Review finds good success rates with sialendoscopy for treating salivary gland obstruction

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About 50% of benign salivary gland disease results from obstructive sialadenitis. The majority of cases are seen in the submandibular gland (80-90%) with 10-15% in the parotid and  < 1% in the sublingual gland.  The aim of this review was to summarize the current literature and determine the efficacy and safety of sialendoscopy in the treatment of obstructive diseases of the salivary glands in adults.

The Medline, Embase and Cochrane library databases and reference lists from identified articles were searched for meta- analyses, systematic reviews, randomized controlled trials, and retrospective studies.  English language Peer reviewed studies reporting success rates for interventional sialendoscopy for the management of obstructive disease of major salivary glands in adult patients with or without a combined surgical approach were included.  Independent selection and data abstraction was undertaken.

  • Twenty-nine studies were included in the analysis; 19 studies considered sialendoscopy alone, 11 studies sialendoscopy and a surgical approach and 3 studies sialendoscopy for radioiodine-induced sialadenitis and 4 studies a combination of approached.
  • The weighted pooled proportion of success rates: –
  • Sialendoscopy alone 0.86 (95% CI, 0.83-0.89)
  • Sialendoscopy and surgery 0.93 (95% CI, 0.89-0.96)

The authors concluded

Findings from the present systematic review and meta-analysis suggest that sialendoscopy is efficacious, safe, and gland preserving for the treatment of obstructive major salivary gland disease.

Comment

This review included both prospective and retrospective studies but it is not clear how many of each type were included.  The authors include some discussion of complications from the procedures and more details are presented in the tables. Overall though this is limited but may be due to the lack of reporting in the original studies. While the review reports high success rates for the procedures as the included studies are all observational studies that are likely to have suffered from a variable degree of selection and ascertainment bias the success levels reported should be treated with a little caution.

Links

Strychowsky JE, Sommer DD, Gupta MK, Cohen N, Nahlieli O. Sialendoscopy for the management of obstructive salivary gland disease: a systematic review and meta-analysis. Arch Otolaryngol Head Neck Surg. 2012 Jun;138(6):541-7. Review. PubMed PMID: 22710505.

 

 

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