What Is Salivary Gland Stone (Sialendoscopy) Endoscopy? What Are the Symptoms? How Is It Treated?

A salivary gland stone is a condition that presents with various symptoms in the mouth. Sialendoscopy is the name of the surgery that enables these stones to be removed.

What Are the Salivary Glands?

The salivary glands produce saliva and release it into the mouth through small ducts. This keeps the mouth and throat moist. Moisture helps with swallowing and digestion. Another function of saliva is to help protect the inside of the mouth from bacteria. There are three major pairs of salivary glands.

Sublingual glands: They are located on both sides of the tongue and on the floor of the mouth.

Submandibular glands: They are located beneath the jawbone.Parotid gland: They are located just in front of the ears. The submandibular glands consist of two parts, superficial and deep. The saliva produced by these glands reaches the mouth through the ducts beside the upper molars.

The parotid gland, also known as the parotid duct gland, is a large duct gland located in front of the ear that releases saliva into the mouth. It is the largest of the salivary glands and produces saliva actively, especially during meals. The function of the parotid gland is to produce and secrete saliva, which aids digestion.

What Are Salivary Gland Diseases and Their Symptoms?

Salivary gland diseases occur when a condition prevents one or more glands from producing secretions. Diseases include cancer, Sjögren's syndrome, infection and salivary gland stones. Each disease has its own symptoms. Symptoms of salivary gland cancer include the following:

Numbness and weakness of the face, neck, jaw or mouth,

Persistent pain in the face, neck, jaw and mouth,

Difficulty opening the mouth fully,

Difficulty swallowing,

Bleeding from the mouth.

A salivary gland tumor may not show any symptoms at first. This cancer accounts for only 1% of cancers affecting the head and neck region. Sjögren's syndrome is a disorder related to body fluids such as tears or saliva. Its symptoms include:

Dry mouth,

Dry eyes,

Dry skin,

Muscle and joint pain,

Swelling of the salivary glands

These are the symptoms observed. Salivary gland inflammation, also known as sialadenitis, may cause symptoms such as fever, decreased saliva production, swelling of the glands and dry mouth.

What Are the Symptoms of a Salivary Gland Stone?

Symptoms of a salivary gland stone generally increase after eating and decrease again after a few hours. The reason symptoms increase after eating is that chewing stimulates the glands to produce saliva. Possible symptoms include:

Swelling of the salivary glands,

Difficulty swallowing,

Painful swelling under the tongue,

Pain in the areas where the salivary glands are located,

A strange taste in the mouth.

How Is a Salivary Gland Stone Diagnosed?

When a patient consults a healthcare professional with complaints, imaging tests may be performed to determine whether stones are present. These tests include X-ray, computed tomography (CT) and magnetic resonance imaging (MRI). In addition, gland scanning tests may be performed. The scanning test is carried out by injecting a radioactive tracer into a vein. Forty-five minutes after the injection of the radioactive substance, a sour substance that stimulates saliva production is given. In this way, the salivary glands are monitored.

What Is Endoscopic Treatment of the Salivary Glands (Sialendoscopy)?

Sialendoscopy is known as salivary gland surgery. This surgery is used as a treatment method for stones, strictures, inflammation and other conditions affecting the salivary glands. An endoscope is used to visualize the inside of the major salivary glands. These are called micro-endoscopes. They measure approximately 0,8-1,6 millimeters. At the tip of the micro-endoscope there is a light, a camera and a grasping instrument. In this way, small stones can be removed. It is also used to widen strictures.

How Is Endoscopic Treatment of the Salivary Glands Performed?

Endoscopic treatment of the salivary glands is often performed under general anesthesia. For surgeries performed under general anesthesia, there are preoperative restrictions. The physician informs the patient about these restrictions. In some cases, topical anesthesia (anesthesia applied by spraying or applying a cream or gel, without injection) may also be used. This varies according to the individual's condition. During surgery, the micro-endoscope is inserted into the gland duct. The procedure is completed using the three different sections of the micro-endoscope. The working section contains wire baskets to remove the stone. The irrigation section contains fluid to clean out residue. The camera and light section helps to see the inside.

In Which Conditions Is Endoscopic Treatment of the Salivary Glands Used?

