title: Intraductal pressure during sialendoscopy.
abstract: BACKGROUND
  Sialendoscopy can be followed by swelling and infection of the salivary gland. A possible pathomechanism is damage of the deeper salivary duct system by intraductal pressure generated by the irrigation fluid.
  
  
  METHODS
  After measuring the physiological intraductal pressures which arise during sialendoscopy, these pressures were simulated in freshly excised salivary glands and the tissue was analysed histologically.
  
  
  RESULTS
  Normal intraductal filling pressure during sialendoscopy is 100-250 daPa, and pressure peaks can be up to 2000 daPa during flushing. A filling pressure of more than 400 daPa results in dilatation of the salivary ducts and acinar area. No direct damage to any duct structures could be observed histologically.
  
  
  CONCLUSIONS
  Irrigation fluid should be administered intermittently rather than continuously during sialendoscopy. The intraductal filling pressure should not exceed 400 daPa to minimise the trauma to the salivary duct system and reduce the risk of developing oedema and inflammation.
authors.affiliation: Department of Otorhinolaryngology,Head and Neck Surgery,University of Cologne,Germany.
authors.forename: J C
authors.initials: JC
authors.lastname: Luers
authors.affiliation: Institute of Pathology, University of Cologne,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ortmann
authors.affiliation: Department of Otorhinolaryngology,Head and Neck Surgery,University of Cologne,Germany.
authors.forename: D
authors.initials: D
authors.lastname: Beutner
authors.affiliation: Department of Otorhinolaryngology,Head and Neck Surgery,University of Cologne,Germany.
authors.forename: K B
authors.initials: KB
authors.lastname: Hüttenbrink
mesh_terms: D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D011312:Pressure / Q000009:adverse effects; D018987:Salivary Ducts / Q000473:pathology / Q000601:surgery*; D012466:Salivary Gland Diseases / Q000175:diagnosis; D012793:Sialadenitis / Q000473:pathology / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000379:methods*; D014393:Tuberculosis, Oral / Q000473:pathology / Q000601:surgery