scholarly journals Early Return to Play After Intramedullary Screw Fixation of Acute Jones Fractures in Collegiate Athletes: 22-Year Experience

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091242 ◽  
Author(s):  
Scott Watson ◽  
Amy Trammell ◽  
Stephanie Tanner ◽  
Steven Martin ◽  
Larry Bowman
Keyword(s):  
Screw Fixation ◽  
Skin Irritation ◽  
Case Series ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Early Return ◽  
Hardware Complications ◽  
Patient Reported ◽  
Intramedullary Screw

Background: There is disagreement among team physicians, without conclusive evidence, as to when high-level athletes with a Jones fracture should be allowed to return to play after being treated operatively with an intramedullary screw. Purpose: To report our experience of early return to sport in collegiate athletes after intramedullary screw fixation of Jones fractures. Study Design: Case series; Level of evidence, 4. Methods: We identified all collegiate athletes with an acute fracture at the base of the fifth metatarsal treated by 1 of 2 orthopaedic surgeons with intramedullary screw fixation over a 22-year period (1994-2015), and we performed a retrospective review of their records. Fixation consisted of a single intramedullary screw. Athletes were allowed to bear weight as tolerated in a walking boot immediately postoperatively and return to play as soon as they could tolerate activity. Patients were contacted to complete patient-reported outcome scores that included the Foot and Ankle Ability Measure (FAAM) score, a brief survey specific to our study, and follow-up radiographs. Results: A total of 26 acute Jones fractures were treated in 25 collegiate athletes (mean age, 20 years; range, 18-23 years). Overall, the athletes returned to play at an average of 3.6 weeks (range, 1.5-6 weeks). Three screws were removed for symptomatic skin irritation. There was 1 refracture after screw removal that was done after radiographic and clinical documentation of fracture union, which was treated with repeat cannulated percutaneous screw fixation. One screw was observed on radiographs to be broken at 1 year postoperatively, but the fracture was healed and the athlete was playing National Collegiate Athletic Association Division I sports without symptoms and continued to play professionally without symptoms. Of 25 athletes, 19 completed the FAAM at an average follow-up of 8.6 years (range, 1.5-20.0 years). They reported scores of 94.9% (range, 70.2%-100%) for the activities of daily living subscale and 89.1% (range, 42.9%-100%) for the sports subscale. Follow-up radiographs were obtained, and no nonunion, malunion, or additional hardware complications were identified. Conclusion: Athletes with acute Jones fractures can safely be allowed to return to play after intramedullary screw fixation as soon as their symptoms allow, without significant complications. In our experience, this is usually within 4 weeks from injury.

scholarly journals Early Return To Play After Intramedullary Screw Fixation Of Jones Fractures In Collegiate Athletes: 23 Year Experience

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0012
Author(s):  
Scott Thomas Watson ◽  
Amy Trammell ◽  
Stephanie Tanner ◽  
Rebecca Snider ◽  
Steven Martin ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Collegiate Athletes ◽  
Patient Reported Outcome ◽  
Return To Play ◽  
Early Return ◽  
Hardware Complications ◽  
Patient Reported ◽  
Outcome Scores ◽  
Intramedullary Screw

