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Endoscopic-assisted gland-preserving therapy for chronic sialadenitis: a German and US comparison.
- Source :
-
Archives of otolaryngology--head & neck surgery [Arch Otolaryngol Head Neck Surg] 2011 Sep; Vol. 137 (9), pp. 903-8. Date of Electronic Publication: 2011 Aug 15. - Publication Year :
- 2011
-
Abstract
- Objective: To determine whether unique patterns of care are evolving in the United States compared with Germany in endoscopic management of chronic sialadenitis.<br />Design: Comparison of consecutive series of patients.<br />Setting: Academic tertiary salivary referral centers in Germany and the United States.<br />Patients: A total of 446 patients having chronic sialadenitis treated with salivary endoscopy.<br />Main Outcome Measures: To compare practice patterns and outcomes at each location, databases tracking patients having chronic sialadenitis treated with salivary endoscopy were searched for the following variables: age, sex, involved gland, radiographic studies, endoscopic findings, endoscopic-related complications, gland preservation rate, patient symptom control, and techniques for managing salivary stones and intraductal scar tissue.<br />Results: Significantly more patients in the US cohort had chronic sialadenitis of the parotid gland (P = .03) and multiple gland involvement (P < .001). Salivary endoscopy was regularly performed using local anesthesia in Germany and using general anesthesia in the United States (P < .001). Endoscopic-related complication rates were higher (10.9% vs 1.6%) and gland preservation rates lower (85.9% vs 98.4%) among US patients; however, patients with intact glands demonstrated similar rates of symptom control at both centers (92.7% in the United States vs 85.3% in Germany) at the last follow-up visit. The lower rate of gland preservation in the United States is largely because of lack of access to lithotripsy for larger salivary stones.<br />Conclusions: Different patterns of care are emerging in the endoscopic management of chronic sialadenitis in the United States compared with Germany, where these techniques were largely developed. Nevertheless, patients with chronic sialadenitis at both locations who undergo endoscopic gland-preserving therapy have high rates of gland preservation and symptom control.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia, General
Anesthesia, Local
Child
Child, Preschool
Chronic Disease
Diagnostic Imaging
Female
Germany
Humans
Lithotripsy methods
Male
Middle Aged
Outcome and Process Assessment, Health Care
Parotid Gland surgery
Postoperative Complications etiology
Postoperative Complications prevention & control
Practice Patterns, Physicians'
Salivary Gland Calculi diagnosis
Sialadenitis diagnosis
Submandibular Gland surgery
United States
Young Adult
Cross-Cultural Comparison
Endoscopy methods
Salivary Gland Calculi surgery
Sialadenitis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1538-361X
- Volume :
- 137
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Archives of otolaryngology--head & neck surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21844406
- Full Text :
- https://doi.org/10.1001/archoto.2011.130