S131: Endoscopic Surgery of the Salivary Glands: A Versatile, Multi-Disciplinary Surgical Technique

Abstract

During the last decade, there has been growing demand for minimally invasive techniques. Since 1990, when salivary gland endoscopy was first introduced, there has been a major step forward in providing an accurate means for diagnosis as well as minimally invasive surgical treatment for salivary gland diseases.This course will review the relevant literature and the history of sialoendoscopy. The author will present his treatment and experience including instruments and current techniques.During the past 13 years, sialoendoscopy including endoscopic assisted procedures were performed on 1,078 glands with symptoms of obstructive disease, 545 males and 533 females, with age ranging from 2 to 96 years. There were 722 submandibular, 347 parotid, and 9 sublingual glands. All patients underwent preoperative and postoperative screening including routine radiography, sialography, and ultrasound. Postoperative examination was routinely performed 1 month following the procedure. Some patients were followed-up as much as 40 months post endoscopy. The majority of procedures were performed under local anesthesia on an outpatient basis. The time for the procedure ranged from 30 to 90 minutes. Our success rate for parotid endoscopic and endoscopic assisted technique sialolithotomy was 86% and the success rate for submandibular endoscopic and endoscopic assistance technique sialolithotomy was 89%. With the addition of ESWL (Extracorporeal Schock Wave Lithotripsy) technique we reach 90% success rate for parotid sialolithiasis and 95% success rate for submandibular sialolithiasis.The endoscopic technique opens new horizons in the field of salivary gland diseases. Salivary gland stones and sialadenitis no longer are absolute indications for sialadenectomy with its all known complications. Owing to growing experience and surgical skills, new endoscopic techniques are in clinical use, and there is a constant improvement of the endoscopic treatment success rates.In the course, we will demonstrate the efficiency and safety of sialoendoscopy and endoscopic assisted procedures as promising methods for use in the diagnosing, removal, and postoperative management of sialadenitis, sialolithiasis and other obstructive salivary gland diseases. Combination of the endoscopic technique with Er-Yag Laser technology, external lithotripsy shock wave and minimal invasive technology, will be discussed in details during the course.Another application of the course will be new endoscopic techniques for parotid trauma surgery and the use of endoscopy for parotid and submandibular oncological surgery. During the last decade, there has been growing demand for minimally invasive techniques. Since 1990, when salivary gland endoscopy was first introduced, there has been a major step forward in providing an accurate means for diagnosis as well as minimally invasive surgical treatment for salivary gland diseases. This course will review the relevant literature and the history of sialoendoscopy. The author will present his treatment and experience including instruments and current techniques. During the past 13 years, sialoendoscopy including endoscopic assisted procedures were performed on 1,078 glands with symptoms of obstructive disease, 545 males and 533 females, with age ranging from 2 to 96 years. There were 722 submandibular, 347 parotid, and 9 sublingual glands. All patients underwent preoperative and postoperative screening including routine radiography, sialography, and ultrasound. Postoperative examination was routinely performed 1 month following the procedure. Some patients were followed-up as much as 40 months post endoscopy. The majority of procedures were performed under local anesthesia on an outpatient basis. The time for the procedure ranged from 30 to 90 minutes. Our success rate for parotid endoscopic and endoscopic assisted technique sialolithotomy was 86% and the success rate for submandibular endoscopic and endoscopic assistance technique sialolithotomy was 89%. With the addition of ESWL (Extracorporeal Schock Wave Lithotripsy) technique we reach 90% success rate for parotid sialolithiasis and 95% success rate for submandibular sialolithiasis. The endoscopic technique opens new horizons in the field of salivary gland diseases. Salivary gland stones and sialadenitis no longer are absolute indications for sialadenectomy with its all known complications. Owing to growing experience and surgical skills, new endoscopic techniques are in clinical use, and there is a constant improvement of the endoscopic treatment success rates. In the course, we will demonstrate the efficiency and safety of sialoendoscopy and endoscopic assisted procedures as promising methods for use in the diagnosing, removal, and postoperative management of sialadenitis, sialolithiasis and other obstructive salivary gland diseases. Combination of the endoscopic technique with Er-Yag Laser technology, external lithotripsy shock wave and minimal invasive technology, will be discussed in details during the course. Another application of the course will be new endoscopic techniques for parotid trauma surgery and the use of endoscopy for parotid and submandibular oncological surgery.