DOCSLIB.ORG

Article Reference

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Article Reference Article Specificity of parotid sialendoscopy MARCHAL, Francis, et al. Abstract To present our initial experience with sialendoscopy of the parotid duct. Reference MARCHAL, Francis, et al. Specificity of parotid sialendoscopy. Laryngoscope, 2001, vol. 111, no. 2, p. 264-71 DOI : 10.1097/00005537-200102000-00015 PMID : 11210873 Available at: http://archive-ouverte.unige.ch/unige:26081 Disclaimer: layout of this document may differ from the published version. 1 / 1 The Laryngoscope Lippincott Williams & Wilkins, Inc., Philadelphia © 2001 The American Laryngological, Rhinological and Otological Society, Inc. Specificity of Parotid Sialendoscopy Francis Marchal, MD; Pavel Dulguerov, MD, PD; Minerva Becker, MD; Gerard Barki; François Disant, MD; Willy Lehmann, MD Objective: To present our initial experience with INTRODUCTION sialendoscopy of the parotid duct. Study Design: An obstructive disease is the usual diagnosis in case of Methods: Diagnostic and interventional sialendos- unilateral diffuse parotid swelling (after exclusion of mumps copy procedures were performed in 79 and 55 cases, parotitis). The classic attitude is an antibiotic and anti- respectively. Diagnostic sialendoscopy was used to inflammatory treatment, followed by radiological studies, classify ductal lesions into sialolithiasis, stenosis, sia- usually sialography,1 which is still considered the gold stan- lodochitis, and polyps. Interventional sialendoscopy dard. Diagnostic sialendoscopy is a recent procedure2,3 al- was used to treat these disorders. The type of endo- scope used, the type of sialolithiasis fragmentation lowing complete visualization of the ductal system and its and/or extraction device used, the total number of diseases and disorders. Major advances in optical technolo- procedures, the type of anesthesia, and the number gies and the development of semirigid sialendoscopes are and size of the sialoliths removed were the dependent responsible for significant progress in salivary gland endos- variables. The outcome variable was the endoscopic copy.4,5 This procedure, by allowing the complete exploration clearing of the ductal tree and resolution of symp- of the salivary ductal system, is positioned to replace sialog- toms. Results: Diagnostic sialendoscopy was possible raphy and other radiological studies6 because of its higher ؎ in all cases, with an average duration of 26 14 min- specificity and cost-effectiveness. utes and no complications. Interventional sialendos- Because sialolithiasis is the main cause of obstructive copy was successful in 85% of cases, with an average disease of the parotid gland, treatment of repeating epi- .(duration of 73 ؎ 43 minutes (؎ standard deviation sodes includes either a parotidectomy or, rarely, marsupi- Multiple procedures were performed in 45% of cases, general anesthesia was used in 24%, and parotidec- alization (sialodochotomy and/or sialodochoplasty) of the tomy in 2%. Multiple sialoliths were found in 58% of initial part of Stensen’s duct, allowing the direct removal ducts and associated with more procedures under of the stone. However, parotidectomy is rarely performed general anesthesia and longer operations. The aver- for inflammatory conditions because it remains a tedious age size of sialoliths was 3.2 ؎ 1.3 mm; larger stones procedure and carries a higher incidence of postoperative were associated with more procedures under general paresis.7,8 While diagnostic sialendoscopy is an evaluation anesthesia, longer and multiple procedures, use of procedure, interventional sialendoscopy must be consid- fragmentation, and sialendoscopy failures. Sialolithi- ered as a valid operation to relieve the obstructive ductal asis fragmentation was required in 10% of cases, with process, alleviating the need for open surgeries. a success rate of 70%. Semirigid sialendoscopes per- Several techniques have been developed since 1990 to formed better than flexible ones. Complications were fragment sialoliths. Extracorporal lithotripsy, popularized mostly minor but were encountered in 12% of cases. 