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Intraductal pressure during sialendoscopy

Published online by Cambridge University Press:  10 September 2014

J C Luers ,
M Ortmann ,
D Beutner  and
K B Hüttenbrink
J C Luers*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
M Ortmann
Affiliation:
Institute of Pathology, University of Cologne, Germany
D Beutner
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
K B Hüttenbrink
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
*
Address for correspondence: Dr Jan Christoffer Luers, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Kerpener Strasse 62, 50924 Cologne, Germany Fax: +49-221-478-4793 E-mail: [email protected]
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Abstract

Background:

Sialendoscopy can be followed by swelling and infection of the salivary gland. A possible pathomechanism is damage of the deeper salivary duct system by intraductal pressure generated by the irrigation fluid.

Method:

After measuring the physiological intraductal pressures which arise during sialendoscopy, these pressures were simulated in freshly excised salivary glands and the tissue was analysed histologically.

Results:

Normal intraductal filling pressure during sialendoscopy is 100–250 daPa, and pressure peaks can be up to 2000 daPa during flushing. A filling pressure of more than 400 daPa results in dilatation of the salivary ducts and acinar area. No direct damage to any duct structures could be observed histologically.

Conclusion:

Irrigation fluid should be administered intermittently rather than continuously during sialendoscopy. The intraductal filling pressure should not exceed 400 daPa to minimise the trauma to the salivary duct system and reduce the risk of developing oedema and inflammation.

Keywords

EndoscopySalivary GlandsSalivary DuctsSialadenitisAcinar cells
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 10 , October 2014 , pp. 897 - 901
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Iro, H, Dlugaiczyk, J, Zenk, J. Current concepts in diagnosis and treatment of sialolithiasis. Br J Hosp Med 2006;67:24–8Google Scholar
2Luers, JC, Grosheva, M, Stenner, M, Beutner, D. Sialoendoscopy: prognostic factors for endoscopic removal of salivary stones. Arch Otolaryngol Head Neck Surg 2011;137:325–9CrossRefGoogle ScholarPubMed
3Luers, JC, Damm, M, Klussmann, JP, Beutner, D. The learning curve of sialendoscopy with modular sialendoscopes: a single surgeon's experience. Arch Otolaryngol Head Neck Surg 2010;136:762–5CrossRefGoogle ScholarPubMed
4Luers, JC, Stenner, M, Schinke, M, Helmstaedter, V, Beutner, D. Tolerability of sialendoscopy under local anesthesia. Ann Otol Rhinol Laryngol 2012;121:269–74CrossRefGoogle ScholarPubMed
5Kroll, T, Finkensieper, M, Hauk, H, Guntinas-Lichius, O, Wittekindt, C. Sialendoscopy – learning curve and nation-wide survey in German ENT-departments [in German]. Laryngorhinootologie 2012;91:561–5Google ScholarPubMed
6Koch, M, Zenk, J, Bozzato, A, Bumm, K, Iro, H. Sialoscopy in cases of unclear swelling of the major salivary glands. Otolaryngol Head Neck Surg 2005;133:863–8CrossRefGoogle ScholarPubMed
7Chu, DW, Chow, TL, Lim, BH, Kwok, SP. Endoscopic management of submandibular sialolithiasis. Surg Endosc 2003;17:876–9Google Scholar
8Marchal, F, Dulguerov, P, Becker, M, Barki, G, Disant, F, Lehmann, W. Specificity of parotid sialendoscopy. Laryngoscope 2001;111:264–71CrossRefGoogle ScholarPubMed
9Marchal, F, Dulguerov, P, Becker, M, Barki, G, Disant, F, Lehmann, W. Submandibular diagnostic and interventional sialendoscopy: new procedure for ductal disorders. Ann Otol Rhinol Laryngol 2002;111:27–35CrossRefGoogle ScholarPubMed
10Nahlieli, O, Nakar, LH, Nazarian, Y, Turner, MD. Sialoendoscopy: A new approach to salivary gland obstructive pathology. J Am Dent Assoc 2006;137:1394–400CrossRefGoogle ScholarPubMed
11Konstantinidis, I, Chatziavramidis, A, Tsakiropoulou, E, Malliari, H, Constantinidis, J. Pediatric sialendoscopy under local anesthesia: limitations and potentials. Int J Pediatr Otorhinolaryngol 2011;75:245–9CrossRefGoogle ScholarPubMed
12Marchal, F, Dulguerov, P. Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg 2003;129:951–6CrossRefGoogle ScholarPubMed
13Baker, OJ. Tight junctions in salivary epithelium. J Biomed Biotechnol 2010;2010:278948Google Scholar
14Seifert, G. Diseases of the salivary glands: pathology, diagnosis, treatment, facial nerve surgery. Stuttgart, Germany: Thieme, 1986Google Scholar