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Ligation salivary duct, intraoral

CPT4 code

Name of the Procedure:

Ligation of Salivary Duct, Intraoral (Salivary Duct Ligation)

Summary

Ligation of the salivary duct is a surgical procedure performed inside the mouth to tie off one of the ducts that drain saliva from the salivary glands to the mouth. This prevents the flow of saliva from a particular gland, usually to manage excessive saliva production or treat recurrent salivary gland infections.

Purpose

The main purpose of this procedure is to address issues related to excessive saliva production or recurring infections in the salivary gland by preventing the flow of saliva through the problematic duct.

Indications

  • Excessive salivation (sialorrhea or drooling)
  • Recurrent infections in the salivary glands
  • Inflammation or swelling of salivary glands (sialadenitis)
  • Blockage or stones in the salivary ducts

Preparation

  • Fasting for several hours before the procedure, as advised by the healthcare provider
  • Adjustments in medication may be required, particularly blood thinners
  • Diagnostic tests such as ultrasound, MRI, or sialography (imaging of the salivary ducts)

Procedure Description

  1. Anesthesia: The procedure is typically performed under local anesthesia, though sedation or general anesthesia may be used in some cases.
  2. Access: A small incision is made inside the mouth to access the affected salivary duct.
  3. Ligation: The duct is then identified and carefully tied off to prevent saliva from flowing through it.
  4. Closure: The incision inside the mouth is closed with sutures, which will usually dissolve on their own.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

The procedure is usually performed in an outpatient surgical center, hospital, or specialist clinic equipped for oral surgeries.

Personnel

  • Oral or maxillofacial surgeon
  • Nurses and surgical assistants
  • Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

  • Swelling and pain at the surgical site
  • Infection
  • Bleeding
  • Injury to adjacent structures, such as nerves
  • Salivary gland atrophy

Benefits

  • Reduced excessive saliva production, improving quality of life
  • Decreased frequency of salivary gland infections
  • Alleviation of discomfort and swelling associated with blocked ducts

Recovery

  • Pain management with prescribed medications
  • Soft diet and mouth rinses to maintain hygiene
  • Initial days of swelling and mild discomfort
  • Follow-up appointments to monitor healing
  • Full recovery typically within a few weeks

Alternatives

  • Botulinum toxin (Botox) injections to reduce saliva production
  • Medications to manage symptoms
  • Sialendoscopy (minimally invasive procedure to clear blockages)
  • Observation and non-invasive management for mild cases

Patient Experience

Patients might experience some discomfort and swelling immediately after the procedure. Pain is generally manageable with medication. Most patients can expect to return to normal activities within a week, although they should follow specific dietary and hygiene instructions to facilitate healing.

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