Rachel Shacham

Long-Term Experience With Endoscopic Diagnosis and Treatment of Juvenile Recurrent Parotitis

PURPOSE Juvenile recurrent parotitis (JRP) is characterized by intermittent swelling of one or both parotid glands simultaneously or on different occasions. The peak incidence of JRP is between the ages of 3 and 6 years, with predominance among males. The etiology and mechanism are still unknown. The diagnosis is made on a clinical basis and is confirmed by ultrasonography or sialography. Our objective was to present our long-term experience with endoscopic diagnosis and treatment of JRP. PATIENTS AND METHODS In this clinical review we report our long-term experience in 70 children who were treated by a combined minimally invasive endoscopic method. Another 5 patients with adult-type JRP were included in the study. RESULTS In 93% of the patients a single treatment was enough to resolve this phenomenon and prevent its recurrence. CONCLUSION Sialoendoscopy and lavage of the parotid gland comprise the treatment of choice for JRP, achieving a high success rate with minimal morbidity.

The ductal stretching technique: an endoscopic-assisted technique for removal of submandibular stones.

Objective: The purpose of this study was to describe an innovative surgical technique for the removal of posterior and hilar stones of the submandibular salivary duct.

Endoscopic treatment of salivary glands affected by autoimmune diseases.

PURPOSE To asses the possibility of an endoscopic technique to diagnose, treat, and maintain the salivary glands in patients with Sjögren syndrome and systemic lupus erythematosus. PATIENTS AND METHODS A total of 8 patients with Sjögren syndrome and 2 with systemic lupus erythematosus with affected salivary glands were included in the present study. The treatment approach included parotid sialoendoscopy with thorough rinsing, and Stensons duct dilation using hydrostatic pressure and a high-pressure balloon. Hydrocortisone 100 mg was injected through direct vision into the duct. The study was exempt by the Barzilai Medical Center review board. RESULTS The main diagnosis of the patients was chronic recurrent parotitis, with the exception of 1 patient, who presented with salivary stones. CONCLUSIONS The pathologic features of the salivary glands resulting from Sjögren syndrome and systemic lupus erythematosus can be managed successfully using an endoscopic approach.

Combined External Lithotripsy and Endoscopic Techniques for Advanced Sialolithiasis Cases

PURPOSE To assess a combined external lithotripsy-sialoendoscopy method developed for advanced salivary gland sialolithiasis. MATERIALS AND METHODS A total of 94 patients (43 males and 51 females) underwent these treatment methods. Of these 94 patients, 60 had pathologic features in the submandibular gland and 34 in the parotid gland. A miniature external lithotripter was used, combined with multifunctional sialoendoscopes and endoscopic-assisted techniques, to achieve effective removal/elimination of the stones in these difficult cases. RESULTS Total elimination of the stone using lithotripsy alone was achieved in 32% of the cases; in 29%, intraductal endoscopic assistance was needed. In the remaining 39%, the removal of a stone was achieved with the help of an endoscopy-assisted extraductal approach (37 cases). At 6 months of follow-up, all patients who had undergone lithotripsy or lithotripsy plus intraductal endoscopy had an absence of symptoms. Of the 37 patients who had undergone an endoscopy-assisted extraductal approach, 35 (95%) remained asymptomatic. CONCLUSIONS Lithotripsy plus intraductal or extraductal endoscopic treatment of sialolithiasis is a highly effective surgical method of eliminating/removing salivary stones, especially those attached to the surrounding tissue and in the secondary ducts. This method helps to avoid resection of the salivary glands and represents an additional development of minimal invasive surgical techniques.

Endoscopic treatment of salivary gland injuries due to facial rejuvenation procedures.

Objective: The purpose of this article is to describe innovative surgical techniques for treatment of salivary gland injuries caused by facial rejuvenation procedures.