Sialendoscopy learning curve: comparing our first and last 100 procedures

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.