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- Title
Sialolithiasis: retrospective analysis of the effect of an escalating treatment algorithm on patient-perceived health-related quality of life.
- Authors
Lommen, Julian; Schorn, Lara; Roth, Benjamin; Naujoks, Christian; Handschel, Jörg; Holtmann, Henrik; Kübler, Norbert R.; Sproll, Christoph
- Abstract
Background: Gland 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. Methods: Patients 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. Results: 87 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. Conclusions: The 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%.
- Subjects
SIALOLITHIASIS; QUALITY of life; SUBMANDIBULAR gland; PAROTID glands; EXTRACORPOREAL shock wave lithotripsy; TREATMENT effectiveness; ENDOSCOPIC surgery
- Publication
Head & Face Medicine, 2021, Vol 17, Issue 1, p1
- ISSN
1746-160X
- Publication type
Article
- DOI
10.1186/s13005-021-00259-1