Interventional sialoendoscopy: early clinical results.
OBJECTIVE
Sialoendoscopy is a novel minimally invasive technique to explore the salivary duct system and to treat obstructive salivary disease. This article describes the early clinical experience with endoscopic salivary duct exploration and sialolithectomy in 2 medical centers.


METHODS
This is a retrospective case series of 94 patients, with submandibular (n = 77) or parotid (n = 17) sialadenitis secondary to sialolithiasis, strictures, or mucous plugs. Patients underwent sialoendoscopy at Baptist Hospital, Miami (n = 52) or at Massachusetts General Hospital, Boston (n = 42). Dilatation of the duct through the natural orifice was accomplished with salivary dilators. Three endoscope systems with diameters from 1.1 to 2.3 mm were used. Using a basket, grasper, lithotripsy, laser, or a combination of these, stones were fragmented or removed endoscopically. Strictures were dilated and mucous plugs removed. All cases were carried out under general anesthesia.


RESULTS
Salivary duct navigation was accomplished in 91/94 patients. In 3 cases, duct dilatation was not possible due to scarring. Symptomatic relief was achieved in 81/91 patients (89.4%). Strictures and mucous plugs were visualized and managed in 18/18 patients. Sialoliths were visualized in 73 patients and stone fragmentation or retrieval was accomplished in 84.93% (62/73) of cases. Complications included 2 patients with temporary lingual nerve paresthesia and 1 patient with excess extravasation of irrigation fluid.


CONCLUSIONS
The results of this study indicate that interventional sialoendoscopy is an effective, minimally invasive alternative treatment for obstructive salivary gland disease.
Papadaki
Maria E
ME
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA.
McCain
Joseph P
JP
Kim
King
K
Katz
Ronald L
RL
Kaban
Leonard B
LB
Troulis
Maria J
MJ
D000328:Adult; D002648:Child; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery; D004106:Dilatation; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010309:Parotitis / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D018987:Salivary Ducts / Q000601:surgery*; D015494:Salivary Gland Calculi / Q000150:complications / Q000601:surgery; D012793:Sialadenitis / Q000209:etiology / Q000601:surgery*; D013364:Submandibular Gland Diseases / Q000209:etiology / Q000601:surgery*