Pediatric Sialendoscopy and Its Role in Pediatric Salivary Gland Disease

Abstract

Purpose of Review

The aim of this review is to discuss the evaluation, workup, indications, and outcomes of sialendoscopy in children. Many factors contribute to salivary gland disease in children including autoimmune disease, genetic defects, viral or bacterial infections, and congenital ductal abnormalities. Sialadenitis is acute swelling of the major salivary glands. In children, parotid sialadenitis is more common than submandibular sialadenitis and sialolithiasis (saliva gland stone) is rare. Before widespread use of the MMR vaccine, mumps, a paromyxovirus, was the most common cause of parotitis in children. In the current era, the most common cause of parotitis in children is juvenile recurrent parotitis (JRP). JRP is a nonspecific sialadenitis associated with recurrent inflammation of the parotid glands. The first episode of JRP generally occurs between the age of 3 and 6 years of age. The interval between acute episodes is variable, with an average from 15 days to 2 months. The treatment of acute sialadenitis includes analgesics, antibiotics, and other conservative measures such as sialogogues, warm compresses, hydration, and massage. Historically, for JRP patients who failed conservative measures, parotidectomy was offered but was associated with significant potential morbidity. Sialendoscopy has emerged as a safe and effective diagnostic and therapeutic option for recurrent sialadenitis with and without stones.

Recent Findings

Sialendoscopy is safe and effective for removal of small, distal salivary stones in the pediatric population. It can also lead to less frequent and severe episodes of acute sialadenitis in patients with JRP.

Summary

Sialendoscopy is a safe and effective procedure for recurrent sialadenitis in the carefully selected pediatric patient.

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