Learning curve for sialendoscopy
Reviewed by Sunil Sharma

Sialendoscopy represents a minimally invasive technique that permits direct salivary tree visualisation and treatment using endoscopic techniques. Previous studies have shown that it is an efficacious, safe and potentially gland preserving method to treat major salivary gland disease. However, it is still not commonly undertaken by ENT surgeons. This French study attempted to compare the results of the first 100 sialendoscopies against those of the last 100 sialendoscopies. As expected, there was an improvement in average operating times between the two groups for diagnostic (39 minutes vs 25 minutes, p=0.0006) and interventional (68 minutes vs 65 minutes, p=0.35) sialendoscopies. There was also a higher rate of success with stone extraction between the two groups (65% vs 90.2%, p=0.006). Also, the percentage of patients requiring general anaesthetic (as opposed to local anaesthetic) decreased between the two groups (63% vs 38%, p=0.0004. This study demonstrates a learning curve with sialendoscopy, however it is difficult to quantify how many cases need to be performed before a practitioner can be deemed to be competent. The results would certainly suggest a role for diagnostic sialendoscopy, and perhaps this should be incorporated into the ENT curriculum.

Sialendoscopy learning curve: comparing our first and last 100 procedures.
Al Hawat A, Vairel B, De Bonnecaze G, et al.
B-ENT
2015;11:281-5.