Evaluation of the parotid gland function before and after endoscopy-assisted stone removal

Publication date: Available online 11 October 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Ya-Qiong Zhang, Xin Ye, Yuan Meng, Ya-Ning Zhao, Deng-Gao Liu, Guang-Yan Yu

Purpose

To quantify the gland function before and after endoscopy-assisted lithectomy for patients with parotid stones, and to analyze the correlations among different evaluation modalities.

Materials and Methods

The study was undertaken among 58 patients (27 males and 31 females) with >5mm or multiple parotid stones who underwent successful endoscopy-assisted surgery at our center from August 2007 through September 2017. Meticulous postoperative manipulations were administered routinely for 3-6 months to promote function recovery of the affected gland. Gland function was evaluated preoperatively and 6-36 months (mean, 12 months) postoperatively by sialography, scintigraphy and sialometry. Statistical analyses were conducted to quantify gland function recovery and to distinguish the correlations among three objective tests.

Results

Preoperative sialograms exhibited ductal ectasia at stone site with ductal stenosis anterior to the stone (n=53), or duct interruption at stone site (n=5). Postoperative sialograms in 45 stone-free patients were categorized as: I approximately normal (n=17); II ectasia or stenosis of the main duct, without persistent contrast on the functional film (n=16); III ectasia or stenosis of the main duct with mild contrast retention (n=6); IV poor ductal shape with evident contrast retention (n=6). Both scintigraphy of 23 preoperative and 12 postoperative patients and sialometry of 24 preoperative and 12 postoperative patients indicated severe preoperative impairment and postoperative improvement of gland function. Postoperatively, though no significant differences of saliva flow rate were found between two sides, scintigraphy showed lower function of the affected gland than the control side. Statistical data showed positive correlations among three methods. Sialography intuitively reflected the ductal shape, while sialometry and scintigraphy were more sensitive for evaluating gland function.

Conclusion

For patients with parotid stones, minimally invasive endoscopic surgery and meticulous postoperative manipulations help preserve the glands and facilitate recovery of gland function. Three evaluating modalities have a certain extent of positive correlations.

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