Interventional Sialendoscopy After Sialadenectomy

Objectives/Hypothesis: To evaluate the use of diagnostic and interventional sialendoscopy in patients with prior parotidectomy or submandibular gland excision and persistent sialadenitis and/or sialolithiasis. Study Design: Retrospective case series. Methods: Retrospective review of medical records, including demographic data, clinical presentation and exam, radiologic studies, and operative reports. Results: Five patients, who had undergone prior sialadenectomy for sialadenitis and/or sialolithiasis, underwent sialendoscopy for persistent symptoms during the study period. Three patients were female and two were male, with ages ranging from 39 to 63 years (median, 47 years). Three patients had prior parotidectomy, and two had prior submandibular gland excision. The duration of time from sialadenectomy to sialendoscopy was 3.25 months to 6 years (median, 26 months). Four of the five patients had successful interventional sialendoscopy, with resolution of their symptoms. These four patients underwent extraction of stones, one of which was previously unrecognized. In one patient, duct cannulation and subsequent sialendoscopy could not be performed owing to scarring at the Stensen's papilla; the patient's symptoms initially persisted after the attempted procedure with gradual improvement. No complications occurred in any patients. Importantly, no sequelae resulted from endoscopic instrumentation and irrigation of salivary ducts that ended in blind pouches. Conclusions: Sialendoscopy is a safe and frequently effective intervention for persistent sialolithiasis and sialadenitis after salivary gland excision.