9 Conclusions: Diagnostic sialendoscopy is a new tech- for sialolithiasis by Iro et al., as well as ductal procedures 10,32,33,35–37 11–13 nique for evaluating salivary duct disease, a tech- such as laser, electrohydraulic, and pneu- nique which is associated with low morbidity. Inter- moblastic14 lithotripsy, has been reported, but leave stone ventional sialendoscopy allows the extraction of fragments in the ductal system. The clearance of these sialoliths in most patients, preventing open gland ex- fragments is incomplete and could become the nidus of cision. Key Words: Salivary gland, parotid, sialolithi- recurrent sialolithiasis.15 asis, stones, endoscopy, instruments, surgical tech- The literature on Stensen’s duct sialendoscopy is lim- nique, laser, treatment, outcome. ited (Table I) because most series report on parotid as well Laryngoscope, 111:264–271, 2001 as submandibular sialolithiasis. Probably, the smaller di- ameter of Stensen’s duct16 has made its exploration more challenging and therefore most previous authors17–19 From the Department of Otolaryngology—Head and Neck Surgery have performed an endoscopy, followed by the blind re- (F.M., P.D., W.L.) and the Department of Radiology (M.B.), Geneva University Hospital, Geneva, Switzerland; Karl Storz GMBH (G.B.), Tüttlingen, Ger- trieval of the stone with a Dormia basket, corresponding, many; and the Department of Otolaryngology—Head and Neck Surgery possibly, to a “endoscopically-assisted stone retrieval,” but (F.D.), Edouard Herriot Hospital, Lyon, France. certainly not to the interventional sialendoscopy described Editor’s Note: This Manuscript was accepted for publication October in the present report. 23, 2000. Send Correspondence to Francis Marchal, MD, CE, 16 Cours de Rive, The aim of this study is to report our 5-year experi- 1204 Geneva, Switzerland. ence with four successive generations of endoscopes in 77 Laryngoscope 111: February 2001 Marchal et al.: Parotid Sialendoscopy 264 patients who had surgery performed by the first author TABLE I. (F.M.) in two university centers (Geneva University Hos- Interventional Sialendoscopy of the Parotid Gland in pital, Switzerland, and Edouard-Herriot Hospital, Claude the Literature. Bernard University, Lyon, France). No. of Interventional No. of Parotid Author, Year Sialendoscopic Cases Sialendoscopic Cases PATIENTS AND METHODS Ko¨ nigsberger, 199032 11 Patients Gundlach, 199233 73 8 The study population consists of 77 consecutive patients *Gundlach, 199434 240 12 (?) suspected of having a disease or disorder of Stensen’s duct who Iro, 199535 20 0 were seen between November 1995 and March 2000. Two pa- Ito, 199636 15 0 tients having bilateral symptoms, a total of 79 diagnostic sialen- doscopic procedures were attempted. These were followed by a Arzoz, 199637 27 4 therapeutic sialendoscopy in 55 cases. Nahlieli, 199738 46 9 6,20 Because of concomitant study protocols, most of the pa- *Nahlieli, 19995 154 57 tients had a preoperative radiological evaluation including sia- lography, ultrasound, magnetic resonance imaging (MRI) sialog- *Probably including cases of the previous reports. raphy, or, rarely, computed tomography (CT) scan. The observed diseases and disorders of Stensen’s duct were classified as sialolithiasis, stenosis, sialodochitis, and ductal pol- 4. The fourth endoscopic system also includes two different yps. The number of instances of each pathological finding in each devices (reference no. 11.516 KA and KT, Karl Storz AG). ductal system was noted. When there were multiple stones, the The diagnostic sialendoscope resembles the single-lumen largest stone was measured with calipers. diagnostic device described above, with slight modifica- The number of diagnostic and interventional procedures tions (handle with rinsing system). The OD is 1.3 mm, was recorded, as well as the type of anesthesia (local vs. general), and the cross-section area is 1.33 mm2. The interven- the fragmentation and extraction device used (discussed later in tional sialendoscope is a double-lumen device with one this section), the total number of sialendoscopic procedures per- channel of 1.1 mm for the endoscope and a working chan- formed per patient, and the number of parotidectomies per- nel of 0.8 mm diameter, which is used for custom-made formed. “Sialendoscopic success” was considered when the lumen baskets and/or laser fibers (Fig. 1). The overall cross- of all the ductal branches was free of any disease. “Sialendoscopic section is 2.29 mm2. The tip of the instrument has been failure” was considered when sialendoscopy was impossible or beveled and blunted for easier cannulation of the