Objectives: There is a general consensus that Jones fractures should be treated operatively with an intramedullary screw in high-level athletes. However, there is disagreement among team physicians, without conclusive evidence as to when the athlete should be allowed to return to play. The objective of this study is to report our experience of early return to sport in collegiate athletes after intramedullary screw fixation of Jones Fractures. Methods: All skeletally mature collegiate athletes with a true Jones fracture of the base of the fifth metatarsal that was treated by one of two orthopaedic surgeons with operative intramedullary screw fixation over a 23 year period (1994-2016) were identified and records reviewed retrospectively. All return to play and complication data was obtained from the athletic trainer database at the two universities. Fixation consisted of a single intramedullary screw (10 partially threaded cannulated screws, 13 cannulated variable pitch screws, 3 solid screws). The athletes were allowed to weight bear as tolerated in a CAM boot immediately postoperatively, and return to play with a carbon fiber insert as soon as they could tolerate activity. In 2016, patients were contacted to complete patient reported outcome scores that included the Foot and Ankle Ability Measure (FAAM) score and a brief survey specific to our study, as well as follow-up radiographs if possible. Results: 26 Jones Fractures were treated in 25 collegiate athletes. The average age was 20 years (18-23). Overall, athletes returned to play or training at an average of 3.5 weeks (1.5-6). All in-season athletes returned to play within 4.5 weeks (1.5-4.5). Off-season athletes returned to play within 4-6 weeks. There were no cases of nonunion (clinically or radiographically). Three screws were removed due to symptomatic skin irritation. There was one re-fracture following screw removal after documented radiographic and clinical fracture union. This patient was treated with repeat cannulated percutaneous screw fixation. The athlete returned to play in 2 weeks. One screw was noted to be broken on an ankle radiograph 1 year post-op, but the fracture was healed and the athlete was playing division 1 sports without symptoms, and continued professionally without symptoms. 18/25 athletes completed patient reported outcome scores at an average of 7.95 years (range 1.2-17) follow-up. The average estimated percent of normal for activities of daily living was 93.8% (70-100%, and for athletic participation was 90.3% (40-100%). Follow up radiographs were obtained on 13/26 fractures at an average of 6.48 years (range 1.2-16) with no nonunion, malunion, or additional hardware complications identified. Conclusion: Athletes with Jones fractures can safely be allowed to return to play after intramedullary screw fixation as soon as their symptoms allow without significant complications. In our experience, this is usually within 4 weeks from injury.

scholarly journals Long-Term Sports Participation and Satisfaction After UCL Reconstruction in Amateur Baseball Players

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110275
Author(s):  
Robert A. Jack ◽  
Somnath Rao ◽  
Taylor D’Amore ◽  
Donald P. Willier ◽  
Robert Gallivan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Case Series ◽  
Sports Participation ◽  
High Rate ◽  
Return To Play ◽  
Baseball Players ◽  
Patient Reported ◽  
Rate Of Progression

Background: While the incidence of ulnar collateral ligament reconstruction (UCLR) has increased across all levels of play, few studies have investigated the long-term outcomes in nonprofessional athletes. Purpose: To determine the rate of progression to higher levels of play, long-term patient-reported outcomes (PROs), and long-term patient satisfaction in nonprofessional baseball players after UCLR. Study Design: Case series; Level of evidence, 4. Methods: We evaluated UCLR patients who were nonprofessional baseball athletes aged <25 years at a minimum of 5 years postoperatively. Patients were assessed with the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC), the Timmerman-Andrews (T-A) Elbow score, the Mayo Elbow Performance Score (MEPS), and a custom return-to-play questionnaire. Results: A total of 91 baseball players met the inclusion criteria, and 67 (74%) patients were available to complete the follow-up surveys at a mean follow-up of 8.9 years (range, 5.5-13.9 years). At the time of the surgery, the mean age was 18.9 ± 1.9 years (range, 15-24 years). Return to play at any level was achieved in 57 (85%) players at a mean time of 12.6 months. Twenty-two (32.8%) of the initial cohort returned to play at the professional level. Also, 43 (79.1%) patients who initially returned to play after surgery reported not playing baseball at the final follow-up; of those patients, 12 reported their elbow as the main reason for eventual retirement. The overall KJOC, MEPS, and T-A scores were 82.8 ± 18.5 (range, 36-100), 96.7 ± 6.7 (range, 75-100), and 91.9 ± 11.4 (range, 50-100), respectively . There was an overall satisfaction score of 90.6 ± 21.5 out of 100, and 64 (95.5%) patients reported that they would undergo UCLR again. Conclusion: In nonprofessional baseball players after UCLR, there was a high rate of progression to higher levels of play. Long-term PRO scores and patient satisfaction were high. The large majority of patients who underwent UCLR would undergo surgery again at long-term follow-up, regardless of career advancement.

