42500 Plastic repair of salivary duct, sialodochoplasty; primary or simple

Name of the Procedure:

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Summary

Sialodochoplasty, commonly referred to as plastic repair of the salivary duct, is a surgical procedure to correct or reconstruct the salivary duct. This primary or simple repair aims to restore normal salivary flow and function by addressing blockages, narrowing, or damage in the duct.

Purpose

The procedure primarily addresses issues stemming from blocked or damaged salivary ducts. The goals are to alleviate symptoms like dry mouth, pain, and swelling, and to prevent recurrent infections or stone formation.

Indications

• Recurrent salivary gland infections
• Salivary duct stones (sialolithiasis)
• Chronic swelling or pain in the salivary glands
• Congenital abnormalities of the salivary duct
• Traumatic injuries to the salivary duct

Preparation

• Patients may be required to fast for a specified period before the procedure.
• Adjustments to certain medications, particularly blood thinners, may be necessary.
• Preoperative imaging studies such as sialography, ultrasonography, or MRI to assess duct anatomy and pathology.

Procedure Description

1. Administration of local or general anesthesia, depending on the complexity and patient condition.
2. The surgeon makes an incision at the site of the damaged or blocked salivary duct.
3. Removal of salivary stones or damaged tissue, followed by repair or reconstruction of the duct using fine sutures.
4. In cases of significant damage, a stent may be placed temporarily to keep the duct open.
5. Closure of the incision with sutures or skin adhesives.

Duration

The procedure typically takes 1 to 2 hours, but the duration can vary based on the complexity of the case.

Setting

The procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeon specializing in otolaryngology or oral and maxillofacial surgery
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding tissues or nerves
• Scarring
• Recurrence of duct blockages or stones
• Temporary or permanent dry mouth

Benefits

• Relief from pain and swelling
• Restoration of normal salivary function
• Reduction in recurrent infections and complications

Recovery

• Pain management with prescribed medications
• Instructions on oral hygiene to prevent infection
• Soft or liquid diet initially to minimize discomfort
• Follow-up appointments to remove stents if placed and to monitor healing
• Typical recovery period ranges from 1 to 2 weeks, with gradual resumption of normal activities.

Alternatives

• Conservative management with medications and hydration
• Sialendoscopy, a minimally invasive procedure to remove stones or dilate the duct
• Radiation or chemotherapy for malignant obstructions
• Pros and cons: Less invasive options may not be effective for severe cases, while surgery offers definitive relief but with higher immediate risks.

Patient Experience

• Patients may experience mild to moderate pain or discomfort postoperatively.
• Swelling and bruising at the surgical site are common but resolve within a few days.
• Pain management through prescribed painkillers and cold compresses.
• Gradual improvement in symptoms and salivary function can be expected during the recovery phase.