- Voice Case of the Week: When Nodules Need Surgery
- Voice Case of the Week: Who Needs a Laryngeal Surgeon?
- Nasal Fractures, Septal Hematoma, and Septal Perforation: Simultaneous Rhinoplasty and Septal Perforation Repair
- Ground-breaking New Treatment Option for Sleep Apnea
- Septal Perforation: Long-Term Outcomes
- Saddle Nose Deformity and Septal Perforation: Correcting Nasal Collapse
- Deviated Septum and Septal Perforation
- Hereditary Hemorrhagic Telangiectasia: Nasal Septal Perforation Repair
- Commonly Misdiagnosed Pathologies: Arteriovenous Malformations
- Salivary Gland Surgery: Sialocele Prevention
How do I know if I’m a candidate for Sialendoscopy of my salivary gland stones?
Question: I just got back from the ENT. I had a CAT scan of my neck to diagnose the size of a salivary gland stone. I was told that my stone is too large to have a scope procedure [sialendoscopy]. He said it was huge. According to him the stone is almost 15 mm on its largest side. I think from looking at the CAT scan that its 12mm x 8mm? He wants to go at it under the tongue, and if that fails wants me to consent to removal through my neck. I want a second opinion, as the scope method seems much less invasive.
Discussion: A CT scan is the best non-invasive study to diagnosis the presence of a salivary gland stone. However, while the CT scan confirms the presence of a stone, it cannot accurately tell you how many stones are present or there exact size. The reason for this ambiguity? Many times a group of tiny crowded stones will appear on CT scan to be one large stone when in fact there are many small stones that are amenable to sialendoscopy (endoscopic diagnosis and removal of salivary gland stones). This is due to limits of resolution of the CT scanning machines (think High-Definition 1080p versus your old 19 inch). In other words we don’t always see the forest for the trees. Unfortunately, many patients will have unnecessary surgery for “large stones” that are really a group of small stones that could be removed with a less invasive procedure that requires no hospitalization, no incision, no scar, and zero percent risk of facial nerve paralysis.
- Diagnosis- On CT Scan many small crowded stones may present as one big stone
- Best Procedure- Sialendoscopy remains the best first choice in salivary gland stone evaluation and treatment-not surgery. There’s no risk of scarring, no hospitalization, and zero risk of facial paralysis with Sialendoscopy.
Sialendoscopy demonstrating the removal of several stones with wire basket:
Read patient stories about Dr. Osborne and Dr. Hamilton
from the Salivary Gland Center, at the Osborne Head & Neck Institute
To learn more about Sialendoscopy and Dr. Ryan Osborne & Dr. Jason Hamilton, visit: http://www.parotid.net.