Endoscopic treatment can be used for salivary stones and for salivary gland damage caused by radiation. A stone can block the duct and cause pain and infection. Removing the stone from there prevents both the blockage and the infection. Radiation-related gland damage may occur due to radioactive material administered in conditions such as thyroid gland disease treatment. Endoscopic treatment helps prevent this condition.

What Are the Advantages and Disadvantages of Endoscopic Salivary Gland Treatment?

Standard surgeries of the submandibular and preauricular salivary glands carry risks such as facial nerve palsy, loss of sensation in the mouth, a surgical scar on the face, or recurrence. These are the risks of non-endoscopic surgery. Endoscopic surgery, on the other hand, has many advantages compared to the standard approach:

Faster recovery,

No long hospital stay,

Very low complication rate,

No permanent nerve damage,

No surgical scar,

Preservation of the individual's functions,

Because endoscopic treatment of the gland is performed through minimal incisions, the risk of complications is lower but not zero. Although rare, the following complications may occur:

Bleeding,

Benign cysts filled with saliva,

Opening of the duct.

What Is the Process Like After Endoscopic Treatment of the Salivary Glands?

After salivary gland surgery, the individual should rest as much as possible and wait for healing. After surgery, swelling and pain may occur in the glands. When you consult your doctor, they may prescribe medication accordingly. Only one week is needed for full recovery after the procedure. During this period, you may consult your healthcare team about which foods can be consumed. After meals, it may be necessary to rinse the mouth with water so that no food particles remain in the treatment area.

Frequently Asked Questions About Salivary Gland (Sialendoscopy) Surgery

The largest salivary glands are located beside the tongue, under the chin and in front of the ears. The surgery usually lasts about 1 hour, but this duration may vary depending on the individual's condition. Inflammation may result from bacterial or viral infections, dehydration, poor oral hygiene, the use of medications that increase fluid excretion, or Sjögren's syndrome. It is not accurate to give definitive information about the healing time of inflammation. It will go away in the shortest possible time with proper treatment. If inflammation does not resolve despite treatment, it is recommended to consult a healthcare professional again. Swelling of the gland may arise for various reasons. These causes may include infection, obstruction, insufficient water intake, tumors and injuries. For problems with the salivary glands, an appointment should be made with the Ear, Nose and Throat (ENT) department. There are points to observe and precautions to take after surgery. After surgery, numbness is generally felt rather than pain. Individuals who feel pain may receive painkillers intravenously at first and orally when they start eating. If there is no reduction in pain despite painkillers, you may consult your doctor again. Generally, most people can start eating again right away. Some people may have to follow diets consisting of soft foods.

After endoscopic surgery, moving and walking help prevent blood clots from forming. Walking also helps return bowel movements to normal. In addition to walking, breathing exercises help expand the lungs. It is generally recommended to do lung exercises twice a day. The length of hospital stay after surgery varies depending on the individual's condition, but in most cases patients can be discharged within 1-4 days. Although rare, stones may recur. Symptoms may vary depending on the gland in which the stone has formed. Stones that develop in the glands beneath the jawbone and in front of the ears may cause swelling during meals. In addition to swelling, pain may also occur. Stones in the gland beneath the jawbone may sometimes cause no symptoms at all. The presence of a stone in the salivary gland can cause many problems. Some of these problems are:

Infection in the mouth,

Infection of the gland,

Recurrent gland infection,

Bad breath.

To treat this problem in the mouth without it leading to more serious conditions, it is recommended that you consult a healthcare facility. Some individuals may be more prone to forming salivary gland stones, due to having risk factors. Risk factors for stone formation are listed as follows:

Age: Frequently seen in individuals between 30 and 60 years old.

Oral hygiene: Poor oral hygiene can lead to bacteria and stone formation.

Water consumption: Individuals who consume insufficient water may have concentrated saliva.

The formation of a stone in the salivary gland is not something that can be fully prevented. The risk can be reduced to some extent by eliminating risk factors as much as possible. Risk can be reduced by drinking enough fluids and maintaining oral hygiene. If you think you are at risk of stone formation or have had a stone before, you may consult a healthcare professional to take the best possible precautions.