Potentials and limitations of diagnostic and therapeutic sialendoscopy

Overview:

Since the introduction of sialendoscopy by Königsberger in 1990 and Katz in 1991, the further development of instruments allowed a therapeutic application by retrieving sialoliths or dilating stenosis. This increased gland preservation. After endoscopic diagnosis of sialolithiasis or narrowing, using a shaft with working channel allowed to treat the disorder by removing stones with grasping forceps and retrieving basket or dilating stenosis with a driller. For chronic sialadenitis the intraductal application of steroids could improve symptoms.

Methods:

Retrospective analysis of sialendoscopies performed since 2012 in the department of ORL in the University Hospital Ulm was done with the data of electronic patient record (ePA).

Results:

In more than 70% of cases, sialendoscopy was performed for submandibular glands, finding sialoliths to be the most frequent cause of obstruction. These could be removed in the same operative session in more than 90% of cases. For concrements up to about 5 mm grasping forceps and retrieving basket were effective. Otherwise, for larger stones in the duct there was the need of marsupialization, for those located in the gland, a mucosa incision in the floor of mouth and blunt preparation into the parenchyma was necessary. The parotideal gland mostly presented stenosis and chronical endothelial inflammation which could be treated with dilation and instillation of corticosteroids, respectively.

Conclusions:

The minimally invasive sialendoscopy with a high rate of successful obstruction removal represents a valid alternative to gland extirpation for non-tumorous sialadenopathies.

Publication History

Publication Date:
18 April 2018 (online)