Dr Nadir Kana, practising at Netcare Milpark, has a clinical and research interest in sialendoscopy for sialolithiasis and obstructive sialadenitis. In suitable patients, semi-rigid endoscopes are used to retrieve salivary stones and treat duct strictures through the mouth, which may avoid the external incision needed for gland excision.
Chronic rhinosinusitis and nasal polyps
Chronic rhinosinusitis is diagnosed when nasal obstruction, discharge, facial pressure or reduced sense of smell persist for more than twelve weeks, with supporting endoscopic or CT findings. Initial treatment is medical; surgery is considered when symptoms persist despite an appropriate course of treatment.
Functional endoscopic sinus surgery (FESS) is performed through the nostrils. The aim is to open the natural drainage pathways of the sinuses and remove polyps, while preserving normal mucosa.
What is sialendoscopy?
Sialendoscopy is the endoscopic examination and treatment of the salivary ducts using miniature semi-rigid endoscopes introduced through the natural duct opening inside the mouth. It allows direct visualisation of stones, strictures and mucous plugs.
Small stones can be retrieved with baskets or graspers; larger stones may require a combined approach with a small incision inside the mouth. Strictures can be dilated under direct vision.
Gland preservation compared with gland excision
Historically, recurrent obstruction of the submandibular or parotid gland was frequently treated by removing the entire gland (sialadenectomy). Gland excision requires an external neck or facial incision and carries risks to the facial, lingual and hypoglossal nerves.
In appropriately selected patients, sialendoscopy offers a gland-preserving alternative that avoids an external scar. Not every patient is suitable, and some will still require gland excision; the options are discussed on the basis of the imaging and endoscopic findings.
- Performed through the natural duct opening in the mouth
- Usually no external skin incision
- Aims to preserve the salivary gland and its function
- Often performed as day-case surgery
Treatments in this area
- Functional endoscopic sinus surgery (FESS)
- Frontal sinus surgery including Draf procedures
- Balloon sinuplasty
- Diagnostic and interventional sialendoscopy
- Sialolithiasis and ductal stenosis management
Your care team may include: ENT and head & neck surgery, Radiology, Anaesthesia (day-case).
