Salivary endoscopy for idiopathic chronic sialadenitis.

OBJECTIVES/HYPOTHESIS: To describe the findings and therapeutic role of salivary endoscopy for idiopathic chronic sialadenitis.

STUDY DESIGN: Retrospective case series.

METHODS: The records of 258 patients who underwent salivary endoscopy between November 2008 and May 2012 were reviewed. Included cases presented with recurrent inflammation and swelling of a single major salivary gland, without identifiable etiology on examination and imaging.

RESULTS: A total of 51 cases (20%) were identified. These patients had a mean age of 54.4 years (range, 23-75) and 57% were female. Mean duration of symptoms was 22.8 months (range, 1-102), with most cases (75%) involving the parotid gland. The primary imaging modalities used were ultrasound (62%) and computed tomography (31%). The most common findings on imaging included ductal dilation (42%), enlarged lymph nodes (23%), normal glandular imaging (15%), and possible sialoliths (14%). The most common findings on salivary endoscopy included stenosis (57%), strictures (27%), and inflammatory debris (18%). Occult stones were the cause of sialadenitis in only 4 (8%) cases. Outcomes included complete symptom resolution in 31 patients (61%), improved but occasional symptoms in 14 patients (27%), and no improvement in 6 patients (12%) after a mean follow-up time of 20.0 months (range, 4-45). Excision of the involved gland was required in 2 (4%) patients.

CONCLUSION: Salivary endoscopy is a minimally invasive technique that is effective in the management of idiopathic chronic sialadenitis refractory to medical therapy. It provides diagnostic information in most patients and offers a therapeutic intervention with gland preservation.