Selective management of obstructive submandibular sialadenitis

We aimed to describe the effect of our surgical and sialoendoscopic technique for diagnosis and treatment of chronic obstructive submandibular sialadenitis.

Between January 2004 and June 2006, 68 patients presented with obstructive symptoms and were diagnosed and treated by interventional sialoendoscopy or excision. The patients all had radiographs and then, if the sialolith could not be found, diagnostic sialoendoscopy. The obstruction was treated by operation or interventional sialoendoscopy depending on the size, shape, site, and quality of the sialolith.

Forty-nine patients had sialoliths shown radiographically, and the features of 19 were found endoscopically and were of three types: radiolucent (n=6), in the branch (n=3), mucus plug (n=3), and stenotic (n=7). Twenty-seven obstructions were successfully removed surgically, giving a success rate of 27/31 (87%). Twenty-seven patients were treated by interventional sialoendoscopy, and in 22 cases the sialoliths were removed directly by sialoendoscopy (22/27, 81%). Obstructive symptoms were relieved in 9 of 10 cases without stones.

Operation or sialoendoscopy can be used to treat the obstruction in the submandibular gland.