See also:
Case Presentation
Video
Operative Note
Preop Dx: Right submandibular sialadenitis with ductal stricture
Postop Dx: Same - additionally: sialolithiasis
Procedure:
- Right submandibular sialodochoplasty with
- Duct cannulation and dilation over 0.015 inch guidewire - 24 then 22 gauge angicath then 4Fr COOK salivary access dilator followed by 7 Fr COOK salivary access dilater
- Removal of 2 mm stone with removal of 7 Fr COOK salivary access dilator (and guidewire)
- Sialendoscopy (1.3 mm Marchal sialendoscope) to 6 cm (tertiary ducts) with slight debris irrigated free, no stone
- Kenalog 10 infused into duct initially with 22 gauge then increased to 18 gauge angiocath (5 cc delivered 2.5 cc retained)
Anesthesia: General OETT
Findings as above and photos. Decision to avoid placement of stent based on clearly identified stone as likely source of obstruction with readily and maximally dilated duct (7 Fr COOK dilator) permitting passage of stone
References
Kondo N, Yoshihara T, Yamamura Y, Kusama K, Sakitani E, Seo Y, Tachikawa M, Kujirai K, Ono E, Maeda Y, Nojima T, Tamiya A, Sato E, Nonaka M. Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography. Auris Nasus Larynx. 2018 Aug;45(4):880-884. doi: 10.1016/j.anl.2017.11.004. Epub 2017 Dec 6. PMID: 29217121.
