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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Sialolithiasis (also termed salivary calculi, or salivary stones) is a crystallopathy where a calcified mass or sialolith forms within a salivary gland, usually in the duct of the submandibular gland (also termed "Wharton's duct"). Less commonly the parotid gland or rarely the sublingual gland or a minor salivary gland may develop salivary stones. The usual symptoms are pain and swelling of the affected salivary gland, both of which get worse when salivary flow is stimulated, e.g.
The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the mandibular ramus, and secretes serous saliva through the parotid duct into the mouth, to facilitate mastication and swallowing and to begin the digestion of starches. There are also two other types of salivary glands; they are submandibular and sublingual glands.
The salivary glands in many vertebrates including mammals are exocrine glands that produce saliva through a system of ducts. Humans have three paired major salivary glands (parotid, submandibular, and sublingual), as well as hundreds of minor salivary glands. Salivary glands can be classified as serous, mucous, or seromucous (mixed). In serous secretions, the main type of protein secreted is alpha-amylase, an enzyme that breaks down starch into maltose and glucose, whereas in mucous secretions, the main protein secreted is mucin, which acts as a lubricant.