Brianne Barnett Roby1, Jameson Mattingly1, Emily L Jensen1, Dexiang Gao2, Kenny H Chan1. 1. Department of Otolaryngology, University of Colorado School of Medicine, Aurora2Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado. 2. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora.
Abstract
IMPORTANCE: Juvenile recurrent parotitis (JRP) is characterized by recurrent painful swelling of the parotid gland that occurs in the pediatric population. Sialendoscopy with and without ductal corticosteroid infusion (DCI) has been found to be effective in the treatment of JRP and autoimmune parotitis. OBJECTIVE: To determine the utility of instrumentation vs pharmacotherapy alone for juvenile recurrent parotitis. DESIGN, SETTING, AND PARTICIPANTS: A retrospective medical record review of pediatric patients undergoing DCI without sialendoscopy at a tertiary pediatric hospital was conducted. The medical records were reviewed to determine the frequency of parotitis events before and after treatment. A multiquestion telephone survey of patients and their parents who underwent the procedure was then conducted to determine patient satisfaction. INTERVENTIONS: Ductal corticosteroid infusion with hydrocortisone through catheter inserted in the parotid duct. MAIN OUTCOMES AND MEASURES: Frequency of symptoms before and after treatment and parental satisfaction with the treatment. RESULTS: Twelve patients with a mean age of 6.7 years were identified. The mean duration and frequency of symptoms before the procedure were 22 months and every 2 months, respectively. Five patients had a recurrence, on average 4 months after the procedure. Four patients underwent repeated surgical procedures. All had a longer duration between episodes compared with before DCI. Eight parents participated in the survey on satisfaction with the procedure, and 75% reported improvement in their child's life postprocedure. CONCLUSIONS AND RELEVANCE: Current literature shows sialendoscopy with corticosteroid application is successful in treating JRP, but it is unclear whether corticosteroid application alone would treat JRP equally. This study shows that DCI alone has similar results as sialendoscopy with corticosteroid application, indicating that it is the corticosteroid application and not the sialendoscopy causing improvement in symptoms. Because JRP must be differentiated from sialolithiasis, we recommend ultrasonography of the involved parotid(s) prior to using DCI alone to ensure no stone is present. Sialendoscopy should be reserved to rule out other parotid ductal pathologic conditions.
IMPORTANCE: Juvenile recurrent parotitis (JRP) is characterized by recurrent painful swelling of the parotid gland that occurs in the pediatric population. Sialendoscopy with and without ductal corticosteroid infusion (DCI) has been found to be effective in the treatment of JRP and autoimmune parotitis. OBJECTIVE: To determine the utility of instrumentation vs pharmacotherapy alone for juvenile recurrent parotitis. DESIGN, SETTING, AND PARTICIPANTS: A retrospective medical record review of pediatric patients undergoing DCI without sialendoscopy at a tertiary pediatric hospital was conducted. The medical records were reviewed to determine the frequency of parotitis events before and after treatment. A multiquestion telephone survey of patients and their parents who underwent the procedure was then conducted to determine patient satisfaction. INTERVENTIONS: Ductal corticosteroid infusion with hydrocortisone through catheter inserted in the parotid duct. MAIN OUTCOMES AND MEASURES: Frequency of symptoms before and after treatment and parental satisfaction with the treatment. RESULTS: Twelve patients with a mean age of 6.7 years were identified. The mean duration and frequency of symptoms before the procedure were 22 months and every 2 months, respectively. Five patients had a recurrence, on average 4 months after the procedure. Four patients underwent repeated surgical procedures. All had a longer duration between episodes compared with before DCI. Eight parents participated in the survey on satisfaction with the procedure, and 75% reported improvement in their child's life postprocedure. CONCLUSIONS AND RELEVANCE: Current literature shows sialendoscopy with corticosteroid application is successful in treating JRP, but it is unclear whether corticosteroid application alone would treat JRP equally. This study shows that DCI alone has similar results as sialendoscopy with corticosteroid application, indicating that it is the corticosteroid application and not the sialendoscopy causing improvement in symptoms. Because JRP must be differentiated from sialolithiasis, we recommend ultrasonography of the involved parotid(s) prior to using DCI alone to ensure no stone is present. Sialendoscopy should be reserved to rule out other parotid ductal pathologic conditions.
Authors: E Papadopoulou-Alataki; A Chatziavramidis; O Vampertzi; S Alataki; I Konstantinidis Journal: Hippokratia Date: 2015 Oct-Dec Impact factor: 0.471
Authors: Urban W Geisthoff; Freya Droege; Cathrin Schulze; Richard Birk; Stefan Rudhart; Steffen Maune; Boris A Stuck; Stephan Hoch Journal: Eur Arch Otorhinolaryngol Date: 2021-06-12 Impact factor: 2.503