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Sialendoscopy is a relatively new minimally invasive technique that permits direct salivary tree visualization and is important in obstructive sialadenitis management and treatment. The present study aimed to examine the sialendoscopy learning curve between March 2009 and March 2013.We compared the first and last 100 sialendoscopies performed in our department with regard to anaesthesia type, operating time, success rate, technical difficulty, major complications, and clinical improvement.General anaesthesia rates were 63% and 38% (P = 0.0004) among the first and last 100 sialendoscopies, respectively. Among the first and last 100 procedures, respectively, average operating times were 39 and 25 minutes (P = 0.00055) for diagnostic sialendoscopies and 68 and 65 minutes (P = 0.35) for interventional sialendoscopies. Successful stone extraction rates were 65% and 90.2% (P = 0.0058) among the first and last 100 procedures, respectively, while the corresponding rates of successful stenosis dilation were 92.5% and 97.1% (P = 0.27). Technical difficulty was encountered in 25% and 17% (P = 0.164) of the first and last 100 sialendoscopies, respectively. Neither group experienced major complications. All patients tolerated the procedures well and had excellent outcomes.Progressive learning regarding sialendoscopy enabled more frequent operation under local anaesthesia, thus better meeting the requirements of a minimally invasive technique. We were able to decrease the operative time in diagnostic sialendoscopy. These two factors support the inclusion of diagnostic sialendoscopy into the diagnostic panel in obstructive glandular diseases.

To present our learning curve in diagnostic and interventional sialendoscopy for obstructive salivary diseases.Monocentric descriptive retrospective study from March 2009 to July 2011. Clinical and demographic data were collected. We are particularly interested in arising technical issues, the use of combined approach, operative time, functional improvement as well as parameter changes over time.92 operations were performed to explore 101 glands (63 parotid glands against 38 submandibular). We found 39.6% of stones and as many stenosis. The rate of complete stone removal was 65% and dilation was effective in 75% of stenosis. The median of the visual analog scale for pain was 1/10 and functional improvement was effective in 77%. The removal of the gland did not exceed 3.3%. No major complication was noted. Since the initiation of this activity, the median operative time was steady while procedures were more complex, with increased interventional sialendoscopy procedure often requiring combined approach. In about 25% of cases, we have been faced with technical issues. These have evolved over time: initially failure to enter the papilla, difficulty of removing large stones today.The learning curve in sialendoscopy allows rapid empowerment and acquisition of expertise in security. Mastery of this technique allows for innovative approaches, complementary to conventional procedure, without compromising neither the operative time nor the functional benefit.

Primary malignant melanoma of the larynx is a very rare entity. There are less than sixty cases described in the literature. Through both cases, we describe and discuss the clinical management of melanoma of the larynx.Two men aged 80 and 61 years were supported for MPL. The tumor was revealed by persistent dysphonia for the first. For the second, it was a second melanoma of laryngeal location. In both cases it was performed a total laryngectomy extended to the first tracheal rings with bilateral lymphadenectomy associated with adjuvant radiotherapy.Excision margins with oncological safety are necessary to except a curative surgery. Still controversial, the adjuvant radiotherapy seems to provide a benefit in terms of local control. The place of targeted therapies remains unclear. However, no prognostic factor is currently clearly identified for this disease.Rare tumor, the MPL is associated with a very poor prognosis. Resective surgery followed by adjuvant radiotherapy is for us the treatment of choice.