Abstract：
OBJECTIVE: To compare rates of sialadenectomy in a veteran population before and after introduction of sialendoscopy.
METHODS: All Veterans Affair (VA) Northern California Healthcare System (NCHS) encounters from 2006 to 2021 for benign obstructive salivary etiologies were identified using International Classification of Disease 9/10 codes. This cohort was then cross referenced with Current Procedural Terminology codes to identify patients who underwent a procedure for their salivary pathologies. The rates of sialadenectomy and minimally invasive procedures were measured before and after sialendoscopy was introduced to the VA NCHCS in 2016. Data was obtained via chart review and demographic information, diagnosis, and procedure type were extracted. Rates of sialadenectomy, minimally invasive procedures, and other patient and procedural characteristics were compared between the Pre-Sialendoscopy Era (PSE) and Sialendoscopy Era (SE). Statistical analysis was performed using Microsoft Excel (Microsoft, version 16.66).
RESULTS: An increasing number of patients per year sought care for benign obstructive salivary pathology in the SE when compared to the PSE cohort and a higher rate of female patients were treated in the SE cohort. A simultaneous reduction in sialadenectomy rates and increase in minimally invasive procedure rates was observed in the SE. Sialendoscopy represented most of the increase in minimally invasive techniques, but there was a slight increase in other procedure types. Submandibular gland obstructive pathologies required the most procedures and resulted in the most gland excisions.
CONCLUSIONS: This retrospective review strongly suggests introducing sialendoscopy reduced the incidence of sialadenectomy for benign non-tumor obstructive pathology in this VA NCHS population. Further prospective studies are needed to evaluate this in a more generalized setting.
METHODS: All Veterans Affair (VA) Northern California Healthcare System (NCHS) encounters from 2006 to 2021 for benign obstructive salivary etiologies were identified using International Classification of Disease 9/10 codes. This cohort was then cross referenced with Current Procedural Terminology codes to identify patients who underwent a procedure for their salivary pathologies. The rates of sialadenectomy and minimally invasive procedures were measured before and after sialendoscopy was introduced to the VA NCHCS in 2016. Data was obtained via chart review and demographic information, diagnosis, and procedure type were extracted. Rates of sialadenectomy, minimally invasive procedures, and other patient and procedural characteristics were compared between the Pre-Sialendoscopy Era (PSE) and Sialendoscopy Era (SE). Statistical analysis was performed using Microsoft Excel (Microsoft, version 16.66).
RESULTS: An increasing number of patients per year sought care for benign obstructive salivary pathology in the SE when compared to the PSE cohort and a higher rate of female patients were treated in the SE cohort. A simultaneous reduction in sialadenectomy rates and increase in minimally invasive procedure rates was observed in the SE. Sialendoscopy represented most of the increase in minimally invasive techniques, but there was a slight increase in other procedure types. Submandibular gland obstructive pathologies required the most procedures and resulted in the most gland excisions.
CONCLUSIONS: This retrospective review strongly suggests introducing sialendoscopy reduced the incidence of sialadenectomy for benign non-tumor obstructive pathology in this VA NCHS population. Further prospective studies are needed to evaluate this in a more generalized setting.
摘要：
目的：比较老年患者在采用鼻内镜检查前后的鼻腺切除术率。
方法：使用国际疾病分类9/10代码确定了2006年至2021年所有退伍军人事务（VA）北加州医疗保健系统（NCHS）遇到的良性阻塞性唾液病因。然后将该队列与当前程序术语代码交叉引用，以识别接受唾液病理学程序的患者。在2016年将唾液腺内镜引入VANCHCS之前和之后，测量了唾液腺切除术和微创手术的发生率。数据是通过图表审查和人口统计信息获得的，诊断,提取了程序类型。唾液腺切除术的比率，微创手术，以及其他患者和手术特征进行了比较,比较了术前内镜时代(PSE)和术前内镜时代(SE)。使用MicrosoftExcel（Microsoft，版本16.66)。
结果：与PSE队列相比，每年有越来越多的患者寻求SE良性梗阻性唾液病理学的治疗，女性患者在SE队列中接受治疗的比例更高。在SE中观察到唾液腺切除术率的同时降低和微创手术率的增加。内窥镜检查代表了微创技术的大部分增长，但其他程序类型略有增加。颌下腺阻塞性病变需要最多的程序，并导致大多数腺体切除。
结论：这项回顾性研究强烈提示，在这一VANCHS人群中，在良性非肿瘤梗阻性病理学中，引入唾液腺镜可以降低唾液腺切除术的发生率。需要进一步的前瞻性研究来在更广泛的背景下评估这一点。
方法：使用国际疾病分类9/10代码确定了2006年至2021年所有退伍军人事务（VA）北加州医疗保健系统（NCHS）遇到的良性阻塞性唾液病因。然后将该队列与当前程序术语代码交叉引用，以识别接受唾液病理学程序的患者。在2016年将唾液腺内镜引入VANCHCS之前和之后，测量了唾液腺切除术和微创手术的发生率。数据是通过图表审查和人口统计信息获得的，诊断,提取了程序类型。唾液腺切除术的比率，微创手术，以及其他患者和手术特征进行了比较,比较了术前内镜时代(PSE)和术前内镜时代(SE)。使用MicrosoftExcel（Microsoft，版本16.66)。
结果：与PSE队列相比，每年有越来越多的患者寻求SE良性梗阻性唾液病理学的治疗，女性患者在SE队列中接受治疗的比例更高。在SE中观察到唾液腺切除术率的同时降低和微创手术率的增加。内窥镜检查代表了微创技术的大部分增长，但其他程序类型略有增加。颌下腺阻塞性病变需要最多的程序，并导致大多数腺体切除。
结论：这项回顾性研究强烈提示，在这一VANCHS人群中，在良性非肿瘤梗阻性病理学中，引入唾液腺镜可以降低唾液腺切除术的发生率。需要进一步的前瞻性研究来在更广泛的背景下评估这一点。
