## 2 Materials and Methods  
This retrospective study included 17 pediatric patients (aged 3-16 years; mean age 6.7 years), who were diagnosed with juvenile recurrent parotitis according to radiologic and clinical features and were treated with sialoendoscopy between May 2016 and March 2023 in the Maxillofacial Department of the Tzafon Medical Center, Poriya, Israel.  
This study was approved by the Tzafon Medical Center institutional review board (approval 0027-23-POR) and was performed under the Declaration of Helsinki principles.  
All the patients approached the Maxillofacial Department of the Tzafon Medical Center with a complaint of recurring events of swelling. All the patients underwent a clinical examination, and most underwent a radiological procedure (US) of the face and neck before a surgical procedure was performed. Three patients did not undergo US due to their young age (3 years old), and one additional patient did not undergo US since the processing of this patient was conducted in early 2018 before the protocol was implemented; since then, US has been performed on all patients, if cooperative. No other imaging was performed on these four patients before sialoendoscopy.  
JRP was diagnosed in cases of a repeating acute unilateral or bilateral episode of parotitis, in some children accompanied by a characteristic US imaging of the parotid gland, showing hypoechoic areas with or without swollen cervical lymph nodes.  
In the acute phase, conservative treatment was given, consisting of hydration, sour foods, gland massage, analgesics (paracetamol), and antibiotic treatment (amoxicillin-clavulanate). This was also recommended as a conservative treatment for future acute episodes.  
After recovery from the acute phase, the patients underwent a thorough evaluation of their medical history and a physical examination, helping to confirm the diagnosis of JRP and to assess the severity of their condition. The parents of children who suffered from two swelling events or more in one year were advised to choose one from two treatment options, the first to wait until the child reaches the age of 16 years, when JRP usually spontaneously resolves, and to manage acute phases in a conservative fashion until then. The second option is to perform a sialoendoscopy. If swelling occurs again, another sialoendoscopy treatment is suggested.  
The parents of 17 children decided to advance with that treatment, due to the potential benefits and good clinical treatment results.  
The inclusion criteria were patients not older than the age of 16 years, who were diagnosed with JRP based on at least two episodes of swelling of the parotid gland unilaterally or bilaterally. All the patients had undergone at least one sialoendoscopy for one of the parotid glands. Most of the children (15 out of 17) were treated under general anesthesia. Treatment under local anesthesia was performed on two children, aged 13 and 16 years.  
The exclusion criteria were patients older than 16 years of age, and patients who were diagnosed with sialolithiasis or Sjogren's syndrome.  
Assessments of medical charts were conducted, as data was collected from the patient's records during pretreatment and follow-up examinations. For each patient, the obtained data included demographics (sex, age at the time of surgical intervention), medical history (background of chronic diseases), US findings (if available), number of sialoendoscopy procedures, sialoendoscopy findings, complications, and clinical outcome.  
The criteria for successful treatment were defined either as total resolution, no swelling episodes in the follow-up period, or a distinct improvement in the frequency or intensity of swelling episodes, subjectively noted by children and their parents, leading to a better life quality during the follow-up period.