See also:

• Salivary Ultrasound
• Salivary Ultrasound Sonopalpation for Stone
• Sialodochoplasty complex with duct scarring
• Submandibular Stone and Bartholin's duct

Modified Ultrasound Note

Procedure: Diagnostic ultrasound of the upper neck and salivary glands

Preop Diagnosis: Submandibular sialoadenitis with sialolithiasis

Postop Diagnosis: Same

Surgeon: xxxx  Assistant: xxxx​

Description of Procedure: Following identification the patient informed consent and a brief timeout the Toshiba Aplio 500 ultrasound with the 14 MHz probe was used to image the upper anterior neck with unremarkable anterior bellies of digastric mylohyoid genioglossus and sublingual glands identified

The right submandibular gland is identified with dilated hilar region measuring 29.5 x 18.1 x 30.4 mm with a heterogeneous nature to the gland with careful inspection demonstrating sialolith overlying the mid- to posterior aspect of the mylohyoid muscle with which digital palpation was identified at the mid ductal area well distal to the gland measuring 7.9 mm for stone size

The right parotid gland was evaluated as hyperechoic and homogeneous with

The left submandibular gland measuring 37.4 mm x 12.4 mm x 29.2 mm and seem to be hyperechoic and homogeneous

The left parotid gland was unremarkable with a hyperechoic homogeneous nature

Ultrasound Findings

Ultrasound Video

Modified Open Stone Removal/Sialendoscopy Operative Note

Preop Dx: Right submandibular sialolithiasis and sialadenitis

Postop Dx: Same

Procedure: 

• Right submandibular sialodochoplasty (complex) with
• Partial right sublingual gland resection
• Open approach to duct with marsupialization with 6-0 maxon
• Removal of 1 cm right submandibular sialolith
• Instillation of 3 cc of kenalog 10 to duct and gland
• Right submandibular sialendoscopy

Surgeon: xxx  Asst: xxx

Anesthesia: General OETT

Findings: large right posterior-mid ductal stone removed through open transoral floor of mouth approach) as per photos below

Sialendoscopy Findings

Postoperative Care

Peridex oral rinses 4 x/day; Augmentin x 10 days; Medrol dose Pak

​

​Modified Dilation In-Clinic Procedure Note

Procedure: Cannulation with dilation of right submandibular duct (7 French Cook dilator) with microscopic control followed by Kenalog-10 infusion 2 cc

Preop Diagnosis: Status post right submandibular duct stone resection and open floor of mouth ductoplasty with duct narrowing

Postop Diagnosis: Same

Surgeon: xxxx   

Anesthesia: Topical 2% viscous lidocaine applied;  premedication with oral ingestion of Augmentin 875 mg

Description of Procedure: Following identification the patient informed consent and a brief timeout in the clinic room with the microscope with her in the supine position and the above-mentioned anesthesia the microscope was used to image the duct opening with photography taken. The 0.015 inch guidewire was placed over which by the Seldinger technique a 7 French Cook dilator was positioned and kept in place for 3-4 minutes removed photographs taken Kenalog-10 instilled and the procedure terminated. She tolerated the procedure well