V.S. and D.-A.C. contributed equally.
Head and Neck
Article first published online: 20 APR 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 6, pages 1301–1305, June 2012
How to Cite
Siedek, V., Clevert, D.-A., Rytvina, M., Ihrler, S., Klotz, L. V., Berghaus, A. and Strieth, S. (2012), Contrast-enhanced ultrasound for monitoring effects of extracorporeal shock wave sialolithotripsy in sialolithiasis. The Laryngoscope, 122: 1301–1305. doi: 10.1002/lary.23281
SonoVue was provided by Bracco Diagnostics, Milan, Italy.
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 1 JUN 2012
- Article first published online: 20 APR 2012
- Manuscript Accepted: 13 FEB 2012
- Manuscript Revised: 3 FEB 2012
- Manuscript Received: 20 SEP 2011
- Contrast-enhanced ultrasound;
- submandibular gland;
- extracorporeal sialolithotripsy;
- Level of Evidence: 2c
Contrast-enhanced ultrasound (CE-US) can be used for noninvasive analysis of functional vascularization. Chronically recurrent sialadenitis due to sialolithiasis of the submandibular gland is associated with increased vascularity. The aim of this investigator-initiated clinical trial was the evaluation of CE-US as a quantitative monitoring technique during gland-preserving extracorporeal shock wave sialolithotripsy (ESWL).
In this prospective clinical evidence level 2c study, perfusion in patients (n = 10) with unilateral sialolithiasis of the submandibular gland was quantitatively analyzed using CE-US before and after ESWL, comparing with the respective contralateral gland.
Before CE-US measurements, a subjective clinical score of complaints (range, 1–10) was documented. The contrast agent SonoVue was injected into a cubital vein. The intensity–time curve gradients (ITGs) were calculated from CE-US data.
The ITGs derived from CE-US measurements revealed higher perfusion in the affected submandibular gland compared to the contralateral side. In parallel to clinical complaints, parametric CE-US data were significantly reduced after ESWL in chronic sialolithiasis-associated sialadenitis.
CE-US–derived ITGs appear to be an independent and quantitative marker for treatment effects of ESWL. Clinical experience and further studies will have to validate this method as a diagnostic tool to decide especially whether to proceed to sialoadenectomy in therapy-refractory cases.