Sialendoscopy

Sialendoscopy is a minimally invasive outpatient procedure used to diagnose and treat salivary gland disorders. Your doctor uses a very thin, flexible tube with a camera and light on the end (micro-endoscope) to examine your salivary glands and ducts. The micro-endoscope is also equipped with tools to perform any necessary procedures. Because it doesn’t require large incisions, sialendoscopy has few side effects and a faster recovery time than traditional surgery.

What are salivary glands?

Salivary glands inside and near your mouth produce saliva to aid in chewing, swallowing, and digesting food. Saliva also protects your teeth from bacteria and decay.

You have three pairs of major salivary glands and hundreds of minor salivary glands in the lining of your cheeks, mouth, tongue, lips, nose, sinuses, and voice box. Problems can affect any of the salivary glands.

The major salivary glands include:

• Parotid glands: The largest of the salivary glands are located in front of your ears. They secrete saliva into the inside lining of your cheek.
• Submandibular glands: Located below the jaw, these glands secrete saliva into the floor of your mouth.
• Sublingual glands: These glands sit right under your tongue and are the smallest of the major salivary glands.

The specialists at Penn Medicine’s Salivary Gland Center are nationally recognized experts in diagnosing and treating salivary gland disorders. As leaders in sialendoscopy, we’ve been performing the procedure since 2013. We’re one of a few institutions in the southeastern Pennsylvania and New Jersey area offering this leading-edge technique.

You may need sialendoscopy if you have a salivary gland problem, such as:

• Chronic inflammation
• Infections of the salivary gland
• Sialadenitis (swelling due to cancer treatment)
• Salivary gland stones (clumps of mineral deposits that may cause swelling, pain, and infection)
• Salivary gland strictures (narrowing of the salivary duct that may cause inflammatory salivary gland disease)
• Salivary gland tumors

If you have a cancerous salivary gland tumor, you also have access to specialists from other Penn Medicine programs, such as head and neck cancer care. Our head and neck surgery experts work with oncologists to create a comprehensive treatment plan for you.

Before a sialendoscopy, your doctor may order imaging tests to get a better look at the salivary gland that’s causing issues. Tests may include ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI).

Sialendoscopy is an outpatient procedure, so you can go home the same day. It’s usually performed under general anesthesia and takes up to an hour. Your doctor will let you know what you can eat and drink before the procedure.

Here’s what to expect during the procedure:

1. You receive general anesthesia, so you’re asleep for the procedure and don’t feel any pain.
2. Your doctor inserts a micro-endoscope with tiny tools into your mouth and through the opening (duct) of the affected salivary gland.
3. They inspect the gland and address the problem (for example, removing salivary stones).
4. Your doctor removes the endoscope.

After the procedure, you’re transferred to a recovery area and monitored for a short period of time. You can go home the same day and return to your normal activities the next day.

Your doctor might recommend a combined approach if you have a complex salivary gland condition, such as large salivary gland stones. This approach uses sialendoscopy and traditional open surgery or another minimally invasive technique, such as transoral robotic surgery (TORS). Penn Medicine surgeons pioneered TORS as a minimally invasive procedure to address various problems in the mouth and throat.

After your sialendoscopy, you may have some swelling and pain. Your doctor may prescribe medication to manage your symptoms, or they may suggest over-the-counter medication.

On the day of your procedure, we recommend resting afterward. Your doctor may instruct you to avoid heavy lifting or straining for a few days. The recovery time for a sialendoscopy is about a week.

It may be difficult to eat for a few days after your procedure. Depending on the extent of your surgery, you may opt for soft foods for up to two weeks. It’s also a good idea to rinse your mouth with water after eating to get rid of any food particles in the treatment area.

Sialendoscopy is a minimally invasive procedure, which means it has fewer complication risks than traditional, open surgery. Complications are rare but may include:

• Bleeding
• Perforation (rupture) of the salivary gland duct
• Ranulas (benign, saliva-filled cysts)
• Strictures

When you come to Penn Medicine, you’ll find otorhinolaryngologists specializing in salivary gland disorders. We are experts at performing sialendoscopy and treat hundreds of patients each year.

Our team is highly skilled in treating even the most complex cases. We invented robotic-assisted sialendoscopy to treat difficult problems like large salivary gland stones. As renowned researchers in this field, we’ve trained other surgeons across the globe.