Sialendoscopy & Salivary Gland Stone Treatment in Chennai

Sialendoscopy is a minimally invasive procedure where a tiny endoscope (1.1-1.6mm diameter) is inserted through the natural opening of the salivary duct in the mouth. This allows direct visualization of the duct interior, identification of stones or strictures, and treatment using specialized instruments—all without any external incisions. The procedure is performed under local or general anesthesia and most patients go home the same day.

Salivary stones (sialoliths) form when calcium and other minerals in saliva crystallize, often due to dehydration, reduced saliva flow, or duct abnormalities. The submandibular gland is most commonly affected (80-90% of cases) because its saliva is thicker and the duct travels upward against gravity. Risk factors include dehydration, certain medications that reduce saliva, and chronic gland infections.

With sialendoscopy, most patients can keep their salivary glands. Gland removal (sialadenectomy) is now reserved for cases with very large stones not amenable to endoscopic removal, severe chronic infection with gland destruction, or suspected tumors. Dr. Vidhyadharan's gland-preserving approach means you maintain natural saliva production and avoid risks of gland removal surgery.

Sialendoscopy has 85-95% success rates for stone removal when performed by experienced surgeons. Success depends on stone size, location, and duct anatomy. Stones under 5mm are usually removed endoscopically. Stones 5-8mm may require laser fragmentation. Larger stones may need combined approach. Even when complete stone removal isn't possible, sialendoscopy often relieves symptoms by improving saliva flow.

Sialendoscopy is well-tolerated with minimal pain. The procedure is performed under local anesthesia (numbing the duct opening) or general anesthesia depending on case complexity. Most patients experience only mild discomfort and swelling for 2-3 days afterward, managed with simple pain medications. There are no external incisions to heal.

Recovery is quick—most patients go home the same day and return to work within 1-2 days. Mild swelling and discomfort are common for 48-72 hours. Normal eating can resume within a day. Complete healing of the duct occurs within 1-2 weeks. This is much faster than traditional gland removal surgery which requires 1-2 weeks recovery.

Recurrence is possible in about 10-20% of patients, especially those with predisposing factors like chronic dehydration, abnormal duct anatomy, or autoimmune conditions. Prevention strategies include staying well-hydrated, using sour candies or lemon to stimulate saliva flow (sialagogues), and managing underlying conditions. Even if stones recur, sialendoscopy can be repeated.

Traditional surgery removes the entire salivary gland through an external incision, with risks of facial nerve injury (for parotid), visible scar, and permanent loss of saliva production. Sialendoscopy uses the natural duct opening—no external incision, no scar, preserved gland function, same-day discharge, and faster recovery. It has revolutionized salivary gland stone treatment.

Yes, sialendoscopy is effective for recurrent sialadenitis (gland infections). By removing stones, dilating strictures, and washing out the duct system, sialendoscopy eliminates the underlying cause of recurrent infections. It is also used for juvenile recurrent parotitis in children and radioiodine-induced sialadenitis after thyroid cancer treatment.

Strictures are narrowings of the salivary duct that block saliva flow, causing recurrent swelling and infections. They can result from previous stones, infections, radiation, or autoimmune conditions. Treatment involves sialendoscopic balloon dilation to widen the narrowed segment, sometimes with temporary stent placement. Multiple dilations may be needed for severe strictures.

Sialendoscopy costs depend on the complexity of the case, whether stone removal or just diagnostic evaluation is needed, use of laser for fragmentation, and anesthesia requirements. The procedure is cost-effective compared to traditional gland removal surgery due to shorter hospital stay and faster recovery. THANC Hospital and Dr. Vidhyadharan provide detailed cost estimates during consultation.

Yes, sialendoscopy is particularly valuable for children with juvenile recurrent parotitis—a condition causing repeated painful parotid swelling. Rather than waiting for the child to "outgrow" the condition, sialendoscopy can provide definitive treatment by washing out the duct system and dilating any narrowings. Dr. Vidhyadharan treats pediatric salivary gland disorders with age-appropriate care.