Modern management of paediatric obstructive salivary disorders: long-term clinical experience

P. Capaccio, P. Canzi, M. Gaffuri, A. Occhini, M. Benazzo, F. Ottaviani, L. Pignataro

Research output: Contribution to journalArticle

Abstract

Recent technological improvements in head and neck field have changed diagnostic and therapeutic strategies for salivary disorders. Diagnosis is now based on colour Doppler ultrasonography (US), magnetic resonance (MR) sialography and cone beam 3D computed tomography (CT), and extra- and intracorporeal lithotripsy, interventional sialendscopy and sialendoscopy-assisted surgery are used as minimally invasive, conservative procedures for functional preservation of the affected gland. We evaluated the results of our long-term experience in the management of paediatric obstructive salivary disorders. The study involved a consecutive series of 66 children (38 females) whose obstructive salivary symptoms caused by juvenile recurrent parotitis (JRP) (n = 32), stones (n = 20), ranula (n = 9) and ductal stenosis (n = 5). 45 patients underwent interventional sialendoscopy for JRP, stones and stenoses, 12 a cycle of extracorporeal shockwave lithotripsy (ESWL), three sialendoscopy-assisted transoral surgery, one drainage, six marsupialisation, and two suturing of a ranula. Three children underwent combined ESWL and interventional sialendoscopy, and seven a secondary procedure. An overall successful result was obtained in 90.9% of cases. None of the patients underwent traditional invasive sialadenectomy notwithstanding persistence of mild obstructive symptoms in six patients. No major complications were observed. Using a diagnostic work-up based on colour Doppler US, MR sialography and cone beam 3D TC, children with obstructive salivary disorders can be effectively treated in a modern minimally-invasive manner by extracorporeal and intracorporeal lithotripsy, interventional sialendoscopy and sialendoscopy-assisted transoral surgery; this approach guarantees a successful result in most patients, thus avoiding the need for invasive sialadenectomy while functionally preserving the gland.
Original languageEnglish
Pages (from-to)160-167
Number of pages8
JournalActa Otorhinolaryngologica Italica
Volume37
Issue number2
DOIs
Publication statusPublished - Apr 1 2017

Fingerprint

Lithotripsy
Ranula
Sialography
Pediatrics
Doppler Color Ultrasonography
Pathologic Constriction
Magnetic Resonance Spectroscopy
Cone-Beam Computed Tomography
Drainage
Neck
Head
Juvenile Recurrent Parotitis
Therapeutics

Keywords

  • Extracorporeal lithotripsy
  • Intracorporeal lithotripsy
  • Juvenile recurrent parotitis
  • Paediatric age
  • Ranula
  • Salivary calculi
  • Salivary duct stenosis
  • Sialendoscopy
  • Sialendoscopy-assisted transoral surgery
  • Ultrasonography

Cite this

Modern management of paediatric obstructive salivary disorders: long-term clinical experience. / Capaccio, P.; Canzi, P.; Gaffuri, M.; Occhini, A.; Benazzo, M.; Ottaviani, F.; Pignataro, L.

In: Acta Otorhinolaryngologica Italica, Vol. 37, No. 2, 01.04.2017, p. 160-167.

Research output: Contribution to journalArticle

@article{cb3498409c724b0490e83799b16e428d,
title = "Modern management of paediatric obstructive salivary disorders: long-term clinical experience",
abstract = "Recent technological improvements in head and neck field have changed diagnostic and therapeutic strategies for salivary disorders. Diagnosis is now based on colour Doppler ultrasonography (US), magnetic resonance (MR) sialography and cone beam 3D computed tomography (CT), and extra- and intracorporeal lithotripsy, interventional sialendscopy and sialendoscopy-assisted surgery are used as minimally invasive, conservative procedures for functional preservation of the affected gland. We evaluated the results of our long-term experience in the management of paediatric obstructive salivary disorders. The study involved a consecutive series of 66 children (38 females) whose obstructive salivary symptoms caused by juvenile recurrent parotitis (JRP) (n = 32), stones (n = 20), ranula (n = 9) and ductal stenosis (n = 5). 45 patients underwent interventional sialendoscopy for JRP, stones and stenoses, 12 a cycle of extracorporeal shockwave lithotripsy (ESWL), three sialendoscopy-assisted transoral surgery, one drainage, six marsupialisation, and two suturing of a ranula. Three children underwent combined ESWL and interventional sialendoscopy, and seven a secondary procedure. An overall successful result was obtained in 90.9{\%} of cases. None of the patients underwent traditional invasive sialadenectomy notwithstanding persistence of mild obstructive symptoms in six patients. No major complications were observed. Using a diagnostic work-up based on colour Doppler US, MR sialography and cone beam 3D TC, children with obstructive salivary disorders can be effectively treated in a modern minimally-invasive manner by extracorporeal and intracorporeal lithotripsy, interventional sialendoscopy and sialendoscopy-assisted transoral surgery; this approach guarantees a successful result in most patients, thus avoiding the need for invasive sialadenectomy while functionally preserving the gland.",
keywords = "Extracorporeal lithotripsy, Intracorporeal lithotripsy, Juvenile recurrent parotitis, Paediatric age, Ranula, Salivary calculi, Salivary duct stenosis, Sialendoscopy, Sialendoscopy-assisted transoral surgery, Ultrasonography",
author = "P. Capaccio and P. Canzi and M. Gaffuri and A. Occhini and M. Benazzo and F. Ottaviani and L. Pignataro",
note = "LR: 20170615; CI: (c) Copyright by Societa Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.; JID: 8213019; OTO: NOTNLM; 2016/09/15 00:00 [received]; 2016/12/12 00:00 [accepted]; 2017/05/19 06:00 [entrez]; 2017/05/19 06:00 [pubmed]; 2017/05/19 06:00 [medline]; ppublish",
year = "2017",
month = "4",
day = "1",
doi = "10.14639/0392-100X-1607 [doi]",
language = "English",
volume = "37",
pages = "160--167",
journal = "Acta Otorhinolaryngologica Italica",
issn = "0392-100X",
publisher = "Pacini Editore s.r.l.",
number = "2",

