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SALIVARY GLAND ENDOSCOPY OR SIALENDOSCOPY
It mainly concerns lithiasis or calculi of the salivary glands, most often of the submandibular gland, more rarely of the parotid gland.
It can help avoid the need for surgery to completely remove the salivary gland.
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These stones, however, are secondary to a dysfunction of the salivary gland itself and tend to recur.
Sialendoscopy is the endoscopic examination of the submandibular gland (a salivary gland located under the horizontal part of the jaw) or the parotid gland (a salivary gland located in front of and below the earlobe). Its purpose is to identify any obstruction within the affected salivary gland, such as a ductal stenosis (narrowing of the duct) or a small salivary stone (calculus).
Parotid sialography opacifying the salivary ducts
The aim of interventional sialendoscopy will be to remove the obstruction.
The procedure can be performed under local or general anesthesia. It requires dilation of the papilla of the affected gland: on the inner surface of the cheek for the parotid gland, or on the floor of the mouth for the submandibular gland. The sialendoscope is inserted to allow exploration of the salivary ducts. The procedure requires irrigation of the salivary tree.
In the presence of a floating or friable stone, surgical removal may be attempted. In the presence of ductal stenosis (narrowing of the duct), endoscopic dilation may be attempted. Endoscopic removal of a stone often requires an incision of the duct papilla. A calibration drain may be placed in certain situations. If the stone is lodged in the duct, an intraoral incision may be made over the stone to allow for its removal. The procedure is performed on an outpatient basis.
Surgical Risks: Pain in the surgical area is relatively minor. General swelling of the examined gland is common, related to irrigation, and subsides within a few hours to a few days. A false passage may occur during endoscopy, especially in the presence of stenosis, due to injury to the salivary duct. In this situation, tender local swelling is present for a few days. Given the instruments used, injuries to the tongue, lips, and gums may occur. A small numb area of the tongue may sometimes be observed when the removal of a salivary stone required an incision in the floor of the mouth. Recurrence of symptoms is possible and may necessitate further surgery. Residual narrowing of the salivary ducts may occur some time after the procedure. Trauma to the entire salivary duct, with partial or complete tearing, may occur in rare cases during the removal of certain salivary stones. In very rare cases, facial mobility disorders may occur in parotid gland disorders. These disorders are usually reversible.
