Learning About Sialendoscopy

Sialendoscopy (say "sy-uh-len-DAW-skuh-pee") is a procedure to diagnose and treat problems inside the salivary gland ducts. These are the tiny tubes that carry saliva into your mouth. Instead of making cuts on the outside of your face or neck, a doctor uses a very thin, flexible tube with a camera on the end. The tube is placed in the duct opening inside your mouth. Small tools can be placed in the ducts.

In many cases, your doctor can find the problem and treat it in the same visit.

It may be done to open narrow or blocked salivary glands. It also can be used to treat conditions that can cause pain and swelling.

It's often done to remove mineral deposits called salivary stones. The salivary glands make saliva, which flows through ducts into your mouth to help with digestion and oral health. Sometimes mineral deposits can form and block these ducts. This prevents saliva from draining the right way. This can cause pain and swelling that is often worse during meals, when your body produces more saliva.

You'll receive local anesthesia to numb the area. Some people also have sedation to make them sleepy. Your doctor will widen the duct opening inside your mouth just enough to pass a tiny scope through it. The camera lets your doctor see inside the duct.

Depending on what’s found:

• A stone may be removed using tiny tools passed through the scope. Or a stone may first be broken into smaller pieces with a laser or shock waves.
• A narrowed duct may be widened using a small balloon.
• A small tube (stent) may be left in place for a while to keep the duct open while it heals.

The procedure usually takes 30 to 90 minutes.

You may have some mild soreness, swelling, or discomfort in your mouth and jaw for a few days. Most people return to their normal activities in 1 or 2 days. Your doctor may recommend a soft diet for a short time. If a stent was placed, you’ll have a follow-up appointment to have it removed. Your doctor may also prescribe antibiotics or medicine for swelling.

Sialendoscopy improves pain and swelling for most people. Salivary stones can sometimes come back, but it's not common. Sometimes another procedure may be needed.

Sialendoscopy is safe, but like any procedure, it carries some risk. Possible problems include:

• Short-term swelling or bruising around the duct.
• Infection.
• Incomplete stone removal. A follow-up procedure may be needed.
• Rarely, a small tear in the duct or damage to nearby structures.

Sialendoscopy isn’t the only option for treatment. Depending on your situation, your doctor may discuss:

• Watchful waiting. Small stones sometimes pass on their own with extra fluids and gentle massage.
• Shock wave therapy (ESWL). Sound waves from outside the body are used to break up stones.
• Open surgery. This is a more involved procedure to remove the stone or the entire gland. This may be done when sialendoscopy isn’t possible or hasn’t worked.