Abstract
Purpose of Review
The aim of this review is to discuss the evaluation, workup, indications, and outcomes of sialendoscopy in children. Many factors contribute to salivary gland disease in children including autoimmune disease, genetic defects, viral or bacterial infections, and congenital ductal abnormalities. Sialadenitis is acute swelling of the major salivary glands. In children, parotid sialadenitis is more common than submandibular sialadenitis and sialolithiasis (saliva gland stone) is rare. Before widespread use of the MMR vaccine, mumps, a paromyxovirus, was the most common cause of parotitis in children. In the current era, the most common cause of parotitis in children is juvenile recurrent parotitis (JRP). JRP is a nonspecific sialadenitis associated with recurrent inflammation of the parotid glands. The first episode of JRP generally occurs between the age of 3 and 6 years of age. The interval between acute episodes is variable, with an average from 15 days to 2 months. The treatment of acute sialadenitis includes analgesics, antibiotics, and other conservative measures such as sialogogues, warm compresses, hydration, and massage. Historically, for JRP patients who failed conservative measures, parotidectomy was offered but was associated with significant potential morbidity. Sialendoscopy has emerged as a safe and effective diagnostic and therapeutic option for recurrent sialadenitis with and without stones.
Recent Findings
Sialendoscopy is safe and effective for removal of small, distal salivary stones in the pediatric population. It can also lead to less frequent and severe episodes of acute sialadenitis in patients with JRP.
Summary
Sialendoscopy is a safe and effective procedure for recurrent sialadenitis in the carefully selected pediatric patient.
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References
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
Katz P. New method of examination of the salivary glands: the fiberscope. Inf Dent. 1990;72(10):785–6.
Marchal F, Dulguerov P. Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg. 2003;129(9):951–6.
Faure F, Querin S, Dulguerov P, et al. Pediatric salivary gland obstructive swelling: sialendoscopic approach. Laryngoscope. 2007;117(8):1364–7.
Thomas WW, Douglas JE, Rassekh CH. Accuracy of ultrasound and computed tomography in the evaluation of patients undergoing sialendoscopy for sialolithiasis. Otolaryngol Head Neck Surg. 2017;156(5):834–9.
Terraz S, Poletti P, Dulguerov P, et al. How reliable is sonography in the assessment of sialolothiasis? AJR. 2013;201:W104–9.
Gadodia A, Seith A, Sharma R, Thakar A. MRI and mr sialography of juvenile recurrent parotitis. Pediatr Radiol. 2010;40:1405–10.
Zenk J, Koch M, Klintworth N, et al. Sialendoscopy in the diagnosis and treatment of sialolithiasis: a study on more than 1000 patients. Otolaryngol Head Neck Surg. 2013;147(5):858–63.
Harrison J. Causes, natural history, and incidence of salivary stones and obstructions. Otolaryngol Clin N Am. 2009;42(6):927–47.
Huoh K, Eisele D. Etiologic factors in sialolithiasis. Otolaryngol Head Neck Surg. 2011;145(6):935–9.
Harrison J, Epivantianos A, Bhatia S. Role of microliths in the aetiology of chronic submandibular sialadenitis: a clinicopathological investigation of 154 cases. Histopathology. 1997;31(3):237–51.
Epivatianos A, Harrison J, Dimitriou T. Ultrastructural and histochemical observations on microcalculi in chronic submandibular sialadenitis. J Oral Pathol. 1987;16(10):514–7.
Marchal F, Kurt A, Dulguerov P, et al. Retrograde theory in sialolithiasis formation. Arch Otolaryngol Head Neck Surg. 2001;127(1):66–8.
Kopec T, Wierzbicka M, Szyfter W, Leszczynska M. Algorithm changes in treatment of submandibular gland sialolithiasis. Eur Arch Otorhinolaryngol. 2013;270:2089–93.
Luers J, Grosheva M, Stenner M, Beutner D. Sialoendoscopy: prognostic factors for endoscopic removal of salivary stones. Arch Otolaryngol Head Neck Surg. 2011;137(4):325–9.
