Learning Progression in the Use of Sialendoscopy for Sialolithiasis: Effect on Outcomes

Abstract

Objectives:

Evaluate how learning progression affects outcomes for the use of sialendoscopy for sialolithiasis.

Methods:

A retrospective chart review was conducted on 79 patients presenting with sialolithiasis between 2008 and 2012 who underwent sialendoscopy on 86 salivary glands at a tertiary medical center. Outcomes compared between the first 43 cases (40 patients) and second 43 cases (39 patients) included successful removal, surgical method, and any further need for intervention.

Results:

For the first 40 patients (group A), the mean age was 50.6 years (range, 21-87), and 55.8% were male. For the second 39 patients (group B), the mean age was 50.8 (range, 15-77), and 46.5% were male. Sialolithiasis was diagnosed based on physical exam or imaging. Mean stone size was similar in both groups: 8 versus 8.6mm, respectively. Where a stone was visualized, complete removal was accomplished in 88.6% of cases in group A versus 97.4% in Group B. Endoscopic removal occurred in 20.0% of the patients in group A, versus 35.9% in group B. A combined approach was used in 45.7% in group A versus 64.1% in group B. 34.3% in group A required gland removal versus 0.0% in group B (P = 0.005). Seventeen point nine percent of patients in group A needed further intervention (medical or surgical) versus 9.3% in group B.

Conclusions:

This study documents a clear learning curve for sialendoscopy for the management of sialolithiasis. With experience, the success of sialendoscopy increases, and there is a significant decrease in the number of gland excisions.