Sialendoscopy combined with transoral sialodochoplasty for treatment of
parotid duct stenosis with megaduct
Abstract
Objectives: Despite advances in the surgical treatment of parotid duct
stenosis, it remains a surgical challenge. This study aimed to analyze
the surgical outcomes of sialendoscopy combined with transoral
sialodochoplasty for the treatment of patients with parotid duct
stenosis with megaduct in parotid glands. Design: Retrospective cohort
study Setting: Academic tertiary medical center Participants: This study
included 13 patients with chronic obstructive sialadenitis caused by
type 2 parotid duct stenosis who underwent sialendoscopy with transoral
sialodochoplasty. Main Outcomes and Measures: All patients completed a
three-point Likert-type rating scale 3 months postoperatively.
Radiologic evaluation using magnetic resonance (MR) sialography was
performed to evaluate megaduct diameter. Thirteen glands underwent
sialendoscopy combined with transoral sialodochoplasty. Results: At 3
months after surgery, six (46.2%) glands showed complete resolution,
and seven (53.8%) showed partial resolution of obstructive symptoms.
Megaduct diameter between pre- and postoperative MR sialography
significantly decreased after transoral sialodochoplasty (8.05 ± 2.675
vs. 4.15 ± 2.400, P = 0.028). Saliva excretion was improved after the
transoral sialodochoplasty, as the distal ducts were visualized with
sialagogues postoperatively. Conclusions: Type 2 parotid duct stenosis
can be successfully treated with sialendoscopy combined with
sialodochoplasty. In cases of large megaduct, transoral sialodochoplasty
appears to offer benefits of reducing the diameter of dilated megaducts
and improving salivary outflow.