Salivary Endoscopy: A Minimally-Invasive Option for Salivary Gland Stones and Blockage
Written by: M. Boyd Gillespie, M.D.
Published by: Chris Milam
What are salivary glands and salivary gland stones?
The major salivary glands produce up to one quart of a critical fluid called saliva each day. Saliva helps to digest certain foods, lubricates the mouth for speech and swallowing, and provides protection to the teeth against bacteria.
Obstruction or blockage of the salivary glands (chronic sialadenitis) is a relatively common disorder that affects up to 2% of the population. Salivary gland obstruction results in pain and swelling in the cheek or under the jawline while eating, and foul-tasting drainage into the mouth. Salivary obstruction can also lead to severe infection with high fevers, severe pain, and neck abscess.
What are the causes of obstruction?
Salivary gland blockage can result from multiple causes including salivary stones, scar tissue, allergic disorders, dehydration, side-effects of certain medications, auto-immune diseases, and tumors. Patients undergoing radioiodine treatment for thyroid cancer are especially prone to salivary gland obstruction due to concentration of radioiodine within the gland parenchyma.
The most common cause of salivary obstruction are salivary stones (sialoliths). Approximately 90% of stones occur in the submandibular glands, and 10% in the parotid glands. The stones are thought to form from mucous sludge which becomes mineralized with deposits of calcium hydroxylapatite. Although plain film radiography or computed tomography may be helpful, up to 60% of stones are radiolucent or too small to be seen by these radiographic modalities.
Ultrasonography is a promising office-based method that may be able identify small stones and dilated salivary ducts not observed with conventional radiography.
How is it traditionally treated?
Traditional treatment of salivary gland obstruction has focused on methods to increase the flow of saliva such as drinking more water, sucking on sour candies or lemons, applying warm compresses, and massaging the swollen gland.
If these measures fail, many patients had to decide whether or not to undergo major surgery to remove the gland in order to relieve the symptoms. Pathologic studies, however, have found that in most cases the gland is relatively normal except for the obstructive site.
UTHSC ENT’s cutting-edge treatment
The UTHSC Department of Otolaryngology-Head and Neck Surgery is currently offering the latest minimally-invasive procedure for the diagnosis and treatment of salivary gland obstruction.
The technique uses semi-rigid, ultra-thin scopes that are inserted into the gland’s natural opening in the mouth in order to visualize the cause of the obstruction. Using specially designed micro-instruments, stones and scar tissue can be removed in order to relieve the blockage. The scope can also cleanse the glands with an irrigation of saline solution and steroids.
The procedure is performed under local anesthesia or light general anesthesia thereby allowing the patient to go home immediately following the procedure.
Great! What is the next step?
M. Boyd Gillespie, M.D., brought this new procedure to Memphis, Tennessee after receiving training in Germany and Switzerland from the developers of the technology.
Dr. Gillespie has trained other American surgeons in the technique, and has personally performed over 1000 cases. Dr. Gillespie is widely published in this specialty and was author of the well-received textbook Gland-Preserving Salivary Surgery (2018).
As director of our ENT department, Dr. Gillespie leads the way as we continue to provide world class treatment in your hometown.
We’d love to hear from you! Schedule an appointment to see if you qualify for this procedure: 901-737-3021
How can UT’s “Dream Team” help?
If you have sleep or snoring issues, we’d love to hear from you! Please call for an appointment to see if you qualify for this procedure: 901-737-3021