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CAT scan of salivary gland showed stone. Taken antibiotics. Have swelling. Surgery only option?

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ENT Specialist
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I recently had a CAT scan of my left salivary gland (near jaw line) which showed a 5 mm stone w/in the gland - far end opposite the duct. My ENT doc said the only relief he can offer is gland removal surgery. I have been thru two courses of antibiotics . Gland swelling occurs during meals - is uncomfortable then and sometimes throughout the day. All bloods tests prior to the CAT scan were normal. I am a 58 yr. old male in good health. Are there no other methods or procedures offered other then gland removal surgery -- this is the only problem in this area I've ever had. If other procedures are offered - where might they be located? I live near Albany, NY
Thank you
Posted Fri, 7 Sep 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 2 hours later

Thanks for the query

It is difficult for a 5mm sialolith (salivary gland stone) to pass by itself through the duct. If it is not removed at the earliest, there would be scarring at the site of the obstruction which can cause narrowing of the duct later on.

In the past, the only treatment option for the sialoliths associated with inflammation was surgery. As a part of the surgery either the entire salivary gland was removed or marsupialization of the duct with stone removal was done.

Recent innovation in the removal of sialolith is sialendoscopy. Sialendoscopy is a new procedure, aiming to visualize the lumen of the salivary ducts and their pathologies. It involves the use of miniature endoscopes (1-3mm wide) to enter the small ducts of the salivary glands.

Smaller stones (< 4 mm) are amenable to endoscopic removal. Intermediate-size stones (5-7 mm) may have to be fragmented further with either a holmium laser or lithotripsy followed by endoscopic extraction. This is a relatively painless and bloodless method to extract the sialolith.

My suggestion to you is to discuss with your doctor about sialendoscopy, so that he can refer you to the appropriate specialist.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: CAT scan of salivary gland showed stone. Taken antibiotics. Have swelling. Surgery only option? 2 hours later

Thank you for your response.
My ENT doctor did not believe sialendoscopy was an option - his group practice does not perform this proceedure, and he seemed to have no interest in discussing it with me.
Might you know of and ENT doctor or hospital in the Albany, NY area who performs this proceedure so I might get a second opinion?

Thank you
Answered by Dr. Naveen Kumar 8 hours later

Thanks for writing back

You can contact:

1. Osborne Head & Neck Institute,
1230 Avenue of the Americas,
New York, NY 0000.

2. NewYork-Presbyterian Hospital
525 East 68th Street
New York, NY 0000

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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