Abstract：
OBJECTIVE: To define symptomatology and responses to treatment in chronic sialadenitis from sialolithiasis versus duct stenosis and establish a minimal clinically significant difference (MCID) in the validated Obstructive Salivary Problem Impact Test (SPIT).
METHODS: Prospective, cohort.
METHODS: Tertiary-care center.
METHODS: Patients completed the SPIT questionnaire at presentation and 3 to 6 months after surgery. SPIT scores and domains were compared between patients with symptomatic sialolithiasis and those with stenosis of a major salivary gland.
RESULTS: Seventy-nine patients completed the SPIT, including 43 (54%) with sialolithiasis and 36 (46%) with stenosis. Stenosis patients displayed greater baseline scores compared to sialolithiasis patients (45.4 ± 19.9 vs 33.3 ± 18.5, P < .013). Frequency and severity of gland swelling and pain (21.9 ± 8.9 vs 17.1 ± 9.6, P = .02) and functional/psychosocial impact subscores were greater in the stenosis versus sialolithiasis groups (18.0 ± 10.9 vs 11.3 ± 9.4, P < .01). For 43 patients who underwent surgical intervention, SPIT scores improved at 3 to 6 months postoperatively in all domains (-18.6 ± 19.4, P < .01). Degree of improvement did not differ between sialolithiasis versus stenosis groups (-22.0 ± 20.9 vs -13.3 ± 15.8, P = .13). The MCID in SPIT score was found to be -13 points. A postoperative SPIT score of less than 10 suggested symptom resolution.
CONCLUSIONS: When compared to sialolithiasis, chronic salivary obstruction from stenosis is associated with greater baseline SPIT scores, indicating poorer sialadenitis-related quality of life due to greater symptom frequency and functional impact. Based on SPIT survey outcomes, a score decrease of 13 points or SPIT score <10 represent significant symptom improvement.
METHODS: Prospective, cohort.
METHODS: Tertiary-care center.
METHODS: Patients completed the SPIT questionnaire at presentation and 3 to 6 months after surgery. SPIT scores and domains were compared between patients with symptomatic sialolithiasis and those with stenosis of a major salivary gland.
RESULTS: Seventy-nine patients completed the SPIT, including 43 (54%) with sialolithiasis and 36 (46%) with stenosis. Stenosis patients displayed greater baseline scores compared to sialolithiasis patients (45.4 ± 19.9 vs 33.3 ± 18.5, P < .013). Frequency and severity of gland swelling and pain (21.9 ± 8.9 vs 17.1 ± 9.6, P = .02) and functional/psychosocial impact subscores were greater in the stenosis versus sialolithiasis groups (18.0 ± 10.9 vs 11.3 ± 9.4, P < .01). For 43 patients who underwent surgical intervention, SPIT scores improved at 3 to 6 months postoperatively in all domains (-18.6 ± 19.4, P < .01). Degree of improvement did not differ between sialolithiasis versus stenosis groups (-22.0 ± 20.9 vs -13.3 ± 15.8, P = .13). The MCID in SPIT score was found to be -13 points. A postoperative SPIT score of less than 10 suggested symptom resolution.
CONCLUSIONS: When compared to sialolithiasis, chronic salivary obstruction from stenosis is associated with greater baseline SPIT scores, indicating poorer sialadenitis-related quality of life due to greater symptom frequency and functional impact. Based on SPIT survey outcomes, a score decrease of 13 points or SPIT score <10 represent significant symptom improvement.
摘要：
目的：定义慢性唾液腺炎与胆管狭窄的症状学和治疗反应，并在经过验证的梗阻性唾液问题影响测试（SPIT）中建立最小的临床显着差异（MCID）。
方法：前瞻性，队列。
方法：三级护理中心。
方法：患者在就诊时和手术后3-6个月完成SPIT问卷。比较了有症状的唾液酸结石患者和主要唾液腺狭窄患者的SPIT评分和领域。
结果：79名患者完成了SPIT，其中43例（54%）合并胆管结石，36例（46%）合并狭窄。狭窄患者的基线评分高于唾液管结石患者（45.4±19.9vs33.3±18.5，P<.013）。腺体肿胀和疼痛的频率和严重程度（21.9±8.9vs17.1±9.6，P=.02）和功能/心理社会影响子评分在狭窄组与唾液管结石组（18.0±10.9vs11.3±9.4，P<.01）中更高。对于43例接受手术干预的患者，术后3~6个月，所有领域的SPIT评分均有改善（-18.6±19.4，P<0.01）。胆管结石与狭窄组之间的改善程度没有差异（-22.0±20.9vs-13.3±15.8，P=.13）。SPIT评分中的MCID为-13分。术后SPIT评分小于10，提示症状缓解。
结论：与唾液管结石相比，狭窄引起的慢性唾液梗阻与基线SPIT评分较高相关,提示由于更多的症状频率和功能影响，与唾液腺炎相关的生活质量较差。根据SPIT调查结果，评分降低13分或SPIT评分<10表示显著的症状改善。
方法：前瞻性，队列。
方法：三级护理中心。
方法：患者在就诊时和手术后3-6个月完成SPIT问卷。比较了有症状的唾液酸结石患者和主要唾液腺狭窄患者的SPIT评分和领域。
结果：79名患者完成了SPIT，其中43例（54%）合并胆管结石，36例（46%）合并狭窄。狭窄患者的基线评分高于唾液管结石患者（45.4±19.9vs33.3±18.5，P<.013）。腺体肿胀和疼痛的频率和严重程度（21.9±8.9vs17.1±9.6，P=.02）和功能/心理社会影响子评分在狭窄组与唾液管结石组（18.0±10.9vs11.3±9.4，P<.01）中更高。对于43例接受手术干预的患者，术后3~6个月，所有领域的SPIT评分均有改善（-18.6±19.4，P<0.01）。胆管结石与狭窄组之间的改善程度没有差异（-22.0±20.9vs-13.3±15.8，P=.13）。SPIT评分中的MCID为-13分。术后SPIT评分小于10，提示症状缓解。
结论：与唾液管结石相比，狭窄引起的慢性唾液梗阻与基线SPIT评分较高相关,提示由于更多的症状频率和功能影响，与唾液腺炎相关的生活质量较差。根据SPIT调查结果，评分降低13分或SPIT评分<10表示显著的症状改善。
