Sialendoscopy Treatment for Juvenile Recurrent Parotitis Safe, Effective

Clinical Question

How effective and safe is sialendoscopy for the treatment of juvenile recurrent parotitis (JRP)?

Background: JRP, the most common inflammatory salivary gland disorder in children in the United States and second only to mumps worldwide, is defined as recurrent episodes of inflammatory parotitis. JRP treatment aims to prevent damage to the gland parenchyma and alleviate patient symptoms. Although the medical treatment has traditionally been the mainstay management, sialendoscopy washout has also been described in the literature as successful.

Study design: A comprehensive literature review of seven studies.

Setting: MEDLINE, Embase, the Cochrane Library, and Google Scholar databases.

Synopsis: The overall population of the studies was 120 children, involving 165 glands (male:female ratio 75:45; average age 7.8 years). Bilateral symptoms were present in 47 of these patients. Sialendoscopy was conducted under general anesthesia in six of the seven publications. The most common endoscopic finding was blanched mucosal appearance (without visible vessels). Other prominent findings included stenotic ducts, dilatations, mucous plugs, and intraductal debris. The most common complication after sialendoscopy was transient swelling of the salivary gland. The weighted pooled proportion of success rates for no further episodes after sialendoscopy by patient was 73% and by gland, 81%. The weighted pooled proportion of success rates for no further sialendoscopy by patient was 87%. There were no major complications reported. Limitations included evidence at levels 3 and 4, small population sizes, short follow-up times, and the possibility of steroid and antibiotic treatment acting as a confounder.

Bottom line: Results suggest that sialendoscopy is effective and safe for the treatment of JRP and may be offered to appropriate patients.

Citation: Ramakrishna J, Strychowsky J, Gupta M, Sommer DD. Sialendoscopy for the management of juvenile recurrent parotitis: a systematic review and meta-analysis. Laryngoscope. 2015;125:1472-1479.