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The aim of this study is to retrospectively investigate the effectiveness of outpatient ductal steroid irrigations (DSIs) as an adjuvant treatment in recurrent inflammatory obstructive sialadenitis (RIOS). A retrospective chart review of prospectively recruited RIOS patients was randomly assigned to group A (i.e., interventional sialendoscopy) or group B (i.e., interventional sialendoscopy with outpatient DSIs). The statistical analysis detected any postoperative difference between groups in terms of the number and severity (attested by 0–10 VAS pain) of episodes of swelling. Interventional sialendoscopy and DSIs were effective and well tolerated in all 122 patients, and a significantly reduced number of salivary gland swelling episodes (p-value = 0.01) was documented in group B compared to group A at any follow-up assessment. When the specific aetiology was considered, repeated DSIs were more effective than interventional sialendoscopy alone in patients with type 1 or 3 stenoses and in those without mucous plugs. Our results confirm the safety and effectiveness of interventional sialendoscopy (both as a single-modality and a multimodal approach) in a large series of adult patients with RIOS at short-, medium-, and long-term analyses. The superiority of a combined therapeutic protocol, with a positive effect still detectable 12 months after the end of the treatment, was attested as well. [ABSTRACT FROM AUTHOR]

Objectives: Multiple affected salivary gland diseases are rare compared to single gland diseases and represent a major diagnostic challenge. These cases are commonly neglected in the scientific literature, despite the considerable suffering of these patients. The aim of this retrospective study was to report disease characteristics, diagnostic pathways, and therapeutic options, including sialendoscopic treatment of multiple affected salivary gland disorders. Methods: Patients experiencing multiple affected salivary gland diseases treated between 2013 and 2020 were consecutively identified. Data regarding demographics, clinical presentation, disease characteristics, treatment, complications, and follow-up were analyzed retrospectively. Results: In total, 71 patients were identified with these diseases and included obstructive disease without sialolithiasis (n = 22), inflammation (n = 15), immune disease (n = 19), radioiodine-induced sialadenitis (RAI) (n = 5), sialadenosis (n = 2), and juvenile recurrent parotitis (JRP) (n = 8). Diagnostic and therapeutic sialendoscopy was performed on 113 salivary glands in 42 patients, leading to completely (n = 27, 64.3%) or partially (n = 11, 26.2%) improved symptoms in most cases. In total, 4 patients did not improve after interventional therapy. Conclusions: Multiple affected salivary gland diseases are rare and diagnostically challenging. Interventional sialendoscopy offers an effective and safe therapeutic option and should be considered in this specific cohort. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to assess how well ChatGPT, an AI-powered chatbot, performed in helping to manage pediatric sialadenitis and identify when sialendoscopy was necessary. Methods: 49 clinical cases of pediatric sialadenitis were retrospectively reviewed. ChatGPT was given patient data, and it offered differential diagnoses, proposed further tests, and suggested treatments. The decisions made by the treating otolaryngologists were contrasted with the answers provided by ChatGPT. Analysis was done on ChatGPT response consistency and interrater reliability. Results: ChatGPT showed 78.57% accuracy in primary diagnosis, and 17.35% of cases were considered likely. On the other hand, otolaryngologists recommended fewer further examinations than ChatGPT (111 vs. 60, p < 0.001). For additional exams, poor agreement was found between ChatGPT and otolaryngologists. Only 28.57% of cases received a pertinent and essential treatment plan via ChatGPT, indicating that the platform's treatment recommendations were frequently lacking. For treatment ratings, judges' interrater reliability was greatest (Kendall's tau = 0.824, p < 0.001). For the most part, ChatGPT's response constancy was high. Conclusions: Although ChatGPT has the potential to correctly diagnose pediatric sialadenitis, there are a number of noteworthy limitations with regard to its ability to suggest further testing and treatment regimens. Before widespread clinical use, more research and confirmation are required. To guarantee that chatbots are utilized properly and effectively to supplement human expertise rather than to replace it, a critical viewpoint is required. [ABSTRACT FROM AUTHOR]

Objective: Antibiotics have been prescribed routinely in sialendoscopy procedures to reduce the risk of postoperative infection, despite the limited evidence supporting this practice. Being necessary to assess the need for antibiotics in Sialendoscopy, aiming to provide evidence-based guidance to clinicians regarding antibiotic administration in this procedure. Materials & method: A prospective, randomized, double-blind, controlled clinical trial to evaluate the of prophylactic antibiotics in Sialendoscopy was designed. Results: A total of 80 patients were included in this study, including 57 females (71.8%) and 23 males (28.8%). In terms of prophylaxis, 36 patients (45%) received prophylactic treatment, and 44 patients (55%) did not. The occurrence of infectious events was observed in 2 patients (5.6%) with prophylaxis and 4 patients (9.1%) without prophylaxis. However, this difference was not statistically significant (p = 0.556). Conclusion: In conclusion, our prospective, randomized clinical trial aimed to address the debate regarding the use of prophylactic antibiotics in sialendoscopy. Our study's findings suggest that the routine use antibiotics may not be necessary to prevent postoperative infections in sialendoscopy procedures. These results have important implications for clinical practice, potentially reducing the unnecessary use of antibiotics and addressing concerns related to antibiotic resistance and adverse drug reactions. [ABSTRACT FROM AUTHOR]

ObjectivesA prospective interventional study was designed to describe our series of patients with submandibular stones undergoing sialendoscopy-assisted TORSS (trans-oral robotic salivary surgery) by means of Si or Xi Da Vinci robotic system between January 2019 and June 2023, in order to assess safety and effectiveness of the procedure.Methods54 adult patients with submandibular stones undergoing sialendoscopy-assisted TORSS between January 2019-June 2023.ResultsThe global success rate was 81.5%, with better surgical outcomes in patients with palpable hilar/hilo-parenchymal stones compared to non-palpable pure parenchymal ones (92.7 vs. 46.2%). In addition, the mean stone size in cases failing TORSS was smaller than that documented in successfully treated patients (7.8 ± 1.8 vs. 9.8 ± 2.4 mm). No major untoward effects were observed (transitory lingual nerve dysfunction in 3 patients undergoing Xi Da Vinci surgery). A positive outcome in terms of post-operative surgical pain, patient's satisfaction and recovery time was observed.ConclusionsIntrinsic stone features (such as size, location/palpability) seems to be predictor for surgical success; an accurate pre-operative planning is mandatory to better select which patient can benefit most from TORSS procedure.