Symptom Outcomes after Sialendoscopy-Assisted Salivary Duct Surgery: A Prospective 6-Year Study.

ObjectiveThe objective is to evaluate the long‐term impact of sialendoscopic‐assisted salivary duct surgery (SASDS) on sialadenitis symptoms using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire.MethodsThe COSS questionnaire, which scores symptoms on a 0–100 scale, was administered prospectively to adult patients pre‐operatively, 1‐year, and 6‐years post‐operatively. We examined COSS scores and categories representing complete (<10), partial (10–25), and no (>25) resolution of symptoms with attention to factors significantly associated with incomplete resolution (≥10).ResultsApproximately 6‐years after SASDS, 111 patients reported scores for 128 symptomatic glands (72 with sialolithiasis, 56 without sialolithiasis). For glands with sialolithiasis, the median COSS score pre‐SASDS was 27.5 (interquartile range [IQR]: 13.5–43), which was significantly reduced to 1.0 (IQR: 0–5.5) at 1‐year and 1.5 (IQR 0–5) at 6‐years postoperatively. Glands without sialolithiasis had a median COSS score of 40.5 (IQR: 23–52.5) preoperatively, that significantly reduced to 13.5 (IQR 5–21) at 1‐year and 14 (IQR 6.5–25.5) at 6‐years post‐operatively. There was no significant difference in scores from 1‐ to 6‐years. Intraoperative presence of sialolith, absence of stenosis, stenosis in the distal duct, and submandibular gland involvement were significant predictors of complete resolution of symptoms at 6‐years.ConclusionApproximately 6‐years after SASDS for sialadenitis, the majority of patients have durable symptom improvement. The sialolithiasis group had higher rates of complete resolution compared to the non‐sialolithiasis group. Presence of ductal stenosis on sialendoscopy, non‐distal stenoses, and parotid gland involvement were risk factors for persistent long‐term sialadenitis symptoms. Laryngoscope, 133:792–800, 2023