Concept

Sialoendoscopy

Summary

Sialoendoscopy is a minimally invasive technique that allows for salivary gland surgery for the safe and effective treatment of obstructive salivary gland disorders and other conditions of the salivary glands. During sialoendoscopy a small endoscope is placed into the salivary glands through the salivary ducts that empty into the mouth. The procedure is not exclusively diagnostic, but is interventional; thus, it can be used for the extraction of salivary stones, salivary duct lavage, dilatation of stenotic segments, or instillation of various medications such as corticosteroids or antibiotics. Thus, sialoendoscopy is an efficient yet simple mode of treatment for major salivary gland obstructions, strictures and sialoliths (salivary stones). Depending on the obstruction, sialoendoscopy can be conducted under local anesthesia in an outpatient office or in the operating room under general anesthesia. Salivary gland stones are one of the major causes of salivary gland infections (sialadenitis). These types of stones can be found in 1.2 percent of the general population. The second leading cause of salivary obstruction is from strictures and adhesions, which can happen from prior salivary gland infections, including childhood infections like mumps. Most strictures could be seen in the parotid duct and mostly in the disease process of chronic recurrent sialadenitis. Generally, the salivary duct opening needs to be either dilated or incised prior to introduction of the endoscope. Once the sialoendoscope is in place, saline is utilized to dilate the salivary duct and its branching. Once the endoscopes are introduced into gland, the internal anatomy is explored either for diagnosis or for treatment of a specific disease entity. The endoscope is introduced into the gland through its natural orifice in the mouth or by making a small incision in the duct opening. These techniques for introduction are completely intraoral techniques.

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