Sialoendoscopy: Three years' experience as a diagnostic and treatment modality

Purpose, This article describes the use of endoscopy for treating sialolithiasis and compares this diagnostic method with other diagnostic methods. Patients and Methods: Forty-six major salivary glands suspected for obstructive pathology (26 males and 20 females aged 12 to 65 years) were treated using a rigid mini-endoscope. The indications for sialoendoscopy were 1) calculus removal that could not be performed by conventional methods, 2) screening the ductal system for any residual calculi after sialolith removal, and 3) determining the status of the major duct lumens. Results: Of the 46 endoscopies attempted, 5 were immediate failures as a result of technical problems. Of the remaining 41 patients, 32 had salivary stones, and nine had sialadenitis without evidence of sialolith formation, Within the former group (22 submandibular and 10 parotid), there were four patients in whom sialolithotomy was unsuccessful (three submandibular and one parotid). Of the 22 patients with submandibular sialolithiasis, seven (32%) were undetected by imaging methods (conventional radiography, sialography, and ultrasound), In the 10 parotid ducts, seven (70%) sialoliths were undetected. in the 28 patients who underwent successful calculus removal, no major post-operative complications were noted. Interesting findings noted during endoscopy were a sphincterlike mechanism in the ductal system, evidence of ductal wall changes associated with the presence of salivary stones, peculiar connection between calculi and the ductal wall, a salivary stone forming around a hair inclusion, and the presence of polyps projecting into the duct lumen. Conclusions: Endoscopy is a minimally invasive technique for-removal of calculi from the salivary glands as well as an excellent diagnostic procedure.