Sialendoscopy as a Useful Diagnostic and Interventional Tool for the Various Salivary Gland Disease: Our Experiences

Abstract

Background and Objectives Sialendoscopy is useful for the diagnosis and treatment of obstructive salivary gland diseases, but not yet universally employed because it requires dedicate, expensive, and fragile endoscopic equipment; moreover, the surgical technique is also delicate. Here, we describe our initial experience of sialendoscopy, as well as the learning curve, precautions, and drawbacks that beginners must overcome in employing sialendoscopy.Subjects and Method The medical records of 98 patients who underwent sialendoscopic procedures at Eunpyeong St. Mary’s Hospital from May 2019 to March 2022 were retrospectively reviewed. The type of procedure, success rate, operation time, and complications were analyzed.Results We have performed a total of 85 sialendoscopic procedures, including 79 to treat submandibular sialolithiasis, two to treat submandibular ductal stenosis, two to treat parotid sialolithiasis, and two to treat parotid ductal stenosis. Of the total of 81 patients with sialolithiasis, 82.4% were treated by sialendoscopy only, 15.3% by hybrid procedure, and 2.3% opted to preserve the salivary gland and convert to external submandibular gland excision. Four patients with ductal stenosis were treated via endoscopic bougination; stents were placed for 4 weeks without any restenosis. The operation time was significantly shorter for the second half than for the first half of the patients (58.6 min vs. 39.8 min). Longer operation time was associated with the parotid gland diseases, larger stones (>5 mm in diameter), more proximal stones (from the salivary gland), and multiple stones. We encountered no major surgical complications.Conclusion Sialendoscopy is useful and safe; even beginners can evaluate and manage obstructive salivary gland diseases.