scholarly journals Patient Reported Outcomes in Athletes following ORIF of Jones Fracture

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Monique Chambers ◽  
MaCalus Hogan ◽  
Dukens LaBaze ◽  
Ermias Abebe ◽  
Joseph Kromka
Keyword(s):  
Patient Reported Outcomes ◽  
Elite Athlete ◽  
Screw Fixation ◽  
Elite Athletes ◽  
Visual Analog Score ◽  
Return To Play ◽  
Secondary Fracture ◽  
Jones Fracture ◽  
Patient Reported ◽  
Intramedullary Screw

Category: Lesser Toes, Midfoot/Forefoot, Sports Introduction/Purpose: Treatment of fractures to the 5th metatarsal metaphyseal-diaphyseal junction, known as Jones’ fractures, can present challenges in the elite athlete significantly prolonging return to play. Non-operative treatments in elite athletes result in a high incidence of nonunion and secondary fracture. Primary screw fixation remains the standard of care for athletes. However, delayed union and nonunion are still very common despite surgical fixation due to the fracture occurring in a watershed area with decreased healing potential. Bone marrow aspirate concentrate (BMAC) is an autologous source of hematopoeitic and mesenchymal stem cells that has been used in the treatment of poor healing fractures. We hypothesize that open reduction internal fixation (ORIF) augmented with BMAC will improve patient-reported outcome measures following Jones’ fractures in athletes. Methods: This study was a retrospective review of elite athletes that underwent intramedullary screw fixation augmented with BMAC for Jones’ fractures at an academic medical institution. All patients were assessed preoperatively and postoperatively to determine their pain outcomes based on their visual analog score (VAS). Student’s t test was used in statistical comparison of the preoperative and postoperative outcome scores. P < 0.05 was considered significant. Results: A total of 16 elite athletes were treated with ORIF with BMAC for a Jones fracture with a mean age of 22.2 years (range 19–26). There were 9 males and 7 females included in the study. Type of athlete ranged across various sport activities, with all patients functioning at a collegiate and/or professional level of elite athletics. The mean visual analog score for pain decreased from 6.2 preoperatively (range 3-8) to 2.75 postoperatively (range 1-6 p = 0.06). All patients have returned to elite competitive sport activity with reports of minimal to no pain. Conclusion: Intramedullary screw fixation of Jones’ fractures with BMAC results in optimal surgical outcomes in the elite athlete. A higher powered and long-term study with validated patient-reported outcomes is needed to confirm our observations.

scholarly journals An Anatomic Approach for Intramedullary Screw Fixation of Fifth Metatarsal Fracture: A Clinical and Radiographic Study

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0032
Author(s):  
Shuo Niu ◽  
Faris Mirza ◽  
Andrew Schwartz ◽  
Sameh Labib
Keyword(s):  
Screw Fixation ◽  
Return To Sport ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Anatomical Landmarks ◽  
Patient Reported ◽  
Metatarsal Fracture ◽  
Screw Position ◽  
Intramedullary Screw

