42650 Dilation salivary duct

Name of the Procedure:

Dilation Salivary Duct

• Common Name(s): Salivary Duct Dilation
• Technical Term: Sialendoscopy with Dilatation

Summary

Dilation salivary duct is a minimally invasive procedure aimed at widening a blocked or narrowed salivary duct. This technique often utilizes a small endoscope to visualize and treat the obstruction, thereby improving saliva flow.

Purpose

• Medical Condition: Salivary duct strictures or blockages, often due to stones (sialolithiasis) or inflammation (sialadenitis).
• Goals: To relieve obstruction in the salivary ducts, restore proper saliva flow, and alleviate related symptoms such as pain and swelling.

Indications

• Symptoms: Recurrent swelling and pain in the salivary glands, especially during meals.
• Conditions: Diagnosed salivary duct stones, strictures, or chronic infection/inflammation.
• Patient Criteria: Patients experiencing symptoms despite conservative treatments like hydration and gland massage.

Preparation

• Instructions: Patients may be advised to fast for several hours before the procedure. Discontinuation or adjustment of certain medications, like blood thinners, may be necessary.
• Diagnostic Tests: Imaging studies such as ultrasound, MRI, or CT scans to locate the obstruction.

Procedure Description

1. Anesthesia: Local anesthesia and sometimes mild sedation is administered for comfort.
2. Endoscope Insertion: A small endoscope is inserted into the mouth and navigated into the salivary duct.
3. Visualization: The endoscope allows direct visualization of the duct and the obstruction.
4. Dilating Device: Special dilating instruments or balloons are used to widen the narrowed duct.
5. Stone Removal: If stones are present, they may be extracted using tiny graspers or broken up using a laser.

Duration

The procedure typically takes between 30 minutes to 1 hour, depending on the complexity of the case.

Setting

• Location: Performed in an outpatient clinic, hospital, or surgical center.

Personnel

• Involved Professionals: Otolaryngologist (ENT specialist), nurse, possibly an anesthesiologist if significant sedation is required.

Risks and Complications

• Common Risks: Mild pain, swelling, and bruising at the site.
• Rare Complications: Infection, persistent duct obstruction, duct perforation, bleeding, or damage to nearby structures.
• Management: Most mild complications can be managed with pain relievers and antibiotics. More serious complications may require additional intervention.

Benefits

• Expected Benefits: Relief from pain and swelling, improved saliva flow, reduced risk of recurrent infections.
• Timeframe for Benefits: Many patients experience immediate relief, with continued improvement over a few days to weeks.

Recovery

• Post-Procedure Care: Patients may need to apply ice packs, take prescribed medications, and avoid certain foods that stimulate saliva excessively.
• Recovery Time: Most patients recover within a few days to a week.
• Restrictions & Follow-Up: Regular follow-up visits to monitor the duct and manage any ongoing issues.

Alternatives

• Other Options: Conservative management (hydration, gland massage), extracorporeal shock wave lithotripsy (ESWL) for stones, surgical removal of duct or gland.
• Pros & Cons: Dilation is less invasive with quicker recovery compared to surgery but may not be effective for all obstructions.

Patient Experience

• During Procedure: Minimal discomfort due to local anesthesia; patients may feel pressure or mild pulling.
• After Procedure: Mild pain and swelling, managed with prescribed pain relievers and anti-inflammatory medications. Most patients report significant improvement in symptoms shortly after the procedure.