TREATMENT OF SALIVARY OBSTRUCTIVE PATHOLOGY SIALOENDOSCOPY
In most hospitals around the world, the way to treat obstructive salivary disease is to remove the gland by open surgery.
At SIALOSS we have specialised in the treatment of this pathology with minimally invasive surgical techniques which, with admissions of less than 24 hours, resolve the problem whilst preserving the gland and avoiding scars.
Despite our experience and that of other groups worldwide, more than 85% of the world’s hospitals still choose to remove the gland. The arguments that have maintained this attitude, which is still defended by some surgeons, have been refuted by current experience:
It is not true that a gland that has been blocked for long periods of time is irretrievably damaged. Multiple studies show that when the blockage is resolved, the gland recovers its function. (1)(2)(3)
It is not true that after extracting a lithiasis, stones are inevitably formed again. The formation of new lithiasis occurs in less than 20% of cases. (4)(5)
It is not true that the location of the stones at certain points in the duct makes their extraction impossible. More than 85% of lithiasis are found in locations in the duct that allow their removal without removing the gland. (6)
It is not true that the complications of minimally invasive techniques are greater than those of glandular resection. Open glandular resection surgery involves major trauma, longer admission times and higher risk of complications. (7)(8)
It is not true that minimally invasive techniques have low success rates. The experience accumulated by our team and by others with more experience worldwide shows a very high success rate with minimally invasive techniques, preserving the gland with minimal surgical trauma. (9)(10)(11)(12)(13)
“We have taken up old ideas, taken advantage of current technology, and are able to offer a different way of healing, without resecting the gland and with minimal surgical trauma”.
The use of minimally invasive techniques in the treatment of obstructive salivary disease is not new. In 1953. Dr H. Seldin demonstrated in a series of over 100 patients that removal of the gland was not necessary in most cases(5).
At the end of the 1990s, several professionals in otolaryngology, radiology and oral surgery showed their interest in minimally invasive techniques once again, promoting the development of millimetric optics that today allow us to explore the salivary ducts.
Current sialoendoscopes allow us to explore the interior of the duct, visualise the anatomy and detect anomalies such as lithiasis, narrowing, mucus plugs and other problems. In addition, they incorporate a working channel through which we can introduce the material required to perform treatments; laser fibres, extraction baskets, clamps…