Diagnosis and treatment of strictures and kinks in salivary gland ducts.
OBJECTIVE
This article describes the use of sialoendoscopy for diagnosis and treatment of strictures and kinks in the major salivary glands ducts.


METHODS
Thirty-four salivary glands with obstruction were diagnosed as having ductal kinks or strictures. Strictures were diagnosed by sialography and sialoendoscopy, kinks were diagnosed mainly by sialography, whereas endoscopy was used to rule out other pathology and to locate the kink. There were strictures in 25 salivary glands (14 male and 11 females; aged 25 to 60 years), 14 in the parotid and 11 in the submandibular gland, and kinks in 9 salivary glands (5 males 4 females; aged 40 to 55 years). Seven kinks were found in the submandibular gland and 2 in the parotid. Treatment of strictures was performed by dilatation procedures with saline under pressure, balloon techniques, and forced manipulation. After these procedures, a polyethylene stent was inserted for 2 weeks. Kinks were treated by advancement ductoplasty and balloon contouring to overcome the acute angle.


RESULTS
Twenty of 25 cases of stricture became completely asymptomatic in a follow-up of 8 to 36 months after treatment. In 4 cases, further revisional dilatation was needed, and in 1 case treatment failed and the gland had to be removed. All 9 cases of kinks became completely asymptomatic in a follow-up of 6 to 24 months after treatment.


CONCLUSIONS
Strictures and kinks should be considered when salivary gland obstruction is present without sialolithiasis.
Nahlieli
O
O
Oral and Maxillofacial Surgery Department, Barzilai Medical Center, 78306-Ashkelon, Israel. nahleili@yahoo.com
Shacham
R
R
Yoffe
B
B
Eliav
E
E
D000328:Adult; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000601:surgery; D004106:Dilatation / Q000379:methods; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018987:Salivary Ducts / Q000473:pathology* / Q000601:surgery; D012466:Salivary Gland Diseases / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D012796:Sialography; D015607:Stents