ABSTRACT
Juvenile recurrent parotitis (JRP) is a rare disease of childhood occurring between the ages of 3 and 5 years, characterized by recurrent non-suppurative parotitis, spontaneously evolving towards parotid gland dysfunction. Clinically, JRP presents in the form of unilateral or bilateral, usually asynchronous, swelling of the parotid gland. The diagnosis is based on ultrasound characteristics. Widespread use of sialendoscopy has opened up new prospects for the management of this disease. This review of the literature evaluates the role of sialendoscopy in the management of JRP. A Medline search retrieved 68 articles, 18 of which concerned JRP. Standard treatment consists of antibiotics for at least 10 days at the acute phase of the disease. All studies demonstrated the diagnostic value of sialendoscopy by visualizing strictures, hypovascularization and whitish intraductal debris. Sialendoscopy is also useful for treatment, by allowing intraductal lavage and, when possible, dilatation of strictures. Lavage is performed with saline solution, hydrocortisone, antibiotics or a combination of these solutions, with no significant differences in terms of efficacy. The mode of administration with or without sialendoscopy also appears to provide similar results. Sialendoscopy appears to be a diagnostic and therapeutic option, although it has not been shown to be more effective than simple lavage. All lavage solutions appear to be effective.
Subject(s)
Endoscopes , Endoscopy, Digestive System , Parotitis/diagnostic imaging , Parotitis/surgery , Patient Satisfaction , Endoscopy, Digestive System/instrumentation , Endoscopy, Digestive System/methods , Evidence-Based Medicine , Humans , Treatment OutcomeABSTRACT
Cholesteatoma is characterized by the accumulation of a desquamating epithelium within the middle ear. Its development and spreading are favoured by chronic inflammatory and suppurative processes. The main clinical manifestations are persistent or episodic, frequently fetid purulent discharge, hearing impairment, vertigo and rarely complications (mastoiditis, labyrinthitis or meningitis). Therapy is preventive: careful management and follow-up of children with recurrent or chronic otitis media with effusion. Surgical treatment is mandatory once cholesteatoma is constituted.
