Modified Operative Note

Preop Dx: Right submandibular sialadentitis with sialolithiasis

Postop Dx: Same

Procedure: 

• Complex right sialodochoplasty
• Sialendoscopy with 0.8 mm Zenk scope after dilation 24-22 gauge angiocath then Marchal over 0.015 inch guidewire
• Open ductoplasty matured with 5-0 vicril and 7-0 PDS
• Most distal stone removed with forceps
• More proximal stone required encircle basket
• Dilation of hilar ductal narrowing through 1.6 mm Zenk scope with biopsy forceps
• Stent (sialodrain type 3 4.5F120TS) placed and secured with 2 separate 5-0 nylons
• Kenalog 10 instilled through drain into gland (5 cc)

Anesthesia: General OETT 6-0

Findings as per photos below. Additionally: the gland hilum was unusual in not clearly showing secondary branching - with one partially occluded (with debris) opened as per above images

Postoperative Care: Augmentin 875 mg po bid for 2 weeks; Peridex for three weeks 4 x day (may substitute 3% dilute peroxide); medrol dose pak; f/u  10 days for drain removal