duct. unsuccessful or when a gland resection was performed. Both instruments were slightly bent to facilitate explora- In the last 40 patients, the pain experienced as a result of tion of the ductal tree. sialendoscopy was evaluated using a 10-cm visual analogue scale. Statistical analysis for categorical variables was performed with the ␹2 test; numerical variables were analyzed with the Student t test (two groups) or the Kruskal-Wallis test (three or Other Materials more groups), as implemented by the Statistical Package for the Other materials include a customized papilla dilator (refer- Social Sciences (SPSS) software (version 9.0, Chicago, IL). ence nos. 745910 and 745845–744856, Karl Storz AG) and cus- tomized grasping wire baskets (prototypes not referenced yet). Fragmentation of larger stones was achieved in this study using Endoscopes
Load more

Recommended publications
  • Oral Manifestations of Systemic Disease Their Clinical Practice
    ARTICLE Oral manifestations of systemic disease ©corbac40/iStock/Getty Plus Images S. R. Porter,1 V. Mercadente2 and S. Fedele3 provide a succinct review of oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease. While the majority of disorders of the mouth are centred upon the focus of therapy; and/or 3) the dominant cause of a lessening of the direct action of plaque, the oral tissues can be subject to change affected person’s quality of life. The oral features that an oral healthcare or damage as a consequence of disease that predominantly affects provider may witness will often be dependent upon the nature of other body systems. Such oral manifestations of systemic disease their clinical practice. For example, specialists of paediatric dentistry can be highly variable in both frequency and presentation. As and orthodontics are likely to encounter the oral features of patients lifespan increases and medical care becomes ever more complex with congenital disease while those specialties allied to disease of and effective it is likely that the numbers of individuals with adulthood may see manifestations of infectious, immunologically- oral manifestations of systemic disease will continue to rise. mediated or malignant disease. The present article aims to provide This article provides a succinct review of oral manifestations a succinct review of the oral manifestations of systemic disease of of systemic disease. It focuses upon oral mucosal and salivary patients likely to attend oral medicine services. The review will focus gland disorders that may arise as a consequence of systemic upon disorders affecting the oral mucosa and salivary glands – as disease.
    [Show full text]
  • Case of Suspected Sialodochitis Fibrinosa (Kussmaul’S Disease)
    Bull Tokyo Dent Coll (2016) 57(2): 91–96 Case Report doi:10.2209/tdcpublication.2015-0028 Case of Suspected Sialodochitis Fibrinosa (Kussmaul’s Disease) Kamichika Hayashi1), Takeshi Onda1), Hitoshi Ohata1), Nobuo Takano2) and Takahiko Shibahara1) 1) Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan 2) Oral Cancer Center, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan Received 14 September, 2015/Accepted for publication 12 January, 2016 Abstract Here we report a case of Kussmaul’s disease, or sialodochitis fibrinosa. This rare disease is characterized by recurrent swelling of the salivary glands, which then discharge clots of fibrin into the oral cavity. An 80-year-old man with a history of allergic rhinitis visited our department with the chief complaint of pain in the bilateral parotid gland area on eating. An initial examination revealed mild swelling and tenderness in this region, and indurations could be felt around the bilateral parotid papillae. Pressure on the parotid glands induced discharge of gelatinous plugs from the parotid papillae. No pus was discharged, and there were no palpable hard objects. Panoramic X-ray showed no obvious focus of dental infection, and there was no calcification in the parotid gland region. Magnetic resonance imaging revealed segmental dilatation of the main ducts of both parotid ducts, with no signs of displacement due to sialoliths or tumors, or of abnormal saliva leakage. Two courses of antibiotic therapy resulted in no improvement. During treatment, gelatinous plugs (fibrin clots) obstructing the left parotid duct were dislodged by massage, which prevented further blockage by encouraging salivary outflow.
