Sialendoscopy in the management of obstructive sialadenitis: clinical experience and treatment outcomes.

BACKGROUND

Obstructive sialadenitis is a common salivary gland disorder. This retrospective study evaluated the outcomes of sialendoscopy in 90 patients treated between July 2018 and December 2023.

OBJECTIVE

To evaluate the success rate, complications, and predictors of treatment outcomes of sialendoscopy in patients with obstructive sialadenitis.

DESIGN

Retrospective cohort study.

SETTING

Security Forces Hospital, Saudi Arabia.

PATIENTS AND

METHODS

A retrospective cohort study was conducted using patient medical records. Patients with obstructive sialadenitis were included.

MAIN OUTCOME MEASURES: Success of sialendoscopy, defined as complete endoscopic stone retrieval with confirmed ductal patency on post-retrieval irrigation. Four procedures in which no sialolith was identified intraoperatively were excluded from the stone-retrieval success denominator (n=94 stone-confirmed procedures).

SAMPLE SIZE: Ninety patients.

RESULTS

Submandibular glands accounted for 74% (67/90) of cases. Success rates for complete stone retrieval were 79% (19/24 parotid) and 79% (55/70 submandibular). Key predictors of success included stone size, location, and number: stones >10 mm (OR=0.17, 95% CI: 0.04-0.67; P=.01), intraglandular location (OR=0.13, 95% CI: 0.03-0.54; P=.005), and multiple stones (OR=0.18, 95% CI: 0.05-0.60; P=.006) significantly reduced success. Complications occurred in 11.2% (11/98) of cases, primarily ductal stenosis and postoperative swelling, with submandibular glands contributing most complications.

CONCLUSION

In this one of the larger reported single-centre Saudi series, sialendoscopy demonstrated high success for obstructive sialadenitis, with stone size >10 mm, intraglandular location, and multiplicity as independent failure predictors. These findings support tailored approaches in Middle Eastern populations.

LIMITATIONS: Retrospective single-center design, lack of long-term follow-up data, and absence of patient-reported outcome measures.