MEET THE DOCTORS IN NYC, ORLANDO, HOUSTON: JULY 2017

Dr. Hamilton and Dr. Osborne will be in New York City, NY on July 26th, Orlando, Florida on July 27th, and Houston, Texas on July 28th. They will be holding discussion sessions with individual patients to discuss the details of surgery. We are scheduling plenty of time between appointments to ensure that you can obtain answers to all of your questions.

Sialendoscopy for Removal of Salivary Gland Stones

No surgical incisions, no scars, zero percent risk of facial nerve paralysis

Large Stone Extraction

Small Stone Extraction

INTRODUCTION TO SIALENDOSCOPY

Dr. Ryan Osborne, Director of Head & Neck Surgery and Salivary Gland Disorders, at the Osborne Head & Neck Institute, specializes in the non-surgical removal of salivary gland stones causing swelling and infection of the major salivary glands.

This is accomplished through a minimally invasive outpatient endoscopic procedure called sialendoscopy that requires no surgical incisions, leaves no scars, and carries a zero percent risk of facial nerve paralysis. He is one of a handful of surgeons in the world that have championed the use sialendoscopy for the safe removal of salivary gland stones, avoiding invasive surgical procedures that are quickly becoming seen as archaic and obsolete by this new technