Endoscope-assisted submandibular sialadenectomy: a new minimally invasive approach to the submandibular gland.
OBJECTIVE
Although submandibular sialadenectomy with a minimal incision improves overall cosmetic outcomes, visualization of the surgical field exposure is relatively limited as compared with that in the conventional procedure. To overcome this limitation, we applied the endoscope system to submandibular sialadenectomy. The aim of this study was to evaluate the technical feasibility and potential role of our endoscope-assisted submandibular sialadenectomy (EASS).


METHODS
We performed EASS on 5 patients, 3 of whom had intraparenchymal sialolithiasis and 2 of whom had pleomorphic adenomas. The dissection was carried out by bipolar dissection with a 4-mm nasal endoscope system.


RESULTS
The procedure achieved successful results for all 5 patients except for 1 who had severe adhesion to the adjacent tissues; this patient suffered from postoperative lingual nerve paresthesia. All the patients achieved good cosmetic outcomes.


CONCLUSIONS
An EASS with bipolar dissection is technically feasible and secures a better surgical view through a minimal incision. However, for patients with severe adhesion to the adjacent tissues, conversion to the wide-open procedure would be safer.
Baek
Chung-Hwan
CH
Department of Otolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jeong
Han-Sin
HS
D008949:Adenoma, Pleomorphic / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003389:Cranial Nerve Diseases / Q000209:etiology / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008036:Lingual Nerve / Q000503:physiopathology; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D015494:Salivary Gland Calculi / Q000601:surgery*; D013363:Submandibular Gland / Q000601:surgery*; D013364:Submandibular Gland Diseases / Q000150:complications; D013365:Submandibular Gland Neoplasms / Q000601:surgery*; D000267:Tissue Adhesions / Q000150:complications; D016896:Treatment Outcome