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Management of obstructive pathology of the salivary glands in elderly patients: a preliminary study

Published online by Cambridge University Press:  29 November 2021

M Familiari ,
F Ferrario ,
L Giordano Open the ORCID record for L Giordano [Opens in a new window] ,
D Di Santo ,
P Indelicato ,
R A Battista  and
M Bussi
M Familiari
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’) – San Raffaele Hospital, Vita-Salute University, Milan, Italy
F Ferrario
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’) – San Raffaele Hospital, Vita-Salute University, Milan, Italy
L Giordano*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’) – San Raffaele Hospital, Vita-Salute University, Milan, Italy
D Di Santo
Affiliation:
Otorhinolaryngology Unit, Istituto di Ricovero e Cura a Carattere Scientifico – Humanitas Research Hospital, Milan, Italy
P Indelicato
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’) – San Raffaele Hospital, Vita-Salute University, Milan, Italy
R A Battista
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’) – San Raffaele Hospital, Vita-Salute University, Milan, Italy
M Bussi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’) – San Raffaele Hospital, Vita-Salute University, Milan, Italy
*
Author for correspondence: Dr Leone Giordano, Department of Otolaryngology – Head and Neck Surgery, IRCCS – San Raffaele Hospital, Vita-Salute University, Via Olgettina 60, 20132Milan, Italy E-mail: giordano.leone@hsr.it
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Abstract

Background

Obstructive pathology is a benign condition of the salivary glands that can affect elderly and co-morbid people. Sialoendoscopy is a minimally invasive surgical procedure with a success rate comparable to standard sialoadenectomy and has the advantage that it can be performed under local anaesthesia.

Methods

This study aimed to assess sialoendoscopy benefits in elderly patients unfit for general anaesthesia. A group of elderly patients (aged 65 years or more) undergoing sialoendoscopy under local anaesthesia were evaluated. Age, co-morbidities, surgical time, hospital stay, and complication and recurrence rates were assessed.

Results

Nineteen sialoendoscopies were performed in 18 elderly patients with a mean age of 69.7 ± 5.6 years, with some of them suffering from multiple co-morbidities. Surgery was successful in 16 patients, while surgery was unsuccessful in 2 patients because of intraglandular stones. The average surgical duration was 54.5 ± 30.1 minutes, and all patients were discharged 2–3 hours after surgery. No post-operative complications were found and only one patient had recurrence during follow up.

Conclusion

Sialoendoscopy under local anaesthesia is a safe and effective procedure in elderly patients who are more prone to complications.

Keywords

Salivary GlandsCalculiSialadenitisFrail ElderlyEndoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 1 , January 2022 , pp. 60 - 63
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Dr L Giordano takes responsibility for the integrity of the content of the paper

References

Capaccio, P, Torretta, S, Ottaviani, F, Sambataro, G, Pignataro, L. Modern management of obstructive salivary diseases. Acta Otorhinolaryngol Ital 2007;27:161–72Google ScholarPubMed
McGurk, M, Escudier, MP, Brown, JE. Modern management of salivary calculi. Br J Surg 2005;92:107–12CrossRefGoogle ScholarPubMed
Rauch, S, Gorlin, RJ. Diseases of the salivary glands. In: Gorlin, RJ, Goldman, HM, eds. Thoma's Oral Pathology, vol 2, 6th edn. St Louis: Mosby 1970;997–1003Google Scholar
Lustmann, J, Regev, E, Melamed, Y. Sialolithiasis. A survey on 245 patients and a review of the literature. Int J Oral Maxillofac Surg 1990;19:135–8Google ScholarPubMed
Wang, YH, Chen, YT, Chiu, YW, Yu, HC, Chang, YC. Time trends in the prevalence of diagnosed sialolithiasis from Taiwanese nationwide health insurance dental dataset. J Dent Sci 2019;14:365–9CrossRefGoogle ScholarPubMed
Gallo, A, Benazzo, M, Capaccio, P, De Campora, L, De Vincentiis, M, Fusconi, M et al. Sialoendoscopy: state of the art, challenges and further perspectives. Round Table, 101(st) SIO National Congress, Catania 2014. Acta Otorhinolaryngol Ital 2015;35:217–33Google ScholarPubMed
Shrivastava, SR, Shrivastava, PS, Ramasamy, J. Health-care of elderly: determinants, needs and services. Int J Prev Med 2013;4:1224–5Google ScholarPubMed
World Health Organization. Definition of an older or elderly person. In: http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html [13 April 2020]Google Scholar
Singh, S, Bajorek, B. Defining ‘elderly’ in clinical practice guidelines for pharmacotherapy. Pharm Pract (Granada) 2014;12:489CrossRefGoogle ScholarPubMed
Declaration of Helsinki (1964). In: https://www.wma.net/wp-content/uploads/2018/07/DoH-Jun1964.pdf [14 April 2020]Google Scholar
World Medical Association. Declaration of Helsinki: Ethical Principles for Human Research Involving Human Subjects (2008). In: https://www.wma.net/wp-content/uploads/2018/07/DoH-Oct2008.pdf [18 November 2021]Google Scholar
Fabie, JE, Kompelli, AR, Naylor, TM, Nguyen, SA, Lentsch, EJ, Gillespie, MB. Gland-preserving surgery for salivary stones and the utility of sialendoscopes. Head Neck 2019;41:1320–7CrossRefGoogle ScholarPubMed
Jablonski, SG, Urman, RD. The growing challenge of the older surgical population. Anesthesiol Clin 2019;37:401–9CrossRefGoogle ScholarPubMed
Lin, HS, McBride, RL, Hubbard, RE. Frailty and anesthesia - risks during and post-surgery. Local Reg Anesth 2018;11:61–73CrossRefGoogle ScholarPubMed
Makary, MA, Segev, DL, Pronovost, PJ, Syin, D, Bandeen-Roche, K, Patel, P et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 2010;210:901–8CrossRefGoogle ScholarPubMed
Deiner, S, Silverstein, JH. Long-term outcomes in elderly surgical patients. Mt Sinai J Med 2012;79:95–106CrossRefGoogle ScholarPubMed
Vila, PM, Olsen, MA, Piccirillo, JF, Ogden, MA. Rates of sialoendoscopy and sialoadenectomy in 5,111 adults with private insurance. Laryngoscope 2019;129:602–6Google ScholarPubMed
Marchal, F, Dulguerov, P, Becker, M, Barki, G, Disant, F, Lehmann, W. Specificity of parotid sialendoscopy. Laryngoscope 2001;111:264–71CrossRefGoogle ScholarPubMed
Marchal, F, Dulguerov, P, Becker, M, Barki, G, Disant, F, Lehmann, W. Submandibular diagnostic and interventional sialendoscopy: new procedure for ductal disorders. Ann Otol Rhinol Laryngol 2002;111:27–35CrossRefGoogle ScholarPubMed
Achim, V, Light, TJ, Andersen, PE. Gland preservation in patients undergoing sialoendoscopy. Otolaryngol Head Neck Surg 2017;157:53–7CrossRefGoogle ScholarPubMed