    [Show full text]
  • The CT and MRI Findings of Fibrinous Sialodochitis ISSN 2474-3666
    ISSN 2474-3666 Case Report Mathews Journal of Case Reports The CT and MRI Findings of Fibrinous Sialodochitis Ai Usami1, Naoya Kakimoto2, Tomonao Aikawa3, Sosuke Takahata3, Mitsunobu Kishino4, Ryoko Okahata1, Tomomi Tsu- jimoto1, Yuka Uchiyama1, Tadashi Sasai1, Shumei Murakami1 1Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry. 2Department of Oral and Maxillofacial Radiology, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University. 3The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry 4Department of Oral Pathology, Osaka University Graduate School of Dentistry Corresponding Author: Ai Usami, Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Den- tistry, 1-8 yamadaoka, Suita, Osaka 556-0871, Japan, Tel: +81-6-6879-2967; Email: [email protected] Received Date: 29 Sep 2016 Copyright © 2016 Usami A Accepted Date: 17 Nov 2016 Citation: Usami A, Kakimoto N, Aikawa T, Takahata S, et al. Published Date: 18 Nov 2016 (2016). The CT and MRI Findings of Fibrinous Sialodochitis. M J Case. 1(4): 019. ABSTRACT Fibrinous sialodochitis is a very rare disease in which the recurrent swelling of the salivary gland is caused by the ob- struction of the glandular duct by a fibrinous material. Few studies have reported both the computed tomography (CT) and magnetic resonance imaging (MRI) findings of fibrinous sialodochitis. We reported a forty-nine-year-old man with this disease including CT and MRI findings. His chief complaint was the recurrent swelling of the bilateral submandibular regions. When his primary dentist pushed them strongly, a whitish jelly-like material and a large amount of clear saliva were expelled from the duct orifices of the submandibular glands.
    [Show full text]
  • Prevalence of Salivary Gland Disease in Patients Visiting a Private Dental
    European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 07, Issue 01, 2020 PREVALENCE OF SALIVARY GLAND DISEASE IN PATIENTS VISITING A PRIVATE DENTAL COLLEGE 1Dr.Abarna Jawahar, 2Dr.G.Maragathavalli, 3Dr.Manjari Chaudhary 1Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India 2Professor, Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai, India 3Senior Lecturer, Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai, India [email protected] [email protected] [email protected] ABSTRACT: The aim of the study was to estimate the prevalence of salivary gland diseases in patients visiting a private dental college. A retrospective analysis was conducted on patients who visited the Department of Oral Medicine from March 2019 to March 2020.Clinically diagnosed cases of salivary gland diseases which included salivary gland neoplasms, xerostomia, necrotizing sialometaplasia, mucocele, ranula, sjogren’s syndrome, sialodochitis, sialadenitis were included in the study.The details of each case were reviewed from an electronic database.From the study we found that 17 patients were diagnosed with salivary gland disease.The most commonly observed salivary gland disease was mucocele of the lip with a frequency of 41.17% in the study population followed by xerostomia (17.65%).Salivary gland disease can occur due to variable causes and might significantly affect the quality of life and daily functioning.Only with a thorough knowledge of the subject it is possible to detect the diseases of the salivary gland in their early stage and manage them more efficiently.
    [Show full text]
  • Jemds.Com Original Article
    Jemds.com Original Article MR SIALOGRAPHY AND CONVENTIONAL SIALOGRAPHY IN SALIVARY GLAND AND DUCT PATHOLOGIES: A COMPARATIVE STUDY Amarnath Chellathurai1, Sathyan Gnanasigamani2, Shivashankar Kumaresan3, Suhasini Balasubramaniam4, Kanimozhi Damodarasamy5, Komalavalli Subbiah6, Sivakumar Kannappan7, Balaji Selvaraj8 1Professor and HOD, Department of Radiodiagnosis, Stanley Medical College, Chennai. 2Associate Professor, Department of Radiodiagnosis, Stanley Medical College, Chennai. 3Assistant Professor, Department of Radiodiagnosis, Stanley Medical College, Chennai. 4Associate Professor, Department of Radiodiagnosis, Stanley Medical College, Chennai. 5Junior Resident, Department of Radiodiagnosis, Stanley Medical College, Chennai. 6Assistant Professor, Department of Radiodiagnosis, Stanley Medical College, Chennai. 7Assistant Professor, Department of Radiodiagnosis, Stanley Medical College, Chennai. 8Assistant Professor, Department of Radiodiagnosis, Stanley Medical College, Chennai. ABSTRACT BACKGROUND MR Sialography has become an alternative method for imaging the salivary gland and duct. MRI is a non-invasive technique with advantages of superior tissue discrimination and multiplanar facility. MRI has no radiation hazard as compared to the conventional sialography and CT sialography; 3D CISS sequence gives details of salivary gland ducts and sialoliths. AIM To compare the accuracy of the conventional sialography and MR Sialography in the diagnosis of salivary gland and duct pathologies. MATERIALS AND METHODS A prospective study was
