Sialendoscopy is a procedure that involves inserting a micro-endoscope into the natural opening of the salivary gland duct as it enters the mouth in order to examine the salivary gland ducts and remove any salivary stones or debris.
Who Needs a Sialendoscopy?
Patients with salivary stones, a condition also called sialolithiasis, may need a sialendoscopy. Salivary stones are hardened mineral deposits that form in the salivary glands. About 80 percent of salivary stones form in the submandibular glands, but they may also form in the parotid glands (on the side of the face, near the ears), the sublingual glands (under the tongue), and the minor salivary glands (in the inside of the cheeks or lips, under the tongue and beneath the palate).
Symptoms of Salivary Stones
Individuals with salivary stones experience swelling, pain or both in the affected salivary gland. Symptoms worsen when the individual is eating or anticipating eating. Individuals may have symptoms that come and go over a period of weeks or be persistent. Symptoms typically worsen if the stone moves or grows in a way that blocks the duct of the gland. Individuals experiencing any of these symptoms should schedule a visit to their primary physician.
Causes of Salivary Stones
The exact cause of salivary stones is unknown, but several factors may increase the likelihood of salivary stone formation:
- Dehydration
- Trauma to the inside of the mouth
- Gum disease
- Smoking
Benefits of a Sialendoscopy
A sialendoscopy will help alleviate symptoms without having to remove the salivary gland. If the stones can be removed, then it is highly likely that the gland will return to normal.
Not all patients will benefit from a sialendoscopy. Patients with large stones or stones that are stuck within the gland will need alternative treatment.
Side Effects and Risks
Most patients experience few or no complications. Uncommon and rare side effects include bleeding, infection and nerve damage.
What to Expect During a Sialendoscopy
The procedure is performed while the patient is under local anesthetic. The physician begins by inserting a micro-endoscope through the natural opening of the salivary gland duct. The opening will be gently stretched to allow the endoscope to be inserted into the gland. In some instances, the physician may need to make a small incision at the opening of the duct to allow the endoscope to pass through.
Once the endoscope reaches the drainage tubes, the physician will rinse the area with fluid in order to clearly see the ducts. This rinsing will cause the glands to become temporarily swollen. Small stones will be removed through the micro-endoscope, while larger stones will need to be broken into smaller pieces before they can be removed.
The procedure typically takes between 20 minutes and half an hour. For cases that require the removal of stones or stretching of strictures, the procedure can take up to 45 minutes.
After the Procedure
Patients will have mild soreness and swelling but are allowed to return home the same day. They will need to make a follow-up visit one month after the procedure.