Objective To conduct a systematic review with meta-analysis to determine the efficacy and safety of sialendoscopy in the treatment of obstructive diseases of the salivary glands in adults.
Data Sources MEDLINE, EMBASE, and the Cochrane Library (no lower limit to October 2010). Reference lists were searched for identification of relevant studies.
Study Selection Prospective or retrospective studies of adult patients treated with interventional sialendoscopy for the management of salivary gland obstruction were selected. Outcome measures included rates of success (symptom-free and absence of residual obstruction), sialadenectomy, and complications. Non-English publications were excluded.
Data Extraction Two independent review authors screened eligible studies, extracted relevant data, and resolved discrepancies by consensus when applicable. Weighted pooled proportion, 95% confidence intervals, and test results for heterogeneity are reported.
Data Synthesis Twenty-nine studies were included in the analysis. The weighted pooled proportion of success rates were 0.86 (95% CI, 0.83-0.89) for studies involving 1213 patients undergoing sialendoscopy alone and 0.93 (95% CI, 0.89-0.96) for the 374 patients undergoing sialendoscopy with a combined surgical approach. Outcomes following interventional sialendoscopy for radioiodine-induced sialadenitis were reported in 3 studies, and success rates were variable. Rates of sialadenectomy were low, and few major complications were reported.
Conclusion Findings from the present systematic review and meta-analysis suggest that sialendoscopy is efficacious, safe, and gland preserving for the treatment of obstructive major salivary gland disease.