Salivary glands produce saliva, which helps moisten the mouth, protect from tooth decay and help with digestion. There are three major salivary glands:
- Parotid- On the cheek and under the ear
- Submandibular- Under the jaw
- Sublingual- Under the tongue
With one of each on either side of the face, they help with keeping the mouth moist and healthy. These salivary glands have ducts or openings from where saliva flows. The opening may become too tight (stricture), or the duct could get blocked by a salivary stone. This could cause saliva to collect in the gland, causing swelling, pain, inflammation and infection.
What is Sialendoscopy?
Sialendoscopy is a minimally invasive procedure to diagnose and treat salivary gland disorders. Some disorders include:
- Strictures
- Small to medium salivary gland stones
- Chronic inflammation
- Other issues affecting the major salivary glands
A tiny endoscope is used to see and address problems inside major salivary glands. A specialized, narrow endoscope called a micro-endoscope allows the doctor to get a view of inside the gland. The micro-endoscopes range from 0.8- 1.6 mm in width. The micro-endoscope is fitted with a light, camera and tools. Small graspers and baskets can be used to extract tiny salivary stones.
Why is a Sialendoscopy performed?
- Salivary Stones: Also called Sialolith, is a hard mineral deposit that forms in a salivary gland. It can cause a blockage in the duct resulting in swelling, pain and infection.
- Radiation-Induced Salivary Gland Damage: In cases where patients are treated with radioactive iodine for thyroid gland disease, salivary glands can absorb the radioactive iodine and get damaged by it.
- Chronic Salivary Gland Infection: Chronically inflamed salivary glands (sialadenitis) can be treated by dilating the ducts and irrigating the gland.
What happens during Sialendoscopy?
The micro-endoscope has three channels, each with its purpose:
- The working channel contains the tools like wire baskets or balloons.
- The irrigation channel pushes fluids or medication to flush out any debris.
- The camera and light channel allow the doctors to see throughout the procedure.
Before a Sialendoscopy, the doctor may order an MRI, CT scan or an ultrasound to get a better look at the salivary gland. The procedure is performed under general anaesthesia and takes about an hour. The surgeon begins by guiding the micro-endoscope into the salivary duct. If the opening is too narrow, it may be gently stretched. The inside of the gland is rinsed with saline to remove any debris. With the light, camera and tools, any stones or blockages inside the gland are removed.
What are the risks of Sialendoscopy?
As it is a minimally invasive procedure, there are fewer risks than with traditional, open surgery. Though rare, these risks include:
- Perforation of the duct
- Bleeding
- Strictures (tightening of the duct)
- Ranulas (benign cysts filled with saliva)
Post-operative care
The patient is monitored after surgery. Depending on their condition, they may be allowed to leave the day of the surgery or the next day.
After surgery, salivary glands may feel sore and swollen. Anti-inflammatory medication may be prescribed to help with the discomfort.
Complete recovery takes about a week, during which patients should avoid straining or heavy lifting. They may resume their routine light work.
Patients should adhere to a soft diet for a few days. Rinsing the mouth after meals is important as it prevents food particles from sticking to the treatment area.