Clinical, Pathological And Sialoendoscopic Study Of Chronic Obstructive Salivary Gland Diseases

Purpose:The aim of this study was to evaluate the efficacy and safety of sialoendoscopy to find the etiology of chronic obstructive sialadenitis and to treat the non-sialolith obstructive sialadenitis by drug irrigation. The purpose of the pathological research of chronic obstructive sialoadenitis is to guide the diagnosis and treatment.Methods:Sialoendoscopy was used to examine65salivary glands in58patients that suspected to have chronic obstructive sialadenitis. The ductal system was viewed in order to identify the obstructive etiology of chronic obstructive sialadenitis. Treatment of the obstruction which was not caused by sialolith was performed by0.9%physiological saline and gentamycin irrigation. Patients were followed up for one week and one month postoperatively. VAS (visual analogue scale) values were recorded for three times and complications were observed. Statistical analysis was performed to analyze the VAS values for evaluating the curative effects of the sialoendospocy. The pathological changes of81patients with chronic obstructive sialadenitis were observed. Their characteristics were finally summarized.Result:One case hadn’t any obstructive findings, the others had the following findings: hyperaemia; inflammation; anabrosis; fibrous substance; stenosis; sialolith; ductal ectasia; mucous plug; pus embolism, and polyp. Treatment of the obstruction which was not caused by sialolith was performed by0.9%physiological saline and gentamycin irrigation. A one week follow-up results were excellent in17cases, good in39cases, and poor in2cases that needed to rinse again. The effective power was97%. A one month follow-up demonstrated that the results were excellent in20cases, good in34cases, and poor in4cases. The effective power was93%. There were no complications other than the presence of immediate swelling after irrigation. The paired t-test analysis of SPSS statistical software was used to test the difference between the preoperative VAS values and the one week postoperative VAS values, furthermore paired t-test was also used to analyze the difference between the preoperative VAS values and the one month postoperative VAS values. There were significant differences (P<0.05) for two times.58salivary glands were saved instead of being resected, to avoid serious consequences after gland excision. The pathological changes of81patients mainly included:inflammatory cell infiltration, histoclasia, analosis and desmoplasia. Besides that, most of the resected salivary glands have ductal ectasia.Conclusion:The major histopathology of chronic obstructive sialadenitis was chronic inflammatory changes. By the correct diagnosis and appropriate treatment such as sialoendoscopy, salivary glands could be saved to restore their functions. The current study concluded that the diagnostic value of sialoendoscopy is high. Simultaneously, sialoendoscopy could treat the non-sialolith caused obstructive sialadenitis by irrigation with no obvious complications, and the effective rate is high. Sialoendoscopy is a minimally invasive diagnostic and treatment method with a good safety and it could save the affected glands that would benefit patients greatly. Furthermore, it will develop quickly and become the capital diagnostic and treatment method of obstructive salivary gland diseases that avoiding the salivary gland excision.