Category: Ankle, Sports, Trauma Introduction/Purpose: Intramedullary screw fixation is the most common surgical intervention for treating Jones fractures and diaphyseal stress fractures of the fifth metatarsal. Proper screw placement is paramount to surgical success. There have been studies describing more traditional antegrade and retrograde approaches, dependent upon fluoroscopy and guidewires. However, we propose a novel, more efficient surgical approach that utilizes anatomical landmarks and plantarflexion angle during screw fixation. The purpose of this study was to evaluate screw position and radiographic healing parameters, return to sport, and patient-reported outcome measures after utilization of our technique for screw fixation of the fifth metatarsal fracture. Methods: This is a retrospective review from 2007 to 2017 of clinical records and radiographs of 31 consecutive patients who had fifth metatarsal fracture open reduction internal fixation using anatomical landmarks and plantarflexion angle (Johnson, Labib and Fowler 2004). The classification of the fracture, surgery time, time to union, and post-operative complications were collected. Return to sport, Tegner score, the Foot and Angle Disability Index (FADI) Sports Module, and the Short Form 12 Physical and Mental Health Composite Scale (SF-PCS/MCS) were obtained through phone interview. Post-operative X-ray analysis, including screw position and bone healing percentage, were evaluated. Post-operative screw position was described as either center-center, oblique, or cortical breach on anteroposterior, lateral or oblique view. Fisher’s exact test was used to determine the difference among frequencies of each screw position. P<0.05 was considered significant. Results: Patient and surgical information were shown in Table 1. Average post-operative follow-up was 98 (36-227) days. Screws were well center-center positioned at all three views on post-op X-ray in most cases (all p<0.001). No case showed the screw protruding into tarsometatarsal joint or cuboid impingement. Average phone interview follow-up was 5.4 (1.0-11.1) years. Tegner scores showed no difference (p=0.58) when compared between pre-injury (6.4) and current level (6.1). At the terminal follow-up, average FADI-sports was 87.2 (37.5-100), SF-PCS was 50.7 (27.3-55.6), and SF-MCS was 59.7 (52.9-67.2). In addition, 12 of 15 (80%) the college or professional athletes (1 lost to follow-up) returned to the same level sports after the surgery. Conclusion: This study quantified the benefit of a novel technique for intramedullary screw fixation of fifth metatarsal fracture that was reliable and reproducible. It facilitated accurate screw positioning, dependable union, and accompanying positive return to sport and patient-reported outcome measures.

scholarly journals Jones Fracture in the Elite Athlete: Patient Reported Outcomes following Fixation with BMAC

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0016 ◽  
Author(s):  
Dwayne Carney ◽  
Monique C. Chambers ◽  
Joseph James Kromka ◽  
Dukens LaBaze ◽  
Robin Vereeke West ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Clinical Decision Making ◽  
Elite Athlete ◽  
Screw Fixation ◽  
Elite Athletes ◽  
Return To Play ◽  
Jones Fracture ◽  
Long Term Study ◽  
Patient Reported ◽  
Intramedullary Screw

Objectives: Jones’ fractures, 5th metatarsal metaphyseal-diaphyseal junction fractures, are a debilitating injury for the elite athlete, particularly in cutting/pivoting sports. These injuries are usually managed surgically due to the high rate of nonunion and re-fracture. Despite primary screw fixation, delayed union and nonunion are not uncommon. Bone marrow aspirate concentrate (BMAC), an autologous source of hematopoietic and mesenchymal stem cells, has been used to augment healing due to the poor healing potential in the watershed region. We hypothesize that open reduction internal fixation (ORIF) augmented with BMAC will improve patient-reported outcome measures following Jones’ fractures in athletes. Methods: This study was a prospectively collected and maintained review of elite athletes that underwent intramedullary screw fixation augmented with BMAC for Jones’ fractures at an academic medical institution. All patients were evaluated preoperatively and postoperatively to assess differences in patient reported outcomes including VAS, PROMIS, FAAM, SF-12 scores, return to play, and complications. Student’s t test was used in statistical comparison of the preoperative and postoperative outcome scores. P < 0.05 was considered significant. Results: A total of 41 elite athletes were treated with ORIF with BMAC for a Jones fracture with a mean age of 25.59 years (range 19-42). There were 26 (63%) males and 15 females included in the study. Type of athlete ranged across the following sport activities: football, basketball, soccer, volleyball. Of note, patients had significantly improved with lower visual analog score for pain (mean Δ3.56, p= 0.001), higher FAAM scores (mean Δ 43.6, p< 0.001), and PASS scores (increased from 11% to 85%, p< 0.001) at 6 months. Additionally, patients showed improvement in SF12, PROMIS10, and FAAM scores at 12 months, although this was not statistically significant due to insufficient follow up at this time. The average numbers of days lost to competition was 131 days. All patients that have returned to elite competitive sport activity report minimal to no pain. Conclusion: Intramedullary screw fixation of Jones’ fractures with BMAC results in optimal surgical outcomes in the elite athlete. The use of patient reported outcomes continues to be a focus of quality measures and should guide clinical decision making for surgical intervention, return to play, and to assess impact of treatment. A higher powered and long-term study with validated patient-reported outcomes is needed to confirm our observations.

