What Is a Sialendoscopy?

Sialendoscopy is a minimally invasive procedure that can treat certain salivary gland disorders. It offers advantages over open surgery but is not appropriate for all salivary gland issues.

Sialendoscopy is a procedure that can diagnose and treat disorders of the major salivary glands. These glands are located in the cheeks and floor of your mouth. They produce saliva and empty it into your mouth through openings called ducts.

Saliva is important because it keeps your mouth moist, helps you digest food, and helps protect your teeth from decay.

Different diseases and disorders can affect your salivary glands. Sialendoscopy is a minimally invasive outpatient surgery that’s able to examine and treat some of these disorders.

What is sialendoscopy?

Sialendoscopy is a minimally invasive surgical procedure used to diagnose and treat salivary gland disorders . Specifically, disorders that affect your major salivary glands — the submandibular glands and the parotid glands.

This procedure allows doctors to see and sometimes correct issues in the major salivary glands using a very small tool, such as a camera or endoscope .

A very small telescoping camera, sometimes called a micro-endoscope, is inserted into your mouth and through the opening of the salivary gland. Different styles of instruments are used to clean or widen the duct and remove any stones or blockages.

Sialendoscopy can be an alternative to open surgery, which has a longer recovery time and greater potential complications.

Why is a sialendoscopy done?

Sialendoscopy is done to examine or treat salivary gland issues. This can include:

• Salivary stones: Sialendoscopy can be used to remove small to medium salivary stones in the salivary gland or ducts that may be blocking saliva flow.
• Radiation-induced salivary gland damage (sialadenitis): This swelling of the salivary glands is due to radiation treatment during cancer.
• Salivary gland strictures: This is a narrowing of the salivary gland ducts that leads to reduced saliva flow.
• Juvenile recurrent parotitis (JPR): JPR is a condition that causes recurring swelling of the parotid glands (the salivary glands between the jaw and cheek).

While not all salivary gland issues can be treated with sialendoscopy, it has several advantages over open surgery.

The advantages of a sialendoscopy are:

• no hospital time
• fast recovery
• it preserves the salivary gland
• a low risk of nerve damage
• a low risk of complications
• no visible incision or scar

What happens during a sialendoscopy?

A sialendoscopy is usually an outpatient procedure. Most of the time, you will go home from the hospital on the same day.

Once you are at the hospital:

1. You will be put under general anesthesia . Occasionally, minor procedures will use only local anesthetic.
2. Your doctor will guide the endoscope tool into your salivary gland duct.
3. The endoscope will be used to irrigate (rinse) the gland and clear it of any debris.
4. The surgeon will inspect the inside of the gland using various tools and attachments. If necessary, blockages and stones may be removed.
5. Occasionally, this approach will be combined with open surgery if more access is needed.
6. The procedure typically takes about an hour unless several stones need to be removed.
7. After recovering from anesthesia, you are usually cleared to go home.

How do you prepare for a sialendoscopy?

Before a sialendoscopy, your doctor will need to know:

• your complete medical history
• all medications you are currently taking
• any allergies or reactions to medications

Before the procedure, you may also need to:

• undergo imaging tests, such as CT scans, MRIs, or ultrasounds
• take medications, such as antibiotics or steroids, either before or after the procedure
• follow your doctor’s directions on eating or drinking

Are there risks from a sialendoscopy?

Sialendoscopy has a low rate of risks and complications, especially when compared to open surgery. But some complications are possible.

Potential complications include:

• Infection: If infection occurs, a course of antibiotics usually resolves the issue.
• Bleeding: This is a greater risk when sialendoscopy is paired with open surgery.
• Nerve damage: There are several nerves near the salivary glands, but the risk of damaging them increases in a combined open surgery approach.
• Salivary gland duct damage: Scarring, tightening (strictures), or perforation of the ducts are possible.
• Other complications: Ranulas (cysts inside your mouth caused by a blocked salivary gland), temporary tingling (paresthesia) in the lingual nerves, or a recurrence of symptoms are possible complications.

What happens after a sialendoscopy?

After a sialendoscopy, you will usually be sent home from the hospital on the same day. Most people are able to return to work or their typical activities the day after the procedure.

You should follow your doctor’s post-procedure instructions, which may include:

• Soft foods: You’ll probably be on a soft food diet for 1 or 2 days while your glands heal.
• Pain management: Over-the-counter or prescription anti-inflammatory medication may be suggested.
• Rinse with water: After eating, you should rinse your mouth with water to keep particles out of the treated area.

If you were given general anesthesia, you will need a ride home from the hospital.

Frequently asked questions

Is a sialendoscopy painful?

You are under general anesthesia during a sialendoscopy, so there is very little pain. Afterward, there might be some discomfort, but you can take over-the-counter pain medication.

What is the success rate of sialendoscopy?

The success rate of sialendoscopy depends on the reason for the procedure. A 2023 research review gives the procedure a pooled success rate of about 80%.

What size stones are needed for sialendoscopy?

Small to medium-sized stones can often be removed with sialendoscopy. Larger stones require a different procedure or a combined approach.

Takeaway

Sialendoscopy is a minimally invasive procedure to examine and treat salivary gland disorders. A small camera with different tool attachments is inserted into the salivary glands through the mouth. There, it can widen or clean out the ducts as needed.

Sialendoscopy is usually a safe and effective alternative to open surgery. While minor complications are possible, outcomes are generally positive with minimal recovery time.