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Sialendoscopy in the Treatment of Salivary Gland Diseases 77/2019

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Sialendoscopy in the Treatment of Salivary Gland Diseases 77/2019 JOHANNA JOKELA Recent Publications in this Series 57/2019 Outi Lyytinen Molecular Details of the Double-Stranded RNA Virus Replication and Assembly 58/2019 Markus Räsänen Vascular Endothelial Growth Factor-B and the Bmx Tyrosine Kinase in Cardiac Hypertrophy and Revascularization 59/2019 Vuokko Nummi Insights into Clinical and Laboratory Phenotypes of Von Willebrand Disease DISEASES GLAND OF SALIVARY IN THE TREATMENT SIALENDOSCOPY DISSERTATIONES SCHOLAE DOCTORALIS AD SANITATEM INVESTIGANDAM 60/2019 Shah Hasan UNIVERSITATIS HELSINKIENSIS Challenges of Hyper-Prolificacy in the Pig: Colostrum and Gut Microbiota 61/2019 Sanna Matilainen Pathomechanisms of Leigh Syndrome: Defects of Post-Transcriptional and Post-Translational Regulation of Mitochondrial Metabolism 62/2019 Kirsi Santti Desmoid Tumor: Oncological Management and Prognostic Biomarkers 63/2019 Hesham E. Abdolhfid Mohamed Evaluation of Prognostic Markers for Oropharyngeal Carcinoma Using Tissue Microarray JOHANNA JOKELA 64/2019 Johanna Uhari-Väänänen Contributions of µ- and κ-Opioidergic Systems to Ethanol Intake and Addiction 65/2019 Susanna Rapo-Pylkkö SIALENDOSCOPY IN THE TREATMENT OF SALIVARY Chronic Pain and Neuropathic Pain among Community-dwelling Older Adults in Primary Health GLAND DISEASES Care Settings 66/2019 Helka Göös Human Transcription Factor Protein-protein Interactions in Health and Disease 67/2019 Maiju Rinne Molecular Evolution of G Protein-Coupled Receptors – Insights into the Orexin System 68/2019 Ester Orav The Role of Kainate Receptor Auxiliary Subunits NETO1 and NETO2 in Development of Hippocampal Circuitry 69/2019 Liang Wang Biological Functions of Novel Mitochondrial Proteins 70/2019 Timo Carpén Novel Diagnostic and Prognostic Aspects of HPV-Related and -Unrelated Oropharyngeal Cancer 71/2019 Jaakko Leinonen Moving Beyond GWAS: Exploring the Function of the Gene LIN28B Associated with Pubertal Timing 72/2019 Anna Steinzeig Antidepressant-Induced Plasticity in the Adult Mouse Visual Cortex 73/2019 Saara Huoponen Costs, Effectiveness and Cost-Effectiveness of Biological Drugs in the Treatment of Rheumatoid Arthritis and Inflammatory Bowel Diseases 74/2019 Elisa Ollikainen Microfluidics and Nanotechnology in Pharmaceutical Analysis and Drug Metabolism Research 75/2019 Sina Hulkkonen DEPARTMENT OF OTORHINOLARYNGOLOGY — HEAD AND NECK SURGERY Incidence and Risk Factors of Carpal Tunnel Syndrome, and Ulnar and Radial Entrapment HELSINKI UNIVERSITY HOSPITAL Neuropathies in Finnish Population FACULTY OF MEDICINE 76/2019 Joel Rämö Genomic, Metabolomic and Clinical Profiling of Dyslipidemia in Families DOCTORAL PROGRAMME IN CLINICAL RESEARCH UNIVERSITY OF HELSINKI 77/2019 Helsinki 2019 ISSN 2342-3161 ISBN 978-951-51-5587-0 Department of Otorhinolaryngology – Head and Neck Surgery Helsinki University Hospital, and Doctoral Programme in Clinical Research Faculty of Medicine University of Helsinki Helsinki, Finland SIALENDOSCOPY IN THE TREATMENT OF SALIVARY GLAND DISEASES Johanna Jokela ACADEMIC DISSERTATION To be presented, with the permission of the Medical Faculty of the University of Helsinki, for public examination in the Richard Faltin lecture hall of the Surgical Hospital, Kasarminkatu 11-13, Helsinki, on 29th of November 2019, at 12 noon. Helsinki 2019 Supervised by Riitta Saarinen, MD, PhD Department of Otorhinolaryngology – Head and Neck Surgery University of Helsinki and Helsinki University Hospital Helsinki, Finland Professor Antti Mäkitie, MD, PhD Department of Otorhinolaryngology – Head and Neck Surgery University of Helsinki and Helsinki University Hospital Helsinki, Finland Reviewed by Docent Jura Numminen, MD, PhD Department of Otorhinolaryngology Tampere University Hospital Tampere, Finland Docent Tero Soukka, DDS, PhD Department of Oral and Maxillofacial Diseases Turku University Hospital Turku, Finland Opponent Professor Francis Marchal, MD, PhD Department of Otolaryngology – Head and Neck Surgery University of Geneva Geneva, Switzerland Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis ISBN 978-951-51-5587-0 (paperback) ISBN 978-951-51-5588-7 (PDF) ISSN 2342-3161 (paperback) ISSN 2342-317X (PDF) http://ethesis.helsinki.fi Hansaprint, Turenki 2019 Sic itur ad astra CONTENTS Contents ..................................................................................... 4 List of original publications ........................................................ 7 Abbreviations ............................................................................. 8 Abstract ...................................................................................... 9 Summary in Finnish .................................................................. 