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Comprehensive Otolaryngology

Stones vs Stenoses: Symptom Burden Differences Using the SPIT Survey

Sunday, October 1, 2023
4:15 PM - 4:21 PM East Coast USA Time
Location: 101AB

    Presenting Author(s)

  • AG

    Arushi Gulati, MD

    Resident
    University of California San Francisco
    San Francisco, CA, United States

    • Senior Author(s)

  • Jolie L. Chang, MD

    Associate Professor, Otolaryngology HNS
    University of California San Francisco
    San Francisco, CA, United States

Disclosure(s):
Arushi Gulati, MD: No relevant relationships to disclose.
Jolie L. Chang, MD: No relevant relationships to disclose.
Introduction: Chronic sialadenitis is caused by salivary duct obstruction due to sialolithiasis or duct stenosis, although specific etiology is not always apparent at presentation. We utilized the Salivary Problem Impact Test (SPIT) survey to assess differences in symptomatology between sialolithiasis and stenosis.

Methods: Patients completed the SPIT, a 25-item validated questionnaire for chronic sialadenitis symptoms, between October 2021 and December 2022. Exploratory factor analysis (EFA) was conducted to identify key symptom domains. Domain subscores were scaled from 0-100 and compared between patients with imaging-confirmed sialolithiasis and stenosis.

Results: 91 patients completed the SPIT from Oct. 2021-Dec. 2022, including 55 (60%) with sialolithiasis and 36 (40%) with stenosis. Stenosis patients had greater total SPIT scores (43.1±23.3 vs. 33.0±20.2, p=0.03) and greater rates of symptoms occurring more than once/week (p=0.03). EFA demonstrated 4 main domains: mealtime pain/swelling, non-mealtime pain/swelling, oral symptoms, and functional impact. Functional impact was greater in the stenosis group (36.6±26.5 vs. 22.0±20.1, p=0.003), including embarrassment, difficulty sleeping and chewing, appearance concern, and impaired daily or social activity (all items p< 0.05). Pain, swelling, and oral symptoms (dryness, foul taste, saliva texture) were not different between groups (all p>0.05). For 31 patients who underwent sialendoscopy, SPIT scores improved by 3 months postoperatively in all domains (-16.9±15.0, p< 0.001). Degree of improvement did not differ by stenosis (n=10, -14.7±13.1) vs. sialolithiasis (n=21, -18.0±16.0; p=0.57).

Conclusions: When compared to sialolithiasis, salivary obstruction from stenosis is associated with higher SPIT scores, indicating poorer sialadenitis-related quality of life, due to greater symptom frequency and functional impact. Quality of life scores for both sialolithiasis and stenosis patients improve with treatment.