Sialendoscopy for inflammatory and obstructive sialadenitis of majory salivary glands
Introduction
Obstructive sialadenitis is one of the most common causes of recurrent sialadenitis in major salivary gland. Patients usually present with recurrent pain or swelling of major salivary gland area, especially at meal time and get improved within a matter of hours. The common causes of obstructive sialadenitis include sialolithiasis (60-70%) and stenosis (20-25%). Sialolithiasis is most commonly found in the submandibular gland and stenosis is most commonly seen in the parotid gland.
What is sialendoscopy?
Sialendoscopy is a minimally invasive surgery that allows the endoscopic visualization of major salivary glands and offers a mechanism to diagnose and treat inflammatory and obstructive sialadenitis related to the ductal system. The indications of sialendoscopy are obstructive sialadenitis (sialolithiasis and stenosis), juvenile recurrent parotitis, radioiodine related sialadenitis and autoimmune disease (Sjogren syndrome).
How is it done?
We perform all our sialendoscopy surgery in the operating room. Most of the diagnostic sialendoscopies are performed under local anaesthesia. Interventional sialendoscopies including removal of duct calculus, dilatation and stenting of the ductal stenosis are performed either under local anesthesia or general anesthesia. It depends on the preference or cooperation of patients. Patients are placed supine with head fixed on a head rest and turned towards the surgeon. Under microscopy, we can identify the orifice of submandibular gland or parotid gland. The orifice is serially dilated with multiple probes of different sizes or conical dilator. After adequate dilatation, sialendoscope is introduced through the dilated orifice. Irrigation fluid is pushed through the irrigation channel of the scope. It helps the ductal lumen open for passage of the sialendoscope, washing out the debris and increasing the intraductal visibility. Sialendoscope is slowly passed from the orifice till the possible lesion site.
Why is it done?
With a minimally invasive technique, it is safe and effective to remove the possible pathology in the inflammatory and obstructive diseases of major salivary gland. We can try to preserve the gland itself and recover the function of gland.
Possible risks & Complications
- Avulsion of the duct
- Perforation of the duct wall
- Temporary lingual nerve paresis
- Stenosis of the orifice or duct
- Ranula
- Acute sialadenitis, etc
Sialendoscopic figures during surgery
(A) Impacted stone (B) Laser fragmentation (C) Removal of stone by basket
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.