Witt R, Iro H, Kock M, et al. Minimally invasive options for salivary calculi. Laryngoscope. 2012;122:1306–11.
Galili D, Marmary Y. Juvenile recurrent parotitis: clinicoradiologic follow-up study and the beneficial effect of sialography. Oral Surg Oral Med Oral Pathol. 1986;61(6):550–6.
Carroll WW, Walvekar RR, Gillespie MB. Transfacial ultrasound-guided gland-preserving resection of parotid sialoliths. Otolaryngol Head Neck Surg. 2013;148(2):229–34.
Kiringoda R, Eisele DW, Chang JL. A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders. Laryngoscope. 2014;124(12):2696–701.
Walvekar R, Razfar A, Carrau R, Schaitkin B. Sialendoscopy and associated complications: a preliminary experience. Laryngoscope. 2008;118:776–9.
Sigismund PE, Zenk J, Koch M, Schapher M, Rudes M, Iro H. Nearly 3,000 salivary stones: some clinical and epidemiologic aspects. Laryngoscope. 2015;125(8):1879–82.
Chang J, Eisele D. Limited distal sialodochotomy to facilitate sialendoscopy of the submandibular duct. Laryngoscope. 2013;123:1163–7.
Quenin S, Plouin-Gaudon I, Marchal F, et al. Juvenile recurrent parotitis: sialendoscopic approach. Arch Otolaryngol Head Neck Surg. 2008;134(7):715–9.
Nahlieli O, Shacham R, Shlesinger M, Eliav E. Juvenile recurrent parotitis: a new method of diagnosis and treatment. Pediatrics. 2004;114(1):9–12.
Shacham R, Droma E, London D, Bar T, Nahlieli O. Long-term experience with endoscopic diagnosis and treatment of juvenile recurrent parotitis. J Oral Maxillofac Surg. 2009;67(1):162–7.
Kohlo K, Saarinen R, Paju A, Stenman J, Stenman U, Pitkaranta A. New insights into juvenile parotitis. Acta Pediatr. 2005;94:1566–70.
Saarinen R, Kolho K, Davidkin I, Pitkaranta A. The clinical picture of juvenile parotitis in a prospective setup. Acta Pediatrica. 2012;102:177–81.
Capaccio P, Sigismund P, Luca N, Marchisio P, Pignataro L. Modern management of juvenile recurrent parotitis. J Laryngol Otol. 2012;126(12):1254–60.
Fazekas T, Wiesbauer P, Schroth B, et al. Selective IgA deficiency in children with recurrent parotitis of childhood. Ped Inf Dis J. 2005;24(5):461.
Banks G, Kirse D, Anthony E, Bergman S, Shetty A. Bilateral parotitis as the initial presentation of childhood sarcoidosis. Am J Otolaryngol. 2013;34(2):142–4.
Civilibal M, Canpolat N, Yurt A, et al. A child with primary Sjogren syndrome and a review of the literature. Clin Pediatr. 2007;46(8):738–42.
Kulkarni K. Unusual presentation of Sjogren syndrome. South Med J. 2005;98(12):1210–1.
de Souza T, Silva I, Carvalho A, et al. Juvenile Sjogren syndrome: distinctive age, unique findings. Pediatr Dent. 2012;34(5):427–30.
Peri Y, Agmon-Levi N, Theodor E, Shoenfield Y. Sjogren’s syndrome, the old and the new. Best Prac Res Clin Rheumatol. 2012;26:105–17.
Coca A, Sanz I. Updates on B-cell immunotherapies for systemic lupus erythematosus and Sjogren’s syndrome. Curr Opin Rheumatol. 2012;24:451–6.
Giglio M, Landaeta M, Pinto M. Microbiology of recurrent parotitis. Pediatr Infect Dis J. 1997;16(4):386–90.
Nguyen A, Francis C, Larsen C. Salivary endoscopy in a pediatric patient with HLA-B27 seropositivity and recurrent submandibular sialadenitis. Int J Pediatr Otorhinolaryngol. 2013;77:1045–7.
