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Sialendoscopy: Removal of Large Stones

About Dr. Ryan Osborne

Ryan F. Osborne, M.D. is the Director of Head and Neck Surgery at OHNI and is an internationally renowned expert in head and neck oncology. He has developed a special interest for the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery.

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Can large salivary gland stones be removed without surgery?

Question: A few weeks ago I started to have pain and swelling along my lower jaw during eating. I also noticed that my mouth was drier than usual. I went to my doctor and he said that I most likely had a salivary gland issue. I was referred to an ENT who diagnosed me with salivary gland stones and told me that they were too large to be removed. The ENT mentioned that I would need to have surgery to remove the gland entirely. I have asked for a second and even third opinion but every doctor has told me the same thing. I am apprehensive about this decision because I would rather avoid the complications of surgery, if possible. Are there any methods available to remove large salivary gland stones non-surgically?

Answer:

Yes, most salivary gland stones (sialolithiasis) can now be treated without surgical intervention. Sialendoscopy is a modern and minimally invasive procedure for the removal of salivary gland stones of all sizes. This cutting edge technique utilizes very small endoscopes that are passed through the salivary gland’s natural opening in the mouth. These endoscopes allow the physician to visualize the inside of the gland’s ducts while simultaneously diagnosing and treating sialolithiasis and any associated changes to the ductal architecture. These advanced maneuvers are accomplished through the use of small instrumentation that is passed through the endoscope, while avoiding the delicate nerves and vasculature associated with the salivary gland. Due to its high efficacy, low associated complications, and preservation of normal salivation, sialendoscopy is considered the gold standard for management of salivary gland stones.

Figure 1. Salivary gland stones counted and measured for display after removal from the ductal system via a sialendoscopy procedure performed at the Osborne Head and Neck Institute. After salivary stones are removed they are correlated with stones visualized on a preoperative CT scan.
Figure 1. Salivary gland stones counted and measured for display after removal from the ductal system via a sialendoscopy procedure performed at the Osborne Head and Neck Institute. After salivary stones are removed they are correlated with stones visualized on a preoperative CT scan.

Currently, traditional surgery, with partial or complete salivary gland excision to remove salivary stones, has lost favor with many physicians and patients alike. The risk of facial nerve paralysis, taste disturbance, facial defects, and an undesirable cosmetic appearance outweigh the benefits of traditional surgery.

Dr. Ryan Osborne, director of Head and Neck Surgery at the Osborne Head and Neck Institute has pioneered the use of sialendoscopy for the treatment of persistent salivary gland stones. Dr. Osborne has recognized that patients with a suspected or confirmed diagnosis of sialolithiasis can benefit from the diagnostic and therapeutic aspects of a single procedure while avoiding the potential complications of classic surgical interventions.

For more information on sialendoscopy and the removal of persistent salivary gland stones, please contact the Osborne Head and Neck Institute.

Key Points:

  • Most salivary glands can be treated without traditional surgical interventions.
  • Sialendoscopy is a modern and minimally invasive procedure for the removal of salivary gland stones of all sizes.
  • Small endoscopes are passed through the salivary glands natural opening in the mouth, allowing a physician to diagnose and treat persistent stones.
  • Due to its high efficacy and lack of serious complications, sialendoscopy is considered the gold standard treatment for salivary gland stones.
  • Dr. Ryan Osborne, director of Head and Neck Surgery at the Osborne Head and Neck Institute has pioneered the use of sialendoscopy for the treatment of persistent salivary gland stones.

Contact a Physician at Osborne Head & Neck Institute

If you would like to speak with one of our physicians regarding this issue or another ear, nose, throat problem; or have other questions or concerns, please complete the contact form below or call us at 310-657-0123.

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