Sialendoscopy

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The sialendoscopy (or salivary duct endoscopy) refers to the reflection of the salivary glands or the passage system within a salivary gland .

Swelling of the salivary glands is a well-known ENT medical condition and requires clarification. In addition to anamnesis and clinical examination, imaging methods are particularly helpful. Here are v. a. the ultrasound , magnetic resonance imaging and computed tomography . If a salivary gland swells repeatedly shortly before, during or after eating, an obstructive (constipating) cause must be suspected. In about 60% of cases, a salivary stone ( sialolithiasis ) is the cause. The suspected diagnosis of a salivary stone is primarily clinical, i.e. H. solely through the medical history or the clinical examination. An ultrasound examination of the salivary gland should be part of the standard diagnosis. Further imaging (MRI, CT) or, in exceptional cases, a sialography or salivary gland scintigraphy will only help if you have special questions .

Up until a few years ago, the only causal therapy option for small stones, provided they were not directly in front of the ostium, i.e. the duct opening into the oral cavity, was to remove the respective salivary gland. In the meantime, there is a method in which the duct system of a salivary gland can be visualized - made visible - with a tiny endoscopic camera. This procedure, known as sialendoscopy, is primarily a diagnostic intervention. If necessary, however, sialendoscopy can be converted into a therapeutic intervention and, for example, a stone in the passage can be removed with a collecting basket and a pincer (interventional sialendoscopy). If a gait pathology is suspected, sialendoscopy now appears to be superior to sialography as a diagnostic tool.

If no stone can be found in the sialendoscopy, the cause may be a drainage disorder of the saliva, such as a scarred stenosis (narrowing) of the duct system or the ostium. This stenosis can be corrected with the help of sialendoscopy, since the diagnostic sialendoscopy already expands the ostium to up to 10 times its original size. A balloon catheter can be used for stenoses in the further course of the duct. Inflammation of the duct system ( sialodochitis ) can also be the cause of recurring swellings or inflammation of the entire gland. This can be diagnosed through sialendoscopy. In addition, sialendoscopy has a therapeutic effect here, as irrigation fluid continuously flows through the gland during the procedure. Medicines can also be applied directly into the duct system in this way.

Overall, the procedure involves few risks; it can be performed on an outpatient basis in most cases and under local anesthesia in many cases. The procedure is covered by the health insurance.

The procedure has been known in Germany for a number of years and is now offered by a few ENT university clinics that specialize in salivary gland diseases.

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