11 1 Introduction ..................................................................... 13 2 Review of the literature .................................................... 15 2.1 Salivary glands .......................................................................... 15 2.1.1 Embryology ......................................................................... 15 2.1.2 Anatomy .............................................................................. 15 2.1.2.1 Parotid gland ................................................................... 15 2.1.2.2 Submandibular gland ...................................................... 16 2.1.2.3 Sublingual gland .............................................................. 17 2.1.2.4 Minor salivary glands ...................................................... 17 2.1.3 Physiology ........................................................................... 18 2.2 Infectious diseases of the salivary glands ................................. 19 2.2.1 Acute suppurative sialadenitis ............................................ 19 2.2.2 Viral infections of the salivary glands ................................. 20 2.2.3 Human immunodeficiency virus (HIV)–related parotitis .. 20 2.3 Obstructive sialadenitis ............................................................ 21 2.3.1 Sialolithiasis ........................................................................ 21 2.3.1.1 Pathophysiology and etiology .......................................... 22 2.3.1.2 Treatment ........................................................................ 23 2.4 Chronic sialadenitis .................................................................. 24 2.4.1 Chronic recurrent parotitis ................................................. 25 2.4.2 Juvenile recurrent parotitis ................................................. 26 2.4.3 Sjögren’s syndrome ............................................................. 26 2.4.4 Chronic sclerosing sialadenitis ............................................ 27 2.4.5 Treatment of chronic sialadenitis ....................................... 27 2.5 Noninflammatory diseases of the salivary glands .................... 29 4 2.5.1 Sialadenosis ......................................................................... 29 2.5.2 Radioiodine-induced sialadenitis ........................................ 29 2.6 Radiological imaging of the salivary glands ............................. 30 2.7 Sialendoscopy ............................................................................ 31 2.7.1 History of sialendoscopy ..................................................... 31 2.7.2 Diagnostic sialendoscopy .................................................... 32 2.7.3 Interventional sialendoscopy .............................................. 34 2.7.3.1 Treatment of sialoliths ..................................................... 34 2.7.3.2 Treatment of strictures and stenosis ............................... 38 2.7.3.3 Treatment of chronic sialadenitis .................................... 39 2.7.4 Complications ...................................................................... 43 2.7.5 Cost-effectiveness of sialendoscopy .................................... 43 2.8 Assessing health-related quality of life (HRQoL) ..................... 44 2.8.1 HRQoL after sialendoscopy ................................................. 45 3 Aims of the study ............................................................... 47 4 Patients and methods ....................................................... 48 4.1 Patients......................................................................................48 4.2 Methods .................................................................................... 50 4.2.1 Sialendoscopy ...................................................................... 50 4.2.2 Medical records ................................................................... 50 4.2.3 Questionnaires (II, III, V) ................................................... 51 4.2.4 Intervention, randomization, and outcomes (III) ............... 52 4.3 Statistical analysis ..................................................................... 53 4.4 Ethical considerations ............................................................... 54 5 Results .............................................................................. 55 5.1 Patients’ characteristics (I–V) .................................................. 55 5.2 Sialendoscopy findings and outcomes (I–V) ............................ 56 5.3 Sialoliths (I, IV) ......................................................................... 58 5.4 Complications (I, IV, V) ............................................................ 59 5.5 Local anesthesia (II) ................................................................
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