scholarly journals Navigated odontoid screw placement using the O-arm: technical note and case series

2017 ◽  
Vol 26 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Jared M. Pisapia ◽  
Nikhil R. Nayak ◽  
Ryan D. Salinas ◽  
Luke Macyszyn ◽  
John Y. K. Lee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Screw Fixation ◽  
Academic Medical Center ◽  
Odontoid Process ◽  
Case Series ◽  
Screw Placement ◽  
Presenting Symptoms ◽  
Patient Reported

OBJECTIVE As odontoid process fractures become increasingly common in the aging population, a technical understanding of treatment approaches is critical. 3D image guidance can improve the safety of posterior cervical hardware placement, but few studies have explored its utility in anterior approaches. The authors present in a stepwise fashion the technique of odontoid screw placement using the Medtronic O-arm navigation system and describe their initial institutional experience with this surgical approach. METHODS The authors retrospectively reviewed all cases of anterior odontoid screw fixation for Type II fractures at an academic medical center between 2006 and 2015. Patients were identified from a prospectively collected institutional database of patients who had suffered spine trauma. A standardized protocol for navigated odontoid screw placement was generated from the collective experience at the authors' institution. Secondarily, the authors compared collected variables, including presenting symptoms, injury mechanism, surgical complications, blood loss, operative time, radiographically demonstrated nonunion rate, and clinical outcome at most recent follow-up, between navigated and nonnavigated cases. RESULTS Ten patients (three female; mean age 61) underwent odontoid screw placement. Most patients presented with neck pain without a neurological deficit after a fall. O-arm navigation was used in 8 patients. An acute neck hematoma and screw retraction, each requiring surgery, occurred in 2 patients in whom navigation was used. Partial vocal cord paralysis occurred after surgery in one patient in whom no navigation was used. There was no difference in blood loss or operative time with or without navigation. One patient from each group had radiographic nonunion. No patient reported a worsening of symptoms at follow-up (mean duration 9 months). CONCLUSIONS The authors provide a detailed step-by-step guide to the navigated placement of an odontoid screw. Their surgical experience suggests that O-arm–assisted odontoid screw fixation is a viable approach. Future studies will be needed to rigorously compare the accuracy and efficiency of navigated versus nonnavigated odontoid screw placement.

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture

2021 ◽  
pp. 107110072110060
Author(s):  
Michael F. Githens ◽  
Malcolm R. DeBaun ◽  
Kimberly A Jacobsen ◽  
Hunter Ross ◽  
Reza Firoozabadi ◽  
...  
Keyword(s):  
Case Series ◽  
High Energy ◽  
Ankle Fractures ◽  
Posttraumatic Arthritis ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Posttraumatic Arthrosis ◽  
Patient Reported

