Clinical management of Sialadenitis

Within the area of salivary gland pathology, obstructive sialadenitis is the most common inflammatory condition of the salivary glands.1 It has been well established in the literature that salivary calculi occur most commonly in the submandibular gland, whereas fewer cases are found in the parotid gland, while the sublingual gland and the minor salivary glands form no more than 2% of cases.2 The early treatment of sialadenitis is usually conservative and involves hydration, anti inflammatory medication in conjunction to antibiotics when a bacterial infection is suspected. However, when initial treatment fails, further intervention is needed. The traditional external approach is sialadenectomy. However, with this exists the potential for injury to the lingual and facial nerves. Further complications including bleeding, infection and an unsightly scar are also found with this procedure.3,4 Sialendoscopy is a relatively new technique that only became available once optics had improved to the extent that fiber-optic endoscopes could be miniaturized to a diameter of 0.9 mm to 1.6 mm. This has ushered in a new era for the management of sialadenitis, particularly in cases where sialadenitis was caused by salivary duct obstruction. It must be noted that in South Africa, there are currently no generally accepted guidelines on the management of sialadenitis secondary to salivary ductal obstruction as well as in the role of sialendoscopy within the treatment algorithm

Evolution of Sialendoscopy in clinical practice: Survey of attending practitioners

Sialendoscopy is a relatively new technique that is safe, minimally invasive and effective as a diagnostic as well as a therapeutic tool for the management of deep seated, proximal, salivary ductal obstruction. However, more than 20 years since its inception it is still not in mainstream use worldwide. Objectives Our aim of this study was to ascertain the awareness of sialendoscopy amongst the medical fraternity in South Africa. More specifically, to determine whether it was frequently used amongst practitioners and the type of cases managed using sialendoscopy. Methods An exploratory survey design involving 100 practitioners was used to collect data, using an online survey involving 10 closed-ended multiple choice questions. Results The results of the study revealed that while practitioners saw patients who could benefit from sialendoscopy, most practitioners did not feel comfortable performing the procedure independently, and as such, most patients were referred on to other professionals for management. The majority of attending practitioners believed that they would benefit from further practical and theoretical training in the field of sialendoscopy, illustrating the need for continued professional development in this area

Measuring tongue strength in adults after partial glossectomy: a review

The purpose of this study is to present a scoping review of the measurements of tongue strength available, particularly in adult patients, following partial glossectomy. The subsequent impact on functionality and quality of life were also explored. Materials and methodsThis study used a scoping review and the study selection comprised two stages of screening: the review of the title and abstract followed by a full-text review. During the first stage of screening, the title and abstracts of all retrieved references were reviewed against the predetermined inclusion criteria. In the second stage of screening, all studies were reviewed at full-text level, utilising the Full-Text Screening Relevance measure. A total of 20 articles were reviewed as they met the inclusion criteria Results The study found that subjective and quality-of-life measures may still be useful in measuring tongue strength in developing contexts as they closely approximate objective measures and are reliable as an interim measure. However, there is still a need for the development of other objective measures, should funding be available