellent option for managing SOS. Successful sialolithotomy resulted in significant improvement in gland function, and QOL.
