Sialolithiasis: retrospective analysis of the effect of an escalating treatment algorithm on patient-perceived health-related quality of life

Head & Face Medicine

Jörg Handschel¹  Henrik Holtmann²  Christoph Sproll³  Julian Lommen³  Lara Schorn³  Benjamin Roth³  Norbert R. Kübler³  Christian Naujoks⁴ 

[1] Clinic for Oral and Maxillofacial Surgery, Klinik am Kaiserteich, Reichsstraße 59, 40217, Düsseldorf, Germany;Department of Oral and Maxillofacial Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany;Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany;MKG Brühl, Uhlstraße 95-97, 50321, Brühl, Germany;

关键词: Sialolithiasis;    Submandibular gland;    Parotid gland;    Minimal-invasive;    Algorithm;   

DOI  :  10.1186/s13005-021-00259-1

来源: Springer

【 摘 要 】

BackgroundGland preserving techniques in the treatment of sialolithiasis have continuously replaced radical surgery. The aim of this study was to evaluate a multimodal treatment algorithm in the therapy of sialolithiasis and assess improvement of HRQoL perceived by patients.MethodsPatients with sialolithiasis were treated by a multimodal treatment algorithm based on multiplicity of stones, stone size, affected gland, and stone position. The therapeutic spectrum ranged from conservative measures, extracorporeal shockwave lithotripsy, interventional sialendoscopy, combined endoscopic-surgical procedures to surgical gland removal as ultima ratio. Outcomes were evaluated by surgeons by means of the electronic patient record and by patients themselves using a standardized questionnaire.Results87 patients treated for sialolithiasis were comprised in this study. The submandibular gland (SMG) was affected in 58.6% and the parotid gland (PG) in 41.4% of cases. Mean patient age was 41.67 years for SMG and 48.91 years for PG. In over 80% of cases sialolithiasis was associated with classic meal-related pain and swelling. Type and intensity of symptomatic sialolithiasis were not dependent on patient age or gender, nor could a relation between the affected gland and the occurrence of symptoms be demonstrated. Overall, 86.2% of cases were reported as cured using the multimodal step-by-step treatment algorithm. Resection of the affected gland could be dispensed in 98.9% of cases. According to patients pain could be reduced in 94.3% of cases.ConclusionsThe analyzed treatment algorithm of increasing invasiveness is a favorable and effective tool to successfully treat sialolithiasis in > 86% of cases. For the first time, the present study shows that patient-perceived improvement of HRQoL due to ease of symptoms has an even higher success rate of > 94%.

【 授权许可】

CC BY