sialendoscopy

Sialendoscopy is a minimally invasive endoscopic technique used to visualize and treat the ductal system of the salivary glands, most often the parotid and submandibular glands. It employs a slender fiberoptic or video endoscope that is introduced through the natural duct orifice (Stensen’s duct for the parotid; Wharton’s duct for the submandibular) with continuous saline irrigation to inspect the ductal lumen.

Indications include obstructive salivary gland disease such as sialolithiasis (stones within the duct or gland), ductal stenosis, and recurrent sialadenitis. It can also be used for diagnostic evaluation of ductal anatomy, juvenile recurrent parotitis, and management of salivary duct injuries or salivaries leaks (sialocele).

During the procedure, typically performed under local anesthesia with sedation or general anesthesia in an outpatient setting, the duct orifice is cannulated and the duct is irrigated while visualized endoscopically. Therapeutic maneuvers may include retrieval of stones with miniature forceps or baskets, fragmentation or lithotripsy of calculi (using laser or other energy sources), dilation of strictures, balloon dilation of narrowed segments, and placement of ductal stents to support drainage during healing.

Advantages of sialendoscopy include gland preservation, avoidance of external incisions, reduced recovery times, and the ability to address multiple ductal segments in a single session. Limitations include limited access for large or intraglandular stones, potential ductal injury, infection, or perforation, and the need for specialized equipment and training. Outcomes are generally favorable for appropriately selected cases, with symptom relief and reduced recurrence of obstruction reported in experienced hands.

History notes that the technique was developed in the late 20th century and has become an established option in salivary gland disease management.