Pearls, Perils, and Learning Curve of Salivary Endoscopy
The use of sialendoscopy for non-neoplastic disorders of the salivary glands is increasing. This relatively new option for the treatment of obstructive and inflammatory salivary conditions, such as sialolithiasis and chronic sialadenitis, has allowed an increasing number of patients to enjoy symptom resolution without gland excision. The adoption of any technological advance, however, carries with it a learning curve. This chapter highlights strategies for both novice and experienced salivary endoscopists to maximize success. Tips for surgeon training, patient selection, and equipment management are included in addition to intraoperative steps and techniques. Common pitfalls are discussed with advice on how to avoid them. With attention to these strategies, sialendoscopy can be successfully incorporated into the treatment algorithm of salivary disorders with minimal risks and limitations.
KeywordsSialendoscopy Sialadenitis Sialolithiasis Parotid Submandibular Salivary Stone Stricture Endoscopy
Expression of saliva from the Wharton’s duct. This can be accomplished by massaging the gland or by running a finger along the course of the duct (MOV 25507 kb)
Dilation of Wharton’s papilla . The dilators are passed sequentially until the conical dilator can be used (MP4 68,057 kb)
Papillotomy to remove a stone in basket. The incision must be made between the fibers of the basket to avoid cutting the basket (MOV 20721 kb)
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