Abstract
Sialendoscopy is gaining in popularity in treating calculus disease. The delicacy of the instrument and the diameter of the salivary ducts are factors that limit the ability to achieve complete success. There is also continued speculation regarding the utility of the procedure, especially among clinicians who are masters of conventional methods like sialadenectomy and sialodochotomy. To assess the efficacy of sialendoscopy over conventional methods in treating sialolithiasis. A prospective case control study was conducted in a tertiary care centre; this study involved 50 patients of sialolithiasis, and it extended over a 36-month period. All had undergone treatment, either by conventional methods or interventional sialendoscopy. All patients with nonpalpable calculi smaller than 6 mm underwent interventional sialendoscopy. Failed sialendoscopies and larger nonpalpable calculi were removed through sialadenectomy. The outcome variables studied included calculus removal, postoperative symptoms, and gland preservation. The success rate in terms of calculus removal by sialendoscopy was 88%, versus 100% by sialadenectomy. The salivary gland was preserved in 88% of the cases in the sialendoscopy group. Only 12% of patients were symptomatic. Sialendoscopy was effective in removing calculi of various sizes; it was definitely superior to conventional methods. Sialadenectomy should be reserved for cases either not suitable for sialendoscopy or in which there was an intervention failure.
Highlights
Sialolithiasis tops the list of causes for obstructive sialadenitis (50%)
Sialendoscopy was effective in removing calculi of various sizes; it was definitely superior to conventional methods
Sialadenectomy should be reserved for cases either not suitable for sialendoscopy or in which there was an intervention failure
Summary
Sialolithiasis tops the list of causes for obstructive sialadenitis (50%). It occurs in 1.2% of the total population, and usually in the 30–60 years age group [1]. Normal histopathology of the excised glands would compel surgeons to strive for salivary gland preservation. These conditions explain the rising trend of minimally invasive procedures like extracorporeal and intracorporeal shock wave lithotripsy, interventional radiology, and sialendoscopy. There is continued speculation regarding the utility of the procedure, especially among clinicians who are masters of conventional methods like sialadenectomy and sialodochotomy
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