Surgery of the salivary glands using sialoendoscopes

Abstract

We have employed sialendoscopy for salivary gland disease since April, 2012 and we report herein on the results of 13 cases who underwent surgery using sialendoscopes. The aim of this study was to clarify the indication of surgery of the salivary glands using sialendoscopy. The clinical features of these cases including operative methods, diagnosis and calculi size were investigated with retrospective chart study. They included 12 salivary stones of the submandibular gland and one case of sialectasis of Stensen's duct. All cases were operated on under general anesthesia and laser was not used. The preservation rate of submandibular glands was 67% in the 12 cases. Of 16 calculi, 5 were removed by exclusively with endoscopes, 7 were removed with a combined approach and 4 were treated with removal of the salivary gland. The median size in the endoscopically removed group was 3.3 mm, while that in the combined approach or removal of the submandibular gland group was 8.1 mm, demonstrating a significant difference. The largest calculus removed with the endoscope was 6.2 mm in diameter. On the other hand, in a case with stenosis of the duct and another case with many calculi in the duct, endoscopic removal was not removed. No operative complication occurred except temporary swelling of the submandibular glands. In conclusion, calculus of submandibular glands with a largest diameter less than 6 mm could be an indication for endoscopic removal when the laser is not used.