Ultraschall Med 2022; 43(03): 289-297
DOI: 10.1055/a-1270-7174
Original Article

Simultaneous Application of Ultrasound and Sialendoscopy and its Value in the Management of Sialolithiasis

Simultane Anwendung von Ultraschall und Sialendoskopie: Wertigkeit in Diagnostik und Therapie von Speichelsteinen
Michael Koch
Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
,
Mirco Lothar Schapher
Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
,
Konstantinos Mantsopoulos
Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
,
Miguel Goncalves
Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
,
Heinrich Iro
Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
› Author Affiliations

Abstract

Objective Ultrasound (US) and sialendoscopy (SE) are routinely used in patients presenting with sialolithiasis in the submandibular (SMG) and parotid gland (PG). The objective was to assess the value of the simultaneous application of US and SE in the management of sialolithiasis.

Study Design Retrospective study. Setting: Tertiary referral center for salivary gland diseases. Participants: Patients in whom US and SE as single investigation tools were neither conclusive nor useful in the management of sialolithiasis were investigated using both methods simultaneously (simUS + SE). Main outcome measures: Establishment of the final diagnosis and/or contribution to the planning/performing of treatment in sialolithiasis.

Results 74 patients were examined by simUS + SE (58.1 % SMG and 41.9 % PG). In all patients (unclear) hyperechoic reflexes were assessed and/or localized by SE-controlled US navigation. 68.9 % of the patients were investigated for diagnostic or differential-diagnostic reasons including distinguishing extraductal from intraductal calcifications and/or to exclude residual stones after therapy. In 52.7 % simUS + SE was used to plan and/or perform further treatment, in 20.3 % to enable performing a combined approach (all PG) and in 29.7 % to evaluate and plan the most adequate therapy (mainly intraductal vs. extracorporeal shock wave lithotripsy, 68.2 % of these SMG). In two cases SE-controlled and US-guided stone extraction was performed.

Conclusion SimUS + SE is an innovative approach which proved to be very useful in managing sialolithiasis. It added valuable information regarding the establishment of a diagnosis or differential diagnosis, planning and performing the most adequate treatment, intraoperative control of therapy and postoperative follow-up.

Zusammenfassung

Ziel Ultraschall (US) und Sialendoskopie (SE) werden routinemäßig bei Patienten mit einer Sialolithiasis der Glandula submandibularis (GSM) und Parotis (GP) angewendet. Ziel war es, den Wert der simultanen Anwendung von US und SE (simUS + SE) für die Sicherung der endgültigen Diagnose und/oder ihren Beitrag zur Planung und Durchführung der Therapie der Sialolithiasis zu untersuchen.

Material und Methoden In einer retrospektiven Studie wurden Patienten, bei welchen US und SE als einzelne Untersuchungsmethoden kein sicheres Ergebnis erbrachten, auf den Mehrwert einer simUS + SE hinsichtlich des weiteren Managements untersucht.

Resultate Bei 74 Patienten erfolgte eine simUS + SE (58,1 % GSM und 41,9 % GP). Bei allen Patienten wurden (unklare) echoreiche Reflexe mittels Navigation durch US und SE evaluiert und/oder exakt lokalisiert. In 68,9 % der Fälle erfolgte die simUS + SE, um die Diagnose zu sichern bzw. mögliche Differenzialdiagnosen abzuklären. In 52,7 % wurde der simUS + SE benutzt, um die weitere Therapie zu planen und/oder durchzuführen. In 29,7 % aller Fälle half die simUS + SE, die am besten geeignete Therapie (insbesondere intraduktale vs. extrakorporale Schockwellen-Lithotripsie) auszuwählen, in 68,2 % dieser Fälle war die GSM betroffen. In 20,3 % konnte sicherer beurteilt werden, ob eine kombinierte Steinextraktion möglich oder sinnvoll war (alle GP). In 2 Fällen wurde eine US-gesteuerte und SE-kontrollierte Steinextraktion durchgeführt.

Schlussfolgerungen Die simUS + SE stellt eine innovative Untersuchung dar, welche sich als nützlich für das Management der Sialolithiasis erwiesen hat. Diese war wertvoll für die Sicherung der korrekten Diagnose oder Differenzialdiagnose, Planung und Durchführung der am meisten geeigneten Therapie, darüber hinaus auch bei der intraoperativen Therapiekontrolle und dem postoperativen Follow-up.



Publication History

Received: 20 August 2019

Accepted: 15 September 2020

Article published online:
15 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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