Minimally invasive techniques in the management of benign surgical salivary problems

ABSTRACT

Sialolithiasis is considered as the commonest underlying pathology for sialadenitis, commonly affecting submandibular salivary glands, to lesser extent parotid glands and rarely sublingual or minor salivary glands. Stenosis of secondary and tertiary ducts of the salivary ductal system can also precipitate suppuration of the salivary glands. Patients with history of sialadenitis were best investigated by ultrasound and/or sialography. Patient should be informed by a written consent that if the endoscopic trial failed, the procedure should be shifted to external sialoadenectomy. Interventional sialoendoscopy is a new procedure to visualize the salivary ductal system followed by stone extraction, fragmentation of big stones then extraction or dilatation of stenosed duct by metallic dilator or balloon catheter. The surgical duration ranged between 10-20 minutes, with limited complications as duct perforation requiring sialoadenectomy or duct stenosis with fibrosis that was detected in the routine postoperative ultrasound and/or sialograms. Being a simple outpatient ambulant procedure, sialoendoscopy avoids the risk of general anesthesia and the need to do maximum neck extension in patients suffering of neck problems