    [Show full text]
  • Specificity of Parotid Sialendoscopy
    The Laryngoscope Lippincott Williams & Wilkins, Inc., Philadelphia © 2001 The American Laryngological, Rhinological and Otological Society, Inc. Specificity of Parotid Sialendoscopy Francis Marchal, MD; Pavel Dulguerov, MD, PD; Minerva Becker, MD; Gerard Barki; François Disant, MD; Willy Lehmann, MD Objective: To present our initial experience with INTRODUCTION sialendoscopy of the parotid duct. Study Design: An obstructive disease is the usual diagnosis in case of Methods: Diagnostic and interventional sialendos- unilateral diffuse parotid swelling (after exclusion of mumps copy procedures were performed in 79 and 55 cases, parotitis). The classic attitude is an antibiotic and anti- respectively. Diagnostic sialendoscopy was used to inflammatory treatment, followed by radiological studies, classify ductal lesions into sialolithiasis, stenosis, sia- usually sialography,1 which is still considered the gold stan- lodochitis, and polyps. Interventional sialendoscopy dard. Diagnostic sialendoscopy is a recent procedure2,3 al- was used to treat these disorders. The type of endo- scope used, the type of sialolithiasis fragmentation lowing complete visualization of the ductal system and its and/or extraction device used, the total number of diseases and disorders. Major advances in optical technolo- procedures, the type of anesthesia, and the number gies and the development of semirigid sialendoscopes are and size of the sialoliths removed were the dependent responsible for significant progress in salivary gland endos- variables. The outcome variable was the endoscopic copy.4,5 This procedure, by allowing the complete exploration clearing of the ductal tree and resolution of symp- of the salivary ductal system, is positioned to replace sialog- toms. Results: Diagnostic sialendoscopy was possible raphy and other radiological studies6 because of its higher ؎ in all cases, with an average duration of 26 14 min- specificity and cost-effectiveness.
    [Show full text]
  • Journal of the Aerospace Medical Association Index
    Journal of the Aerospace Medical Association Index Clinical Problems in Aviation Medicine You’re the Flight Surgeon Cases from the Aerospace Medicine Residents' Teaching File Aeromedical Grand Rounds Topics in Aeromedical Certification Cases from CAMI Clinical articles with aeromedical disposition I have indexed the "Clinical Problems in Aviation Medicine" (CPAM), "You’re the Flight Surgeon" (YTFS), "Cases From The Aerospace Medicine Residents' Teaching File" (AMRTF), "Aeromedical Grand Rounds" (AGR), "Topics in Aeromedical Certification" (TAC), "Cases from CAMI" (FAA Civil Aerospace Medical Institute Aerospace Medical Certification Division) columns, and other articles discussing the aeromedical disposition of particular clinical conditions in the journal of the Aerospace Medical Association from its inception in 1930 through December 2016 by topic. The CPAM series published 14 article from September 1961 to November 1963 from Mayo Clinic. The first YTFS article was in January 1975 and continues to the present. YTFS articles before August 1990 are not indexed in PubMed; and prior to April 1989 no authors were listed. The AMRTF series published 80 numbered cases from October 1984 through 2004. Case number 5 I cannot find in PubMed or the AsMA index. The AGR series published 19 articles from November 1993 through December 1996. The TAC series published 21 articles from January 1998 to August 2001. The CAMI series published 19 articles from June 2006 through September 2008. In the clinical and review articles I not did not include retrospective reviews or prospective incidence studies of a population; mishap or inflight incapacitation review; specific medication review, unless it was in the context of a clinical condition; and non-aviation environments (including parachuting, diving) and passenger- and aeromedical evacuation- related conditions.
