Salivary Duct Intervention

Interventional sialography can be used to remove stones or delayed strictures from the submandibular or parotid glands. For stone removal, short-tipped, wire retrievable baskets are predominately used. Stones in the intraglandular ducts are almost impossible to remove, while stones proximal to the anatomic genu of either the parotid or submandibular ducts are also difficult to remove. More distal stones are amenable to percutaneous extraction. Stones 20% greater than the diameter of the duct should probably not be removed percutaneously. An access sheath, in the parotid or submandibular duct, greatly aids retrieval. Additionally, strictures in the parotid or submandibular ducts can be dilated with small guidewire and balloon systems. Reasonably high technical success of between 80% and 92% is reported with balloon siloplasty.