Treatment of salivary gland stones
Sometimes an infection can lead to swelling that pushes a small stone out on its own. Stones can also break into multiple smaller stones that may come out on their own.
However, treatment is usually needed to remove stones or fragments. People with salivary gland stones should never attempt to break or remove stones on their own as it may cause damage or scarring.
At Penn Medicine, minimally-invasive procedures are the most common treatment used to address salivary gland stones. Unlike traditional salivary gland surgery, these procedures treat glands instead of removing them entirely, allowing patients to avoid the side effects of removal. Surgical gland removal is only performed in rare cases where minimally-invasive procedures aren’t able to remove the stone.
Small and some medium salivary gland stones are primarily treated with sialendoscopy, a minimally-invasive outpatient procedure that extracts the stones. Penn Medicine ENT is a national leader in this cutting-edge treatment and one of only two institutions in the Philadelphia region offering it.
General anesthesia is typically used for sialendoscopy; however, topical anesthesia may be used for simple procedures. Recovery is almost instantaneous, and there are no stitches, scars, or lasting pain.
Medium or large stones, commonly in the parotid gland, can be broken up using a laser (lithotripsy), but this procedure is also rarely needed.
Because of their location, larger salivary gland stones usually require a surgical procedure combined with sialendoscopy to remove them. The surgeon will make an incision either in the back of the mouth or near the ear. If the salivary duct is narrow, the surgeon may place a stent in the duct to hold it open. Stents can be removed two to four weeks after the procedure.
After a surgical procedure, you may be sore at the incision site. Recovery can take up to two weeks. It’s important to eat soft foods and take pain medication as required during recovery.
If it’s difficult to reach a salivary stone because of its size, location or quantity, your surgeon may use TORS-sialo or sialo-TORS-sialo. TORS is a revolutionary minimally invasive procedure invented at Penn Medicine to provide access to areas of the mouth and throat that are difficult to reach with traditional surgery.
Robotic technology can help your surgical team get a clearer picture of the area and move around better in tight spaces. In addition, it allows the surgeon to use a much smaller incision, which helps to protect the nerves in the mouth and prevent scarring.