Idiopathic Chronic Parotitis: Imaging Findings and Sialendoscopic Response

ORL J Otorhinolaryngol Relat Spec. 2015;77(5):302-9. doi: 10.1159/000438760. Epub 2015 Sep 17.

Abstract

Background/aims: The purpose of this study was to correlate imaging and sialendoscopic findings to therapeutic response in patients with idiopathic chronic parotitis.

Methods: We retrospectively reviewed 122 consecutive sialendoscopies performed in an academic medical center by two surgeons between 2008 and 2013. Forty-one (34%) and 54 (44%) patients were excluded on the basis of having parotid or submandibular sialolith, respectively. Nineteen cases were included in the study with idiopathic chronic parotitis. There was a median follow-up of 5 months.

Results: Computed tomography (CT) imaging had a sensitivity and specificity of 80.0 and 71.4%, respectively, for predicting abnormal findings on sialendoscopy, while magnetic resonance imaging (MRI) had 100% accuracy in a small set of cases. In glands with noticeable pathology present on preoperative imaging or sialendoscopy, 11 out of 12 glands (92%) treated experienced symptomatic improvement, while 3 out of 7 glands (43%) without pathology on imaging or endoscopy experienced symptomatic improvement (p = 0.038).

Conclusions: Sialendoscopy for the treatment of idiopathic chronic parotid disease can improve pain and swelling with a higher frequency of success in patients with abnormalities noted on endoscopy. CT and MRI have a moderate degree of accuracy in predicting which patients will benefit from therapeutic sialendoscopy.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Diagnosis, Differential
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Parotitis / diagnosis*
  • ROC Curve
  • Retrospective Studies
  • Salivary Glands / pathology*
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult