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Sialendoscopy is a modern, minimally invasive endoscopic technique that has revolutionised the diagnosis and treatment of salivary gland disorders. This advanced procedure allows doctors to directly visualise and treat blockages in the salivary ducts, offering a safer and more effective alternative to traditional open surgery. With its precise approach and minimal discomfort, sialendoscopy is becoming the gold standard in managing chronic salivary gland issues.
Whether caused by stones, infections, or strictures, salivary gland disorders can significantly affect quality of life, leading to pain, swelling, and recurrent infections. Thankfully, sialendoscopy offers hope to patients who previously had limited options.
Synopsis
What Conditions Does Sialendoscopy Treat?
Sialendoscopy is primarily used to treat conditions that obstruct the salivary ducts. The most common among these include:
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Sialolithiasis (salivary gland stones): The most frequent indication for sialendoscopy. Stones can block the duct, leading to swelling and pain, especially during meals.
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Chronic sialadenitis: Recurrent inflammation of the salivary glands due to ductal obstruction or infection.
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Ductal strictures: Narrowing of the ducts, often related to autoimmune diseases such as Sjögren’s syndrome.
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Mucous plugs or debris: Often observed in younger individuals and can cause intermittent swelling.
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Post-radiation ductal blockages: Following head and neck cancer treatments.
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Unknown causes of recurrent swelling: Where imaging doesn’t show a clear source of obstruction.
By offering a clear view inside the ducts, sialendoscopy helps doctors both diagnose and treat the condition in a single sitting.
The Sialendoscopy Procedure: Step-by-Step
Sialendoscopy is typically performed as an outpatient procedure under local or general anaesthesia, depending on the complexity. Here’s a step-by-step overview:
1. Ductal Access.
A small dilator or probe is used to gently open the natural duct opening near the mouth.
2. Insertion of the Endoscope.
A tiny endoscope—usually 0.8 to 1.6 mm in diameter—is inserted into the salivary duct.
3. Visual Exploration.
The doctor carefully navigates the ductal system, identifying any stones, blockages, or inflammation.
4. Treatment Delivery.
Once the issue is visualised, miniature tools are inserted through the working channel of the endoscope:
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Stone retrieval baskets or forceps for stone removal.
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Irrigation to flush out debris or mucous plugs.
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Balloon dilation for strictures.
5. Post-Procedure Irrigation.
The ducts are flushed with saline or anti-inflammatory solutions to reduce inflammation and promote healing.
The entire process usually takes 30–60 minutes, and patients can often go home the same day.
Benefits of Sialendoscopy
There are several reasons why sialendoscopy is preferred over conventional surgical approaches:
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Minimally invasive: No external incisions or scars.
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Preserves the gland: Reduces the need for complete gland removal.
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Quick recovery: Most patients return to normal activities within a day or two.
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Low complication rate: Fewer risks compared to open surgery.
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Real-time diagnosis and treatment: Both achieved in a single session.
This technique has been widely adopted due to its safety, effectiveness, and patient satisfaction.
Sialendoscopy Risks & Side Effects.
Like any medical procedure, sialendoscopy is not entirely without risk. Although it is considered very safe, understanding potential sialendoscopy risks is important:
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Temporary ductal swelling: A common and usually mild reaction post-procedure.
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Mild bleeding: May occur during or after the procedure.
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Discomfort or pain: Especially when performed under local anaesthesia.
In most cases, these side effects resolve on their own with minimal intervention. However, patients are advised to monitor for prolonged swelling or pain.
Possible Complications of Sialendoscopy
Though rare, some patients may experience sialendoscopy complications, particularly if underlying conditions exist:
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Infection: if sterile precautions are compromised.
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Ductal perforation: Can occur with excessive force or anatomical difficulty.
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Salivary fistula: Extremely rare; may require surgical repair.
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Stone fragmentation: If not completely removed, remnants can cause recurrence.
To reduce the chance of complications, the procedure should always be carried out by trained specialists familiar with the salivary duct system.
Recovery & Aftercare
Post-procedure care is simple but essential for optimal recovery:
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Hydration: Encourages salivary flow to prevent further blockages.
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Sialogogues: Sour candies or lemon juice can stimulate saliva production.
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Anti-inflammatory medications: To reduce discomfort and swelling.
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Antibiotics: If there’s any sign of infection or pre-existing inflammation.
Patients are typically advised to follow up with their specialist within a week. Most individuals experience immediate relief and improved salivary flow.
Doctors Who Perform Sialendoscopy
Sialendoscopy is a specialised procedure usually performed by:
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ENT (Ear, Nose, Throat) surgeons: Particularly those with additional training in head and neck or salivary gland surgery.
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Maxillofacial surgeons: Especially in cases involving gland-preserving techniques.
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Interventional radiologists or salivary endoscopists: In advanced centres.
Doctors who perform sialendoscopy are often found in tertiary hospitals or salivary gland centres. At institutions like Manipal Hospitals Delhi, skilled ENT specialists with expertise in endoscopic techniques perform this advanced procedure regularly.
Choosing the right specialist ensures higher success rates and lower complication risks.
Conclusion
Sialendoscopy represents a major advancement in the diagnosis and management of salivary gland disorders. As a gland-preserving and minimally invasive option, it offers tremendous advantages over traditional surgery. By ensuring a quick recovery, fewer complications, and higher patient comfort, it is becoming the standard of care worldwide.
If you suffer from recurrent swelling, unexplained salivary gland pain, or have been diagnosed with a stone or duct blockage, speak to a specialist today about sialendoscopy. At leading centres like Manipal Hospitals Delhi, experienced doctors offer state-of-the-art salivary duct care with excellent outcomes. Book an appointment with an expert now.
FAQ's
The procedure is minimally painful and usually done under local or general anaesthesia.
Costs vary by region and hospital but generally range between ₹20,000 and ₹20,000–₹50,000 in India.
Sialography is a diagnostic imaging technique; sialendoscopy allows both diagnosis and treatment.
Stones up to 5–7 mm can usually be removed; larger ones may need fragmentation first.
Contact a salivary gland specialist or ENT surgeon at a tertiary care hospital such as Manipal Hospitals.
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