Background: Supination-adduction (SAD) type II ankle fractures can have medial tibial plafond and talar body impaction. Factors associated with the development of posttraumatic arthritis can be intrinsic to the injury pattern or mitigated by the surgeon. We hypothesize that plafond malreducton and talar body impaction is associated with early posttraumatic arthrosis. Methods: A retrospective cohort of skeletally mature patients with SAD ankle fractures at 2 level 1 academic trauma centers who underwent operative fixation were identified. Patients with a minimum of 1-year follow-up were included. The presence of articular impaction identified on CT scan was recorded and the quality of reduction on final intraoperative radiographs was assessed. The primary outcome was radiographic ankle arthrosis (Kellgren-Lawrence 3 or 4), and postoperative complications were documented. Results: A total of 175 SAD ankle fractures were identified during a 10-year period; 79 patients with 1-year follow-up met inclusion criteria. The majority of injuries resulted from a high-energy mechanism. Articular impaction was present in 73% of injuries, and 23% of all patients had radiographic arthrosis (Kellgren-Lawrence 3 or 4) at final follow-up. Articular malreduction, defined by either a gap or step >2 mm, was significantly associated with development of arthrosis. Early treatment failure, infection, and nonunion was rare in this series. Conclusion: Malreduction of articular impaction in SAD ankle fractures is associated with early posttraumatic arthrosis. Recognition and anatomic restoration with stable fixation of articular impaction appears to mitigate risk of posttraumatic arthrosis. Investigations correlating postoperative and long-term radiographic findings to patient-reported outcomes after operative treatment of SAD ankle fractures are warranted. Level of Evidence: Level IV, retrospective case series.

scholarly journals Return to Sport After Large Single-Surface, Multisurface, or Bipolar Osteochondral Allograft Transplantation in the Knee Using Shell Grafts

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712096792
Author(s):  
James L. Cook ◽  
Kylee Rucinski ◽  
Cory R. Crecelius ◽  
Richard Ma ◽  
James P. Stannard
Keyword(s):  
Femoral Condyle ◽  
Case Series ◽  
Return To Sport ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Osteochondral Allograft ◽  
Level Of Evidence ◽  
Recreational Athletes ◽  
Patient Reported

Background: Return to sport (RTS) after osteochondral allograft (OCA) transplantation for large unipolar femoral condyle defects has been consistent, but many athletes are affected by more severe lesions. Purpose: To examine outcomes for athletes who have undergone large single-surface, multisurface, or bipolar shell OCA transplantation in the knee. Study Design: Case series; Level of evidence, 4. Methods: Data from a prospective OCA transplantation registry were assessed for athletes who underwent knee transplantation for the first time (primary transplant) between June 2015 and March 2018 for injury or overuse-related articular defects. Inclusion criteria were preinjury Tegner level ≥5 and documented type and level of sport (or elite unit active military duty); in addition, patients were required to have a minimum of 1-year follow-up outcomes, including RTS data. Patient characteristics, surgery type, Tegner level, RTS, patient-reported outcome measures (PROMs), compliance with rehabilitation, revisions, and failures were assessed and compared for statistically significant differences. Results: There were 37 included athletes (mean age, 34 years; range, 15-69 years; mean body mass index, 26.2 kg/m2; range, 18-35 kg/m2) who underwent large single-surface (n = 17), multisurface (n = 4), or bipolar (n = 16) OCA transplantation. The highest preinjury median Tegner level was 9 (mean, 7.9 ± 1.7; range, 5-10). At the final follow-up, 25 patients (68%) had returned to sport; 17 (68%) returned to the same or higher level of sport compared with the highest preinjury level. The median time to RTS was 16 months (range, 7-26 months). Elite unit military, competitive collegiate, and competitive high school athletes returned at a significantly higher proportion ( P < .046) than did recreational athletes. For all patients, the Tegner level at the final follow-up (median, 6; mean, 6.1 ± 2.7; range, 1-10) was significantly lower than that at the highest preinjury level ( P = .007). PROMs were significantly improved at the final follow-up compared with preoperative levels and reached or exceeded clinically meaningful differences. OCA revisions were performed in 2 patients (5%), and failures requiring total knee arthroplasty occurred in 2 patients (5%), all of whom were recreational athletes. Noncompliance was documented in 4 athletes (11%) and was 15.5 times more likely ( P = .049) to be associated with failure or a need for revision than for compliant patients. Conclusion: Large single-surface, multisurface, or bipolar shell OCA knee transplantations in athletes resulted in two-thirds of these patients returning to sport at 16 to 24 months after transplantation. Combined, the revision and failure rates were 10%; thus, 90% of patients were considered to have successful 2- to 4-year outcomes with significant improvements in pain and function, even when patients did not RTS.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

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