Saving Face with Sialendoscopy

If you suffer from salivary gland stones, you know how irritating or painful they can be. Statistics show that nearly one out of every 100 people will develop one of these stones at some point in life. The standard treatment is surgery, which can be risky, and leave a big scar.

In Thursday's Medical Moment how new, super tiny technology allows surgeons to remove those stones, without using the scalpel.

13-year-old Seara Schoenbeck has enjoyed a healthy childhood until about two years ago, when she started having pain in her mouth.

"You know, I thought it was a cold sore, but then it kept on getting bigger and then it burst, and it kept on doing that over and over," explains Seara Schoenbeck who suffered with salivary gland stones.

A stone was stuck in one of her submandibular glands. Traditionally, surgeons would remove the entire gland.

"I was so scared about them going inside my neck," says Seara.

Possible nerve damage and a big scar were tough for Seara to swallow.

"To see her scared and worried hurt me," says Seara’s father Richard.

Dad discovered a minimally-invasive alternative called a sialendoscopy.

"We can leave the glands alone," explains Gary Josephson, MD, the Chairman of the Department of Surgery at Nemours/ Wolfson Children's Hospital.

Doctor Gary Josephson enters the salivary duct and gland through the floor of the mouth using a diagnostic scope with a camera the size of a toothpick.

"While you're doing this you're watching the monitor,” says Dr. Josephson. “So it looks to me like it is giant!"

Once the camera is in, saline is run through the duct to keep it open while the surgeon sends in this tiny drill to break up the stone. If the pieces don't flush out with the saline, this tiny wire basket is used to catch and pull out the remains.

"When we're done with this there's minimal pain, and they're good to go," says Dr. Josephson.

"I am grateful that I live in a technology world," says Seara.

Seara was put under anesthesia for the procedure, but left the hospital that same day. She was back to normal in less than 48-hours.

Compare that to the standard procedure that would require at least a one to two-day hospital stay, and a longer recovery due to the incision and removal of the gland.

Insurance companies typically cover the new procedure.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Saving Face with Sialendoscopy
REPORT: MB# 3664

BACKGROUND: A salivary gland stone, also called salivary duct stone, is a calcified structure that may form inside a salivary gland or duct. It can block the flow of saliva into the mouth. The majority of stones affect the submandibular glands located at the floor of the mouth. Less commonly, the stones affect the parotid glands, located on the inside of the cheeks, or the sublingual glands, which are under the tongue. Many people with the condition have multiple stones. (SOURCE: www.mayoclinic.com/health/kidney-stones)

CAUSES: The cause for salivary gland stones is unknown, but factors contributing to less saliva production and/or thickened saliva may be risk factors for salivary stones. These factors include: dehydration, poor eating, and use of certain medications, such as antihistamines. Trauma to the salivary glands may also raise the risk for salivary stones. (SOURCE: www.mayoclinic.com/health/kidney-stones)

SYMPTOMS: The stones cause no symptoms as they form, but if they reach a size that blocks the duct, saliva backs up into the gland, causing pain and swelling. Inflammation and infection within the affected gland may follow. (SOURCE: www.mayoclinic.com/health/kidney-stones)

TREATMENT: More and more, doctors are using a newer and less invasive technique called sialendoscopy to remove salivary gland stones. Developed and used successfully in Europe for a decade, sialendoscopy uses tiny lighted scopes, inserted into the gland's opening in the mouth, to visualize the salivary duct system and locate the stone. Then, using micro instruments, the surgeon can remove the stone to relieve the blockage. The procedure is performed under local or light general anesthesia, which allows the patient to go home right after the procedure. (SOURCE: www.mayoclinic.com/health/kidney-stones)

FOR MORE INFORMATION, PLEASE CONTACT:

Erin Wallner
Nemours Children Hospital
Erin.Wallner@nemours.org

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Céline McArthur at cmcarthur@ivanhoe.com.


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