Winter 2012

Minimally Invasive Treatment for Recurrent Sialadenitis

Although rare, the recurrent inflammation and infection of the salivary glands, known as juvenile recurrent sialadenitis, can seriously affect a child's overall quality of life. Lab Scene

Kristina Rosbe, M.D., director of Pediatric Otolaryngology at UCSF Benioff Children’s Hospital, says, "Without accurate diagnosis and treatment, this condition can persist for years and be a source of enormous frustration for patients and their families."

Yet, until recently, it was difficult to pinpoint the exact cause of the swelling and treatment options were few and problematic. Not all patients respond to antibiotics and surgery involves risk and potential complications, including potential disfigurement.

Now, doctors at UCSF Benioff Children's Hospital are among the few in the country using sialendoscopy, a minimally invasive treatment using a tiny endoscope, to effectively diagnose and treat juvenile recurrent sialadenitis.

Minimally Invasive, Maximally Effective

CT Scan

During a pediatric sialendoscopy, doctors thread the miniature endoscope into the salivary gland duct. A video monitor linked to the endoscope allows them to see intraductal problems and, in many cases, provide immediate treatment.

Infections are flushed. Small salivary gland stones are extracted through a flushing port, while larger stones can be broken up using energy from an yttrium aluminum garnet (YAG) laser delivered through a fiber-optic cable.

UCSF Benioff Children's Hospital is one of the only children's medical centers in the United States that offer this highly specialized technique, which several large studies conducted in Europe have shown to be effective.

Interior of Mouth

The outpatient procedure usually takes about an hour and has yielded few complications or risks to date. Although patients often experience gland swelling immediately after the procedure, the swelling usually resolves within a few hours.

Rosbe says that in her own experience, pediatric sialendoscopy leads to the complete and permanent resolution of symptoms in about 75 percent of cases. "We handle up to a dozen procedures for juvenile recurrent sialadenitis a year, and over the past several years, we have not had to repeat the procedure in the same patient for recurrent symptoms," she says.

For more information, contact Dr. Kristina Rosbe at (415) 353-9385 or [email protected].

Winter 2012 Table of Contents

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