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Sialendoscopy is a procedure that can be performed under local or general anesthesia. For diagnostic purposes or the treatment of minor, quickly resolvable conditions, local anesthesia may be sufficient. The duration of the procedure varies depending on the complexity of the condition. Diagnostic procedures or the removal of small stones typically take up to half an hour. However, for larger stones requiring fragmentation, the procedure may extend to several hours.
This technique involves accessing the ducts of the major salivary glands using a micro-endoscope. The endoscope allows for direct visualization of the duct lumen, enabling both diagnosis and simultaneous treatment of identified pathologies. The major salivary gland ducts vary in diameter from 0.5 mm to 3.2 mm, becoming significantly narrower at their opening into the oral cavity. Consequently, the endoscopes and instruments used are meticulously designed to be extremely fine, often millimetric in size. A typical endoscope features three lumens: one for visualization, a washing channel for irrigation, and a working channel through which various micro-instruments can be introduced. The total outer diameter of these endoscopes ranges from 1.1 mm to 1.8 mm.
The procedure begins by carefully locating and gently dilating the natural opening of the salivary gland duct to facilitate endoscope insertion. Once adequately dilated, the micro-endoscope is advanced progressively through the duct towards the salivary gland. Throughout the procedure, continuous irrigation with saline solution is maintained to ensure clear visualization and keep the duct distended. The internal structures of the duct and gland branches are visualized and examined on a monitor. The endoscope is advanced as far as the patient's anatomy allows, exploring all accessible branches within the gland. If a pathology is detected, specialized micro-instruments are passed through the working channel of the endoscope to perform the necessary therapeutic intervention. In certain instances, small intraoral incisions may be required, or a temporary stent (a small plastic tube) may be placed within the duct to maintain its patency post-procedure.
How is endoscopic salivary gland surgery (Sialendoscopy) performed?
This technique involves accessing the ducts of the major salivary glands using a micro-endoscope. The endoscope allows for direct visualization of the duct lumen, enabling both diagnosis and simultaneous treatment of identified pathologies. The major salivary gland ducts vary in diameter from 0.5 mm to 3.2 mm, becoming significantly narrower at their opening into the oral cavity. Consequently, the endoscopes and instruments used are meticulously designed to be extremely fine, often millimetric in size. A typical endoscope features three lumens: one for visualization, a washing channel for irrigation, and a working channel through which various micro-instruments can be introduced. The total outer diameter of these endoscopes ranges from 1.1 mm to 1.8 mm.
The procedure begins by carefully locating and gently dilating the natural opening of the salivary gland duct to facilitate endoscope insertion. Once adequately dilated, the micro-endoscope is advanced progressively through the duct towards the salivary gland. Throughout the procedure, continuous irrigation with saline solution is maintained to ensure clear visualization and keep the duct distended. The internal structures of the duct and gland branches are visualized and examined on a monitor. The endoscope is advanced as far as the patient's anatomy allows, exploring all accessible branches within the gland. If a pathology is detected, specialized micro-instruments are passed through the working channel of the endoscope to perform the necessary therapeutic intervention. In certain instances, small intraoral incisions may be required, or a temporary stent (a small plastic tube) may be placed within the duct to maintain its patency post-procedure.