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New treatment options for salivary gland stones

Posted on May. 31, 2015 ( comments)
Sialendoscope

A sialoendoscope is an ultrathin endoscope that can be used to treat salivary gland stones and other salivary gland conditions. Image courtesy of KARL STORZ Endoscopy-America, Inc.

You may have heard about kidney stones or gallbladder stones, but did you know that your saliva leaves behind deposits that can also turn into stones? These stones can form deep within the saliva glands or saliva ducts throughout the mouth — or even within the crevices of the tonsils.

Stones in the saliva glands located in the cheeks or under the jaw can block the flow of saliva. This can result in minor discomfort to severe pain and swelling. In some cases, stones can cause infections severe enough to require hospitalization.

Just like other types of stones that can form in our bodies, there are not many proven methods to prevent salivary gland stones. Staying well hydrated only gets you so far when your body is predisposed to form these stones.

If you are experiencing periodic cheek swelling or swollen glands under the jaw, often occurring during or immediately after eating food, you may have salivary stones. If you have a blockage that has caused an infection, the swelling can become even more painful and persistent and will not clear up without antibiotics.

In the past, we generally diagnosed these stones with imaging studies, such as ultrasound or CT scan. There are cases that are difficult to diagnose with imaging studies, however. Some stones are invisible on x-rays because of their size, and occasionally something other than a stone (such as a scar band inside the mouth) can cause blockage of a saliva duct.

Fortunately a new, minimally invasive technology using ultrathin endoscopes (less than 2mm diameter) called sialoendoscopy now allows us to see directly into the salivary glands to diagnose and even treat various salivary gland disorders. Small stones in the ducts can be seen, grasped and removed using this special endoscope. Dilations and directed medication delivery can also be performed with sialendoscopes.

Despite technological advances, certain stones still cannot be retrieved in a minimally invasive fashion. Large stones located within the depths of the saliva glands generally can't be taken out and so we must remove the entire gland. Fortunately, there are many salivary glands located throughout the mouth and throat to make up for the loss of a single gland.
 
Sialendoscopy to treat various salivary gland disorders is performed at MultiCare by me in my office in Tacoma, as well as by Joseph Shvidler, MD, Ear, Nose and Throat specialist at MultiCare Gig Harbor Medical Park.

About The Author

Oliaei_Sepehr Sepehr Oliaei, MD

Sepehr Oliaei, MD, is an otolaryngologist (ear, nose and throat specialist) at MultiCare ENT, Sinus & Allergy Specialists - Tacoma. To schedule an appointment or evaluation, call 253-403-0065.

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