We have three major paired salivary glands, the sublingual (below the tongue), submandibular (below the jaw bone) and the Parotid gland (around the ear).
All the glands produce saliva of different composition and drain into the mouth through narrow ducts. Any obstruction to salivary flow through these ducts can lead to saliva being stuck in gland which gets infected over time and leads to the gland becoming swollen and painful. This process has been reported since time immemorial and traditionally for the submandibular gland used to be surgically removed to resolve the condition, For the parotid gland, since the facial nerve comes in close contact with the gland only conservative management was offered in the form of antibiotics and reassurance without any cure for condition.
With the advent of Sialendoscopes which are miniature endoscope small enough to fit inside the ducts we are now able to directly address the cause of obstruction of saliva and permanently cure the problem without any gland removal or scar. This is a relatively painless procedure and is done in a daycare setting where the patient can be discharged the same day and can resume his normal activities from the sialendoscopies can be done as a diagnostic procedure for unexplained recurrent gland infections or as a therapeutic procedure for stone removal and duct stricture dilatations. The procedure is safe, minimally invasive and repeatable without any major complications.
Our policy for gland removal is that we try and preserve the gland and its function by all means possible.
However, even despite our high success rate in preservation of gland, some patients do require gland excision, especially in cases of intraglandular stones, complete ductal stenosis, revision cases and irreversible changes of gland due to chronic infection and tumors.