Specificity of parotid sialendoscopy

Objective: To present our initial experience with sialendoscopy of the paro tid duct. Study Design: Methods: Diagnostic and interventional sialendoscop y procedures were performed in 79 and 55 cases, respectively. Diagnostic si alendoscopy was used to classify ductal lesions into sialolithiasis, stenos is, sialodochitis, and polyps. Interventional sialendoscopy was used to tre at these disorders. The type of endoscope used, the type of sialolithiasis fragmentation and/or extraction device used, the total number of procedures , the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables. The outcome variable was the endoscopic clea ring of the ductal tree and resolution of symptoms. Results: Diagnostic sia lendoscopy was possible in all cases, with an average duration of 26 +/- 14 minutes and no complications. Interventional sialendoscopy was successful in 85% of cases, with an average duration of 73 +/- 43 minutes (+/- standar d deviation). Multiple procedures were performed in 45% of cases, general a nesthesia was used in 24%, and parotidectomy in 2%. Multiple sialoliths wer e found in 58% of ducts and associated with more procedures under general a nesthesia and longer operations. The average size of sialoliths was 3.2 +/- 1.3 mm; larger stones were associated with more procedures under general a nesthesia, longer and multiple procedures, use of fragmentation, and sialen doscopy failures. Sialolithiasis fragmentation was required in 10% of cases , with a success rate of 70% Semirigid sialendoscopes performed better than flexible ones. Complications were mostly minor but were encountered in 12% of cases. Conclusions: Diagnostic sialendoscopy is a new technique for eva luating salivary duct disease, a technique which is associated with low mor bidity, Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision.