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Learning curve in diagnostic and interventional sialendoscopy for obstructive salivary diseases
Sialendoscopy is a new diagnostic and surgical tool for management of salivary gland diseases that offers the opportunity to treat selected pathologies less invasively and with better results compared to previous techniques. As with any new technique, an adequate training programme involving a gradu...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Pacini Editore SpA
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720929/ https://www.ncbi.nlm.nih.gov/pubmed/26824914 http://dx.doi.org/10.14639/0392-100X-352 |
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author | FARNETI, P. MACRÌ, G. GRAMELLINI, G. GHIRELLI, M. TESEI, F. PASQUINI, E. |
author_facet | FARNETI, P. MACRÌ, G. GRAMELLINI, G. GHIRELLI, M. TESEI, F. PASQUINI, E. |
author_sort | FARNETI, P. |
collection | PubMed |
description | Sialendoscopy is a new diagnostic and surgical tool for management of salivary gland diseases that offers the opportunity to treat selected pathologies less invasively and with better results compared to previous techniques. As with any new technique, an adequate training programme involving a gradual learning curve is mandatory to quickly obtain results similar to those reported in the literature. This includes an appropriate diagnostic programme, correct patient selection and knowledge of possible pitfalls. In this retrospective study, the outcomes of the first 141 procedures (74 on the parotid gland and 67 on the submandibular gland) performed with this technique in our Department from 2009 to 2013 were compared with those reported in the literature. Patients were divided into three groups: Group A (the first 49 procedures performed), Group B (the next 50 procedures), and Group C (the last 42 procedures). There were no statistically significant differences relative to mean procedure times, recurrence of symptomatology after treatment, need for further treatments and rates of minor complications between groups. No major complications were seen. The increase in experience resulted in an increased number of interventional sialendoscopies performed under local anaesthesia instead of general anaesthesia (51% vs 18% vs 14%). In only three of 130 glands treated (2.3%) was gland resection required. We also evaluated which technique had been used for stone removal and rate of failure, which was similar in all groups (13.6% vs 15% vs 15%). Our results do not substantially differ from those reported in the literature. Initial difficulties in catheterising the papilla could be overcome with practise on fresh human specimens or fresh pig heads. Lack of precision regarding diagnostic imaging techniques was remedied by improving the competence of the surgeon in performing pre- and postoperative ultrasound. The creation of specialised centres capable of treating up to 1 to 2 million people would be desirable in order to better stratify pathologies, validate the investment in equipment and gain the necessary experience in the various surgical techniques. |
format | Online Article Text |
id | pubmed-4720929 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Pacini Editore SpA |
record_format | MEDLINE/PubMed |
spelling | pubmed-47209292016-01-29 Learning curve in diagnostic and interventional sialendoscopy for obstructive salivary diseases FARNETI, P. MACRÌ, G. GRAMELLINI, G. GHIRELLI, M. TESEI, F. PASQUINI, E. Acta Otorhinolaryngol Ital Salivary Glands Sialendoscopy is a new diagnostic and surgical tool for management of salivary gland diseases that offers the opportunity to treat selected pathologies less invasively and with better results compared to previous techniques. As with any new technique, an adequate training programme involving a gradual learning curve is mandatory to quickly obtain results similar to those reported in the literature. This includes an appropriate diagnostic programme, correct patient selection and knowledge of possible pitfalls. In this retrospective study, the outcomes of the first 141 procedures (74 on the parotid gland and 67 on the submandibular gland) performed with this technique in our Department from 2009 to 2013 were compared with those reported in the literature. Patients were divided into three groups: Group A (the first 49 procedures performed), Group B (the next 50 procedures), and Group C (the last 42 procedures). There were no statistically significant differences relative to mean procedure times, recurrence of symptomatology after treatment, need for further treatments and rates of minor complications between groups. No major complications were seen. The increase in experience resulted in an increased number of interventional sialendoscopies performed under local anaesthesia instead of general anaesthesia (51% vs 18% vs 14%). In only three of 130 glands treated (2.3%) was gland resection required. We also evaluated which technique had been used for stone removal and rate of failure, which was similar in all groups (13.6% vs 15% vs 15%). Our results do not substantially differ from those reported in the literature. Initial difficulties in catheterising the papilla could be overcome with practise on fresh human specimens or fresh pig heads. Lack of precision regarding diagnostic imaging techniques was remedied by improving the competence of the surgeon in performing pre- and postoperative ultrasound. The creation of specialised centres capable of treating up to 1 to 2 million people would be desirable in order to better stratify pathologies, validate the investment in equipment and gain the necessary experience in the various surgical techniques. Pacini Editore SpA 2015-10 /pmc/articles/PMC4720929/ /pubmed/26824914 http://dx.doi.org/10.14639/0392-100X-352 Text en © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/ |
spellingShingle | Salivary Glands FARNETI, P. MACRÌ, G. GRAMELLINI, G. GHIRELLI, M. TESEI, F. PASQUINI, E. Learning curve in diagnostic and interventional sialendoscopy for obstructive salivary diseases |
title | Learning curve in diagnostic and interventional
sialendoscopy for obstructive salivary diseases |
title_full | Learning curve in diagnostic and interventional
sialendoscopy for obstructive salivary diseases |
title_fullStr | Learning curve in diagnostic and interventional
sialendoscopy for obstructive salivary diseases |
title_full_unstemmed | Learning curve in diagnostic and interventional
sialendoscopy for obstructive salivary diseases |
title_short | Learning curve in diagnostic and interventional
sialendoscopy for obstructive salivary diseases |
title_sort | learning curve in diagnostic and interventional
sialendoscopy for obstructive salivary diseases |
topic | Salivary Glands |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720929/ https://www.ncbi.nlm.nih.gov/pubmed/26824914 http://dx.doi.org/10.14639/0392-100X-352 |
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