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. 2025 Jun 27;63(2):69-74.
doi: 10.4274/tao.2025.2024-8-13. Epub 2025 Jun 24.

A Comprehensive Study of Combined Approach Sialendoscopy in Managing Salivary Gland Sialolithiasis

Milind Navalakhe  1 , Monankita Sharma  1 , Anoushka Sahai  1 , Mruganayani Jadhav  1 , Pooja Shriwastav  1 , Ashwini Janerao  1
Affiliations

A Comprehensive Study of Combined Approach Sialendoscopy in Managing Salivary Gland Sialolithiasis

Milind Navalakhe et al. Turk Arch Otorhinolaryngol. .

Abstract

Objective: Obstructive salivary gland diseases were traditionally managed conservatively, with surgical treatment reserved for refractory cases only. These surgeries, ranging from papillotomy to sialadenectomy, often involved numerous complications. In the past two decades, sialendoscopy, a minimally invasive technique, has made tremendous progress due to its advantages. This study aims to describe the efficacy of combined approach sialendoscopy as a minimally invasive option for large-sized sialolithiasis that is not amenable to sialendoscopy alone.

Methods: It is an ambispective study of 12 patients over a span of 3.5 years at a tertiary care center conducted with all consenting patients who were treated with combined approach sialendoscopy. Ultrasonography and computed tomography of the patients was done. Therapeutic intervention in the form of combined approach sialendoscopy was done at the same sitting as diagnostic sialendoscopy and postoperative follow-up was conducted for a duration of six months.

Results: In this study of 12 patients undergoing sialendoscopy, glandular swelling was a universal presenting symptom, with 80% patients exhibiting meal-stimulated exacerbation and post-massage relief. Submandibular involvement predominated (83%), with parotid cases comprising the remainder. All patients had sialoliths >6 mm and underwent combined approach sialendoscopy, yielding a 100% immediate symptomatic resolution rate. Recurrence occurred in 16%, successfully managed with repeat sialendoscopy.

Conclusion: As endoscopy is integral to otorhinolaryngology, sialendoscopy represents the evolution of minimally invasive salivary gland surgery. This study highlights the different methods of combined approach sialendoscopy in managing larger as well as distally placed sialoliths, thus reinforcing its role as a superior gland-preserving modality.

Keywords: Sialolithiasis; combined modality therapy; minimally invasive surgical procedures; salivary glands; sialendoscopy.

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Conflict of interest statement

Conflict of Interest: There is no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Combined approach submandibular duct sialendoscopy A. Red arrow: sialolith shown in proximal submandibular duct B. Green arrow: duct slitting incision, Blue arrow: lingual nerve C. Stone delivered through intraoral incision D. Calculus (2.5x1.5 cm)
Figure 2
Figure 2
Duct marsupialization of submandibular duct post sialendoscopic sialolith removal with duct slitting
Figure 3
Figure 3
Combined approach parotid sialendoscopy A. Modified Blair incision with flap elevated and localization of duct (pink intravenous cannula was inserted in the parotid duct as a marker) B. Blue arrow: stone visualized through external incision C. Stenting of parotid duct D. Postoperative picture of patient with Minivac drain in-situ
Figure 4
Figure 4
A. Sialoliths seen on ultrasonography with a dilated duct B. Sialolith seen in submandibular duct on CT scan CT: Computed tomography
See this image and copyright information in PMC

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References

    1. Bachalli PS, Moorthy A. Obstructive salivary gland disease and sialendoscopy. Bonanthaya K, Panneerselvam E, Manuel S, Kumar VV, Rai A, editors. Oral and Maxillofacial Surgery for the Clinician. Singapore: Springer; 2021. p. 975-80.
    1. Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L. Modern management of obstructive salivary diseases. Acta Otorhinolaryngol Ital. 2007;27(4):161–72. - PMC - PubMed
    1. Hald J, Andreassen UK. Submandibular gland excision: short- and long-term complications. ORL J Otorhinolaryngol Relat Spec. 1994;56:87–91. - PubMed
    1. Scully C. Lumps and swellings in the salivary glands. Oral and Maxillofacial Medicine. 3rd ed. London: Churchill Livingstone; 2013.
    1. Andretta M, Tregnaghi A, Prosenikliev V, Staffieri A. Current opinions in sialolithiasis diagnosis and treatment. Acta Otorhinolaryngol Ital. 2005;25(3):145–9. - PMC - PubMed

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