Sialoendoscopy –Newer frontiers in minimally invasive ENT treatments

What is sialoendoscopy

New technology aims to visualize the lumen of the salivary ducts and Treat various inflammatory and obstructive pathologies

How is it done?

Sialoendoscopy involves the use of miniature endoscopes to enter the small ducts of the salivary system in search of disease

What kind of instruments are used?

Flexible endoscopes which are 0.75 – 1mm in diameter are used. After dilating the passage of the salivary duct, these scopes are passed in. One by one many ducts can be examined.

What are the procedures possible using this technique?

   1. Diagnostic scopy to examine the ducts
   2. Washes to remove sludge and mucus plugs
   3. Stone removal
   4. Dilation of duct strictures
   5. Biopsies of the gland

How long does it take?

This may be possible in 30 minutes for a diagnostic examination, to 1-1.5 hours for therapeutic procedures ?

How is it different and advantageous from earlier treatment methods?

Traditional methods were limited to medications followed by open surgery for complete removal of the gland. This required a long hospital stay, risk of complications e.g. nerve injury, bleeding, pain, etc.

With this new method the advantages are:

   1. No Scar
   2. Quick Recovery
   3. Return Home Same Day
   4. No Tissue Damage To Surrounding Areas

When can we use this technology?

We can use this technology to diagnose and treat some common problems salivary glands. By far the most common problem is stones, causing sialadenitis

   1. Duct calculi (stones)
   2. Strictures
   3. Dryness of mouth
   4. Foreign Bodies
   5. Mucus plugs/sludge
   6. Ductal granulomas

This is also used to get biopsies from intraductal lesions, and for complicated autoimmune conditions which may involve the salivary glands.

Can this be used for large stones as well?

Yes. With newer technologies, a narrow (Holmium)laser fiber can be passed with the endoscope and used to break down large stones, which can then be retrieved in a minimally invasive manner.

How long is the recovery process following a sialendoscopy (salivary stone removal)?

It is recommended that a patient rest and relax for the remainder of the day Some pain and discomfort, as well as swelling, is to be expected. Most patients can resume all activities within a day

Can this technology be used in children?

Yes. Recurrent infection can happen in children, and often requires repeated antibiotics or even surgery. This procedure can be done safely, even in young children.