Abstract

OBJECTIVE
To determine whether unique patterns of care are evolving in the United States compared with Germany in endoscopic management of chronic sialadenitis.
DESIGN
Comparison of consecutive series of patients.
SETTING
Academic tertiary salivary referral centers in Germany and the United States.
PATIENTS
A total of 446 patients having chronic sialadenitis treated with salivary endoscopy.
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.
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.
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.

Links

Publisher Full Text

Authors

Gillespie MB, Koch M, Iro H, Zenk J

Institution

Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, 29425-5500, USA. gillesmb@musc.edu

Source

Archives of otolaryngology--head & neck surgery 137:9 2011 Sep pg 903-8

MeSH

Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia, General
Anesthesia, Local
Child
Child, Preschool
Chronic Disease
Cross-Cultural Comparison
Diagnostic Imaging
Endoscopy
Female
Germany
Humans
Lithotripsy
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Parotid Gland
Physician's Practice Patterns
Postoperative Complications
Salivary Gland Calculi
Sialadenitis
Submandibular Gland
United States
Young Adult

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21844406