    [Show full text]
  • Thieme: Emergency Imaging: a Practical Guide
    Contents Foreword xiii Stuart E. Mervis, MD, FACR Preface xv Acknowledgments xvi 1 Introduction to Emergency Imaging 1 Observing and Interpreting Reporting Grading and Measuring Incidental Findings Learning Radiology CT Window and Level Approximate Radiation Doses for Emergency Studies (mSV) CT Contrast Administration, Risks, and Adverse Reactions 2 Brain 9 Approach Imaging and Anatomy Clinical Presentations and Differential Diagnosis Cerebral Edema Patterns Anatomic Variants and Incidental Findings Skull Fracture Epidural Hematoma Acute Subdural Hematoma Subacute and Chronic Subdural Hematoma Subdural Hygroma Traumatic Subarachnoid Hemorrhage Cerebral Contusion Diffuse Axonal Injury Pneumocephalus Cerebral Swelling Cerebral Herniation Posttraumatic Atrophy and Encephalomalacia Hypertensive Hemorrhage Amyloid Angiopathy Subarachnoid Hemorrhage Arteriovenous Malformation Cavernous Malformation Anoxic Injury Cerebral Infarct: Arterial Territories vii viii Contents Venous Sinus Thrombosis and Venous Infarct White Matter Disease Cerebritis and Brain Abscess Herpes Encephalitis Neurocysticercosis Bacterial Meningitis Low- and Intermediate-Grade Gliomas Glioblastoma Primary CNS Lymphoma Cerebral Metastasis Hydrocephalus 3 Head and Neck 83 Approach Imaging and Anatomy Clinical Presentations and Differential Diagnosis Nasal and Naso-Orbito-Ethmoid Fracture Zygomaticomaxillary Complex Fracture Le Fort Fractures Midface Smash Injury Orbital Wall Fractures Globe and Orbital Soft Tissue Injury Temporal Bone Fracture Mandible Fracture Laryngeal Fracture
    [Show full text]
  • Non-Neoplastic Parotid Disorders
    Non-neoplastic Parotid Disorders David W. Eisele, M.D., F.A.C.S. Department of Otolaryngology- Head and Neck Surgery Johns Hopkins University School of Medicine Disclosure Nothing to disclose Objectives • Presentation • Evaluation • Classification system parotid enlargement - Inflammatory - Non-Inflammatory Non-neoplastic Parotid Disorders • Variety of clinical disorders - Primary gland disorder - Systemic disorder with gland involvement • Local symptoms +/- systemic or asymptomatic • Diagnosis generally dependent on clinical evaluation and diagnostic studies • Treatment largely guided by diagnosis and patient complaints History • Determine which salivary gland or glands are involved • Progression of enlargement • Inciting factors for enlargement • Nature and duration of symptoms • Pain: character, severity, frequency History • Associated Symptoms - Head and Neck - Systemic • Review of Systems • Medications • Past Medical History • Social History (eg. alcohol use) • Family History Physical Examination • Complete Head and Neck Exam • Inspection / Palpation of Salivary Glands - enlargement (unilateral/bilateral) - consistency - tenderness - mobility • Differentiate diffuse gland enlargement from discrete mass or anatomic anomaly Physical Examination • Cranial Nerves V, VII, X, XI, XII •Eyes - lacrimal gland enlargement - tear adequacy • Neck lymphadenopathy - unilateral or bilateral Team Approach • Radiology • Pathology / Cytopathology • Internal Medicine • Rheumatology, Endocrinology • Infectious Diseases • Pediatrics • Psychiatry • Nutrition
    [Show full text]
  • A Rare Case of Unilateral Pneumoparotid
    SCIENTIFIC ARCHIVES OF DENTAL SCIENCES Volume 2 Issue 11 November 2019 Case Report A Rare Case of Unilateral Pneumoparotid Mohammed Salman Basha* Department of Oral and Maxillofacial, Oral and Maxillofacial Surgeon at Aster Sanad Hospital, Riyadh, Saudi Arabia *Corresponding Author: Mohammed Salman Basha, Department of Oral and Maxillofacial, Oral and Maxillofacial Surgeon at Aster Sanad Hospital, Riyadh, Saudi Arabia. Received: September 26, 2019; Published: October 15, 2019 Abstract tumors of salivary glands, systemic diseases or syndromes. We here present a rare case of right parotid swelling due to retrograde Parotid swelling is not an uncommon finding. Enlargement of parotid can happen due to infections, obstruction in salivary flow, Keywords: Parotid Swelling; Parotiditis; Pneumoparotid; Pneumoparotitis; Pneumosialoadenitis movement or insufflation of air from the mouth into the parotid gland and possible management options. Introduction echoic cluster of foci with posterior acoustic shadow likely of being a calculus, Stenson’s duct was not clearly visible. A CT with contrast was done showed right parotid enlargement, with multiple free Enlargement of major salivary glands are routinely seen in our are the largest salivary gland. They secrete serous saliva through air foci within the gland parenchyma, discrete dense foci of small clinical practice. Parotid glands are a major salivary gland and within duct, tumors, autoimmune or lymphoproliferative diseases. parotid duct into mouth. Enlargement may occur due to obstruction calcifications (Figure 2 and 3). Acute enlargements also are noted as a result of viral and bacterial infections. An acute swelling of the parotid was seen in our patient due to air within the left parotid causing acute discomfort to the patient.
