Sialoendoscopy

Sialoendoscopy – About

Sialolithiasis (salivary gland stone) is the most common disease of the salivary glands, affecting 12 in 1000 people in the adult population. It can occur at any age and most commonly occurs in the salivary gland that are located under your jaw, called submandibular glands. They also occur in the parotid gland, which is located in your cheek. These occur when calcium deposits in the duct of the gland, blocking the flow of saliva, causing pain and discomfort associated with eating. This page contains information about the symptoms and treatment of this common condition.

Sialoendoscopy – Diagnosis

When flow of saliva through the salivary gland slows down, material in the duct can form stones. These stones block the outflow of saliva, causing swelling and pain in the gland.

Stones can form in any of the major salivary glands. These include the parotid gland and the submandibular gland.

Pain (parotid causes cheek pain, submandibular stones cause jaw and mouth pain)

Swelling of the Face
Symptoms suggestive of stones should be evaluated by an Ear, Nose, and Throat physician that specializes in salivary gland disease. You should have a careful examination and may also have a CT scan done to confirm the presence of a stone.

Sialoendoscopy – Treatment

Traditionally, the only treatment option for persistent salivary gland stones associated with inflammation was surgery. Surgery could include removal of the entire salivary gland and duct or marsupialization of the duct with stone removal.

Other methods of treatment focused on prevention. These include:

  • Sialogogues substances that naturally increase salivary flow
  • Hydration to increase the amount of saliva, preventing stasis and build-up of stones in the duct system
  • Massage of the gland to manually move stones through the system, preventing large stone formation
  • Antibiotics to prevent infection from duct obstruction
  • Warm compresses over the affected gland.

Although these methods are helpful, they may only provide temporary relief. Most patients will require more definitive intervention at some point.

Salivary gland endoscopy (sialoendoscopy) is relatively new treatment option for patients in the United States. This technique has been commonly perfomed in Europe for more than two decades. With sialoendoscopy, the ducts of the salivary glands are dilated with small instruments. Then, very tiny scopes are introduced into the ducts and maneuvered upstream into the substance of the affected salivary gland. Any small stones that are encountered can potentially be removed with baskets. Narrowed portions of the duct can be dilated. Steroids can be infused directly into the ductal system through the scope to minimize symptoms related to salivary gland inflammation. Sialoendoscopy can be both diagnostic and therapeutic. It is most commonly performed in the operating room and can be repeated as needed. With the advent of sialoendoscopy, many patients now have a viable treatment option that may allow them to preserve the affected salivary gland.

Open salivary gland surgery still represents definitive treatment for many conditions. It can be used as a back-up when endoscopic intervention has failed, or as up-front treatment for patients that want to avoid the risk of recurrence. Unique among other structures in the head & neck, salivary glands are located close to nerves that are critical for normal facial movement, taste, and sensation. Complications associated with injuries to these nerves include:

  • Loss of oral sensation
  • Loss of taste
  • Facial weakness
  • Scarring associated with surgical incisions
  • Facial deformity
  • Occasionally, if the duct is not removed completely, recurrent symptoms may occur.

Despite the proximity of the salivary glands to these critical structures, open salivary gland surgery is often performed safely, and with minimal side effects, by the experienced surgeons at ENT Center of Utah. You should discuss with your surgeon whether conservative measures, salivary gland endoscopy, or open salivary gland surgery is right for you.

  Conditions Treated

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