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Sialendoscopy for Salivary Gland Disorders

​UC San Diego Health is the only hospital in San Diego County offering minimally invasive removal of salivary stones that can cause swelling, pain and chronic infection.

The benefits of the innovative endoscopic procedure, known as sialendoscopy, over traditional surgical approaches include:

Incision-Less Procedure for Salivary Gland Disorders

Eating is one of life's simple pleasures but, if you have a salivary stone in your mouth, mealtime may become a source of anxiety. Read how UC San Diego Health can help.

  • Preservation of the patient's salivary gland. Traditional surgery removes the affected gland.
  • Very low risk of damage to adjacent nerves
  • No hospitalization, as the procedure is done on an outpatient basis
  • No wound care
  • No incision, thus no scar

In addition, sialendoscopy allows the physician to directly visualize the stone (or other cause of inflammation) prior to therapeutic intervention, modifying as needed. It also enables the delivery of medication directly to the affected area.

Charles Coffey, MD, a head and neck surgeon at UC San Diego Health, specializes in the procedure and was trained by one of the nation's early champions of the minimally invasive approach. He currently performs 24 to 36 sialendoscopies per year and has a greater than 80 percent success rate in restoring quality of life to patients with salivary stones. Most of his patients return to normal daily life within two days and will not need a second intervention.

What Is a Salivary Stone?

Salivary stones are crystals made of calcium and other constituents of saliva.

Why Are Salivary Stones a Problem?

Microscopic salivary stones are common and harmless, passing without notice through the salivary gland ducts into the mouth. For reasons that are not well understood, these tiny stones sometimes continue to accrete material, growing to a size that can block the duct. When saliva cannot exit the duct, the gland swells, causing inflammation and often pain and infection. Anything that triggers salivary production, such as chewing and even the aroma of a favorite dish, can exacerbate the condition. Flare-ups can also occur unexpectedly and may be disfiguring. Living with a salivary stone is largely a quality of life issue as eating becomes a source of pain and disfiguring swelling. Many individuals will receive multiple courses of antibiotics before seeking specialized medical expertise.

What Is Sialendoscopy?

Sialendoscopy makes use of advances in miniaturization that enable cameras as small as 0.8 millimeters in diameter (approximately the thickness of a pencil lead) to be housed within long, thin endoscopes. During sialendoscopy, an endoscope is inserted into the affected duct in the mouth. Once the stone is located, the necessary removal equipment is threaded through a port in the scope to access the stone. The stone is then grasped and extracted or mechanically broken into smaller pieces, which are subsequently removed. In some cases, a stent may be used to widen a narrow duct. There is no incision because the stone is accessed through a natural opening in the mouth. This is important because surgery can injure nerves in the area, potentially causing weakness in movement of the face or tongue, numbness or alteration of taste sensation.

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