    [Show full text]
  • Statistical Analysis Plan
    Cover Page for Statistical Analysis Plan Sponsor name: Novo Nordisk A/S NCT number NCT03061214 Sponsor trial ID: NN9535-4114 Official title of study: SUSTAINTM CHINA - Efficacy and safety of semaglutide once-weekly versus sitagliptin once-daily as add-on to metformin in subjects with type 2 diabetes Document date: 22 August 2019 Semaglutide s.c (Ozempic®) Date: 22 August 2019 Novo Nordisk Trial ID: NN9535-4114 Version: 1.0 CONFIDENTIAL Clinical Trial Report Status: Final Appendix 16.1.9 16.1.9 Documentation of statistical methods List of contents Statistical analysis plan...................................................................................................................... /LQN Statistical documentation................................................................................................................... /LQN Redacted VWDWLVWLFDODQDO\VLVSODQ Includes redaction of personal identifiable information only. Statistical Analysis Plan Date: 28 May 2019 Novo Nordisk Trial ID: NN9535-4114 Version: 1.0 CONFIDENTIAL UTN:U1111-1149-0432 Status: Final EudraCT No.:NA Page: 1 of 30 Statistical Analysis Plan Trial ID: NN9535-4114 Efficacy and safety of semaglutide once-weekly versus sitagliptin once-daily as add-on to metformin in subjects with type 2 diabetes Author Biostatistics Semaglutide s.c. This confidential document is the property of Novo Nordisk. No unpublished information contained herein may be disclosed without prior written approval from Novo Nordisk. Access to this document must be restricted to relevant parties.This
    [Show full text]
  • Recurring Bilateral Parotid Gland Swelling: Two Cases of Sialodochitis fibrinosa
    The Journal of Laryngology & Otology (2006), 120, 330–333. Clinical Record # 2006 JLO (1984) Limited doi:10.1017/S0022215106000296 Printed in the United Kingdom First published online 18 February 2006 Recurring bilateral parotid gland swelling: two cases of sialodochitis fibrinosa KAZUAKI CHIKAMATSU, MD, MASATO SHINO, MD, YOICHIRO FUKUDA, MD, KOICHI SAKAKURA, MD, NOBUHIKO FURUYA,MD Abstract Salivary gland swelling is a commonly encountered clinical symptom, but the establishment of a diagnosis is occasionally difficult. Here, we present two sialodochitis fibrinosa patients with recurring bilateral parotid swelling. In both patients, secretion of mucous plugs containing numerous eosinophils was observed from Stensen’s ducts. As expected, the level of interleukin-5 in the saliva was much higher than that in the serum. One patient had no medical history of allergic disease; the other had allergic rhinitis which had never been associated with parotid gland swelling. Microbiological examination was unable to isolate significant bacterial specimens from the mucous plugs. Thus, although allergy and/or bacterial infection are reportedly implicated as causes of sialodochitis fibrinosa, there may exist other possibilities for its pathogenesis. Interleukin-5 seems to play a crucial role in the pathogenesis of sialodochitis fibrinosa. Key words: Salivary Gland Diseases; Parotid Gland; Interleukin-5 Introduction symptoms had recently progressed and she was referred Salivary gland swelling is a commonly encountered clinical to our hospital. On physical examination, she had diffuse symptom and can be caused by various inflammatory or bilateral swelling of the parotid glands. She had neither noninflammatory disorders. Inflammatory salivary dis- facial nerve palsy nor palpable cervical nodes. orders can be grouped according to the aetiology of the An intraoral examination showed unremarkable find- infection and its time course.
    [Show full text]