Sialendoscopy for Definitive Management of a Submandibular Abscess following Radiotherapy for Oropharyngeal Squamous Cell Carcinoma

ORL J Otorhinolaryngol Relat Spec. 2018;80(5-6):223-226. doi: 10.1159/000492967. Epub 2018 Oct 31.

Abstract

Background/aims: Sialendoscopy has as yet been shown to be ideal for the management of sialolithiasis and chronic inflammatory diseases of the salivary gland. However, its applicability to the management of a broad range of salivary gland disease is continually growing.

Methods: Here we present a case report where sialendoscopy was used to successfully manage an intraparenchymal submandibular gland abscess in a patient with oropharyngeal squamous cell carcinoma managed with primary chemoradiation.

Results: The use of sialendoscopy enabled visualization of the patency of salivary ducts, drainage of abscess, and irrigation of antibiotic-impregnated fluid. In this particular patient, we were able to avoid a transcervical approach through a previously irradiated field, which would have necessitated concurrent tracheostomy and placed undue risk to surrounding neurovascular structures.

Conclusion: Sialendoscopy should thus, in select patients, be considered as an initial intervention for patients with intraparenchymal salivary gland abscesses in which prior therapy creates an increased risk of complication from an open transcervical approach.

Keywords: Complication; Difficult airway; Ludwig’s angina; Sequela of head and neck radiation; Sialendoscopy; Submandibular gland; Xerostomia.

Publication types

  • Case Reports

MeSH terms

  • Abscess / etiology
  • Abscess / therapy*
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / radiotherapy
  • Drainage / methods
  • Endoscopy* / methods
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Oropharyngeal Neoplasms / complications
  • Oropharyngeal Neoplasms / radiotherapy
  • Sialadenitis / therapy
  • Staphylococcal Infections / therapy*
  • Submandibular Gland / diagnostic imaging
  • Submandibular Gland Diseases / diagnostic imaging
  • Submandibular Gland Diseases / etiology
  • Submandibular Gland Diseases / therapy*
  • Tomography, X-Ray Computed