(A239) Recurrent Sialadenitis and Sialendoscopic Analysis: Single Institution Review

Introduction: In patients with recurrent sialadenitis (RS), interventional sialendoscopy is an effective diagnostic and therapeutic tool. We aim to identify patient attributes and endoscopic findings that contribute to persistent sialadenitis requiring repeat operative interventions.

Methods: This is a retrospective review of 101 patients with RS at a tertiary medical center between 2015-2023 who underwent sialendoscopy. RS was defined as 3 or more documented episodes of painful gland swelling. Demographic data, medical history, and operative findings were analyzed. Comparisons were made between patients with persistent sialadenitis and patients without recurrence post-initial intervention. Univariate and multivariate analyses using Pearson’s chi-squared test, Fisher’s exact test and a two-tailed t-test were performed using SPSS version 29.0.

Results: 80.2% of patients with RS had complete symptom resolution after initial endoscopic intervention. No significant differences were found among demographic data, smoking history, autoimmune history, or operative findings such as ductal stenosis and debris. The presence of chronic inflammation in the form of ductal fibrosis, mucosal pallor, or hypervascularity was significantly higher in patients with persistent sialadenitis despite initial operative intervention (p=0.005). In addition, chronic inflammatory changes were associated with prior radioactive iodine use (p=0.023). Patients with sialoliths were more likely to achieve and maintain symptom resolution after endoscopic intervention (p= 0.004).

Conclusions: Patients with signs of chronic inflammation are more likely to require further operative interventions. Sialolithiasis can be a favorable prognostic factor for patients with RS with respect to maintaining a disease free state post-intervention. Further research is needed to identify additional patient characteristics that may guide treatments and reduce the need for recurrent interventions.