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Sialendoscopy is a minimally invasive outpatient procedure that has been performed by Penn ENT since 2013. Penn is one of only two institutions in the Philadelphia region offering this cutting-edge technique.

What Is Sialendoscopy?

Endoscopic procedures are common in many fields of medicine. During an endoscopic procedure, a doctor uses a slender, flexible tube with a camera and a small light on the end to look inside the body.

Sialendoscopy uses this technique to examine and treat problems in the salivary glands and ducts, including:

Because it doesn’t require large incisions, sialendoscopy avoids the side effects of traditional surgery, which can include nerve damage, scarring, and facial nerve paralysis.

What Happens During Sialendoscopy?

Sialendoscopy takes up to an hour. During the procedure, a doctor inserts a 1.3 millimeter micro-endoscope into the mouth and through the natural opening of the salivary gland that is being treated.

The micro-endoscope is made up of three different channels, and each one has a specific purpose:

  1. The working channel contains the tools needed to perform the procedure, such as wire baskets used to remove a salivary gland stone or balloons used to inflate a narrowed duct.
  2. The irrigation channel pushes fluids or medication into the duct to flush out stone fragments, protein buildup, and other debris.
  3. The camera and light help the doctor and their team see throughout the procedure.

How Should I Prepare for Sialendoscopy?

Usually, sialendoscopy is performed under general anesthesia. If you are having general anesthesia, your doctor will advise you about what you can eat and drink before your procedure.

For simple procedures, sialendoscopy can be done with a topical anesthesia.

What Happens After Sialendoscopy?

When the procedure is over, you will be transferred to a recovery area and monitored for a short time. Most patients return home the same day and return to normal routines the day after.

You may have some swelling and pain, which can be managed with medication. You should not experience the side effects associated with traditional surgery, including bleeding, scarring or infections.

A Combined Approach

Doctor performing TORS procedure

Some salivary gland conditions are more complex than others, such as large salivary gland stones. In a combined procedure, your doctor may combine sialendoscopy with a traditional surgical procedure or another minimally invasive surgical procedure. Combined approaches are typically used to address salivary gland conditions of the submandibular or parotid glands.

Robotically-assisted sialendoscopy procedures were invented at Penn and can be used to treat some complex salivary gland conditions:

  • TORS-sialo: A robotically assisted procedure that removes large salivary gland stones from the submandibular gland
  • Sialo-TORS-sialo: A robotically assisted procedure that removes multiple or deeply-lodged salivary gland stones

Patients treated with a combined approach may have soreness where an incision was made. You should eat soft foods for up to two weeks and take pain medication as prescribed.

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