What Is the Learning Curve of Sialoendoscopy?

Abstract

Objectives:

Sialoendoscopy is becoming the gold standard method for diagnosis and treatment of Salivary gland inflammatory diseases (SGID). Our objectives are:1) Analyze our initial experience with sialoendoscopy. 2) Measure the learning curve to implement this technique.

Methods:

We reviewed the data from 113 consecutive sialoendoscopies from September 2010 to January 2013. These procedures were performed for diagnosisor intervention in 82 patients (62% female), with mean age 46.4 (4 to 83). They were divided into 2 groups: A, with the first 60 exams, and B, with the last 53 exams. We compared the following outcomes in the 2 groups: failure in papilla catheterization, failure to complete the exam, complication rates and need to repeat exams in the same patient. The most common diagnoses were lithiasis, stenosis, scars, radiodine sialoadenitis, Sjogren Disease.

Results:

In Group A, failure to catheterize papilla were 18.3%, versus 3.7% in Group B (95% CI, 3.58 to 25.62), P = 0.016 (statistically significant-SS). Failure to complete the examination was 21.6% in Group A versus 7.5% in Group B (95% CI 1.52 to 26.68), P = 0.036 (SS), and need to repeat exams was 23.3% in Group A versus 3.7% in Group B (95% CI 7.78 to 31.42), P = 0.0027 (SS). The overall complication rate was 11.2%, 15% in Group A, 7.5% in Group B, P = 0,23 (not SS).

Conclusions:

Sialoendoscopy is a challenging procedure. In our experience we found statistically better outcomes for the exam after 60 procedures. The complication rate was statistically the same.