}

TY - JOUR

T1 - Modern management of paediatric obstructive salivary disorders: long-term clinical experience

AU - Capaccio, P.

AU - Canzi, P.

AU - Gaffuri, M.

AU - Occhini, A.

AU - Benazzo, M.

AU - Ottaviani, F.

AU - Pignataro, L.

N1 - LR: 20170615; CI: (c) Copyright by Societa Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.; JID: 8213019; OTO: NOTNLM; 2016/09/15 00:00 [received]; 2016/12/12 00:00 [accepted]; 2017/05/19 06:00 [entrez]; 2017/05/19 06:00 [pubmed]; 2017/05/19 06:00 [medline]; ppublish

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Recent technological improvements in head and neck field have changed diagnostic and therapeutic strategies for salivary disorders. Diagnosis is now based on colour Doppler ultrasonography (US), magnetic resonance (MR) sialography and cone beam 3D computed tomography (CT), and extra- and intracorporeal lithotripsy, interventional sialendscopy and sialendoscopy-assisted surgery are used as minimally invasive, conservative procedures for functional preservation of the affected gland. We evaluated the results of our long-term experience in the management of paediatric obstructive salivary disorders. The study involved a consecutive series of 66 children (38 females) whose obstructive salivary symptoms caused by juvenile recurrent parotitis (JRP) (n = 32), stones (n = 20), ranula (n = 9) and ductal stenosis (n = 5). 45 patients underwent interventional sialendoscopy for JRP, stones and stenoses, 12 a cycle of extracorporeal shockwave lithotripsy (ESWL), three sialendoscopy-assisted transoral surgery, one drainage, six marsupialisation, and two suturing of a ranula. Three children underwent combined ESWL and interventional sialendoscopy, and seven a secondary procedure. An overall successful result was obtained in 90.9% of cases. None of the patients underwent traditional invasive sialadenectomy notwithstanding persistence of mild obstructive symptoms in six patients. No major complications were observed. Using a diagnostic work-up based on colour Doppler US, MR sialography and cone beam 3D TC, children with obstructive salivary disorders can be effectively treated in a modern minimally-invasive manner by extracorporeal and intracorporeal lithotripsy, interventional sialendoscopy and sialendoscopy-assisted transoral surgery; this approach guarantees a successful result in most patients, thus avoiding the need for invasive sialadenectomy while functionally preserving the gland.

AB - Recent technological improvements in head and neck field have changed diagnostic and therapeutic strategies for salivary disorders. Diagnosis is now based on colour Doppler ultrasonography (US), magnetic resonance (MR) sialography and cone beam 3D computed tomography (CT), and extra- and intracorporeal lithotripsy, interventional sialendscopy and sialendoscopy-assisted surgery are used as minimally invasive, conservative procedures for functional preservation of the affected gland. We evaluated the results of our long-term experience in the management of paediatric obstructive salivary disorders. The study involved a consecutive series of 66 children (38 females) whose obstructive salivary symptoms caused by juvenile recurrent parotitis (JRP) (n = 32), stones (n = 20), ranula (n = 9) and ductal stenosis (n = 5). 45 patients underwent interventional sialendoscopy for JRP, stones and stenoses, 12 a cycle of extracorporeal shockwave lithotripsy (ESWL), three sialendoscopy-assisted transoral surgery, one drainage, six marsupialisation, and two suturing of a ranula. Three children underwent combined ESWL and interventional sialendoscopy, and seven a secondary procedure. An overall successful result was obtained in 90.9% of cases. None of the patients underwent traditional invasive sialadenectomy notwithstanding persistence of mild obstructive symptoms in six patients. No major complications were observed. Using a diagnostic work-up based on colour Doppler US, MR sialography and cone beam 3D TC, children with obstructive salivary disorders can be effectively treated in a modern minimally-invasive manner by extracorporeal and intracorporeal lithotripsy, interventional sialendoscopy and sialendoscopy-assisted transoral surgery; this approach guarantees a successful result in most patients, thus avoiding the need for invasive sialadenectomy while functionally preserving the gland.

KW - Extracorporeal lithotripsy

KW - Intracorporeal lithotripsy

KW - Juvenile recurrent parotitis

KW - Paediatric age

KW - Ranula

KW - Salivary calculi

KW - Salivary duct stenosis

KW - Sialendoscopy

KW - Sialendoscopy-assisted transoral surgery

KW - Ultrasonography

U2 - 10.14639/0392-100X-1607 [doi]

DO - 10.14639/0392-100X-1607 [doi]

M3 - Article

VL - 37

SP - 160

EP - 167

JO - Acta Otorhinolaryngologica Italica

JF - Acta Otorhinolaryngologica Italica

SN - 0392-100X

IS - 2

ER -