Questionnaire
The results of the questionnaire are summarized in Table 5.
The median follow-up time between intervention and filling out of the questionnaire was 37 months (2-126 months). The majority of patients (64.4%) reported to have no residual symptoms.
Patients with residual symptoms (35.6%) were further evaluated. When they were asked to rate their current pain on a scale from 0 (no pain) to 10 (severe pain and need for pain relief), the median score was 3 (0-9, SD=2.5). When asked to rate their symptoms improvement, the median score was 7 (0-9, SD=3.1). In 31.5%, the patient indicated that their salivary gland problem still had an impact on their quality of life, such as the need of carrying a water bottle or frequently using gums or candies to keep their mouth moist.
Eventual gland excision was only performed in 16 patients (11% of total in the responder group), most frequently because of a non-retrievable stone, recurrence of a stone or recurrent sialadenitis. All gland excisions where performed in our department.
Neither caffeine consumption (p=0.440), smoking (p=0.171) nor xerostomia inducing medications (p=0.449) were, on univariate analysis (Chi-square test) significantly associated with a higher rate of residual symptoms (Of note, bilateral sialendoscopic interventions were significantly associated with a higher rate of residual symptoms (p<0.01, Chi-square test)).
During the first postoperative checkup, 16.4% of the 136 responders (10 patients were lost to follow-up at first checkup) reported they still had residual symptoms. However, at the time they completed the questionnaire they reported residual symptoms in 35.6%, which is significantly higher (p<0.01, Mc Nemar test).
Parotid sialendoscopies were associated with a higher percentage of patients reporting residual symptoms (46.9%) as compared to 26.8% of patients undergoing sialendoscopy of the submandibular gland (p= 0.012, Chi-square test). However, there was no significant difference between the parotid and submandibular group when scaling both their current pain and improvement on a scale from 0 to 10 (respectively p= 0.597 and p=0.566, Mann-Whitney U test). Resection of the parotid gland was necessary in 9.4% and of the submandibular gland in 12.2% in the responder group (p=0.588, Chi-square test).
The highest percentage of patients reporting residual symptoms was found in the RPC group (81.3%). For the pathology groups “stenosis”, “recurrent sialadenitis” and “lithiasis” this was respectively 44.6%, 50% and 16.2%, a trend to significant difference (p<0.01, Chi-square test). For the RPC group however, all of the patients indicated that sialendoscopy improved their symptoms. The median score when asked to rate both their pain and improvement on a scale from 0 to 10 was respectively 3 and 8. Preservation of the gland was possible in 85.3% in the lithiasis group, 89.3% in the stenosis group and 100% in the RPC and recurrent sialadenitis group