Morales-Bozo I, Landaeta M, Urzua-Orellana B, Retamales P. Association between the occurrence of matrix metalloproteinases 2 and 9 in parotid saliva with the degree of parotid gland damage in juvenile recurrent parotitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:377–83.
Katz P, Hartl D, Guerre A. Treatment of juvenile recurrent parotitis. Otolaryngol Clin N Am. 2009;42(6):1087–91.
Jabbour N, Tibesar R, Lander T, Sidman J. Sialendoscopy in children. Int J Pediatr Otorhinolaryngol. 2010;74(4):347–50.
Hackett A, Baranano C, Reed M, et al. Sialendoscopy for the treatment of pediatric salivary gland disorders. Arch Otolaryngol Head Neck Surg. 2012;138(10):912–5.
Martins-Carvalho C, Plouin-Gaudon I, Quenin S, et al. Pediatric sialendoscopy: a 5-year experience at a single institution. Arch Otolaryngol Head Neck Surg. 2010;136(1):33–6.
Strychowsky J, Sommer D, Gupta M, Cohen N, Nahieli O. Sialendoscopy for the management of obstructive salivary gland disease: a systematic review and meta-analysis sialendoscopy for salivary gland obstruction. Arch Otolaryngol Head Neck Surg. 2012;138:541–7.
Gary C, Kluka EA, Schaitkin B, Walvekar R. Interventional sialendoscopy for treatment of juvenile recurrent parotitis. J Indian Assoc Pediatr Surg. 2011;16(4):132–6.
Berta E, Angel G, Lagarde F et al. Role of sialendoscopy in juvenile recurrent parotitis (JRP). Eur Ann Otorhinolaryngol Head Neck Dis 2017;(17)30101–1. https://doi.org/10.1016/j.anorl.2017.06.004.
Schneider H, Kock M, Kunzel J, et al. Juvenile recurrent parotitis: a retrospective comparison of sialendoscopy versus conservative therapy. Laryngoscope. 2014;124:451–5.
•• Rosbe KW, Milev D, Chang JL. Effectiveness and costs of sialendoscopy in pediatric patients with salivary gland disorders. Laryngoscope. 2015;125(12):2805–9. Only review in the current literature to compare costs of medical therapy versus sialendoscopy for obstructive sialadenitis in children demonstrating equal effectiveness but much greater costs for sialendoscopy
Ogden MA, Rosbe KW, Chang JL. Pediatric sialendoscopy indications and outcomes. Curr Opin Otolaryngol Head Neck Surg. 2016;24(6):529–35.
Silva L, Babicsak G, Dolci RL. Salivary gland endoscopy in children: a systematic review. Rev Assoc Med Bras. 2016;62(8):795–9.
•• Capaccio P, Canzi P, Gaffuri M, et al. Modern management of paediatric obstructive salivary disorders: long-term clinical experience. Acta Otorhinolaryngol Ital. 2017;37:160–7. One of the largest reviews of pediatric patients undergoing sialendoscopy for obstructive sialadenitis with a reported success rate of 91% and mean follow-up of almost 2 years
•• Ramakrishna J, Strychowsky J, Gupta M, Sommer DD. Sialendoscopy for the management of juvenile recurrent parotitis: a systematic review and meta-analysis. Laryngoscope. 2015;125(6):1472–9. Meta-analysis of current literature on sialendoscopy for JRP. 7 studies included with conclusions that sialendoscopy is effective and safe
Roby BB, Mattingly J, Jensen EL, Gao D, Chan KH. Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness. JAMA Otolaryngol Head Neck Surg. 2015;141(2):126–9.
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Rosbe, K.W. Pediatric Sialendoscopy and Its Role in Pediatric Salivary Gland Disease. Curr Otorhinolaryngol Rep 5, 235–239 (2017). https://doi.org/10.1007/s40136-017-0162-4
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DOI: https://doi.org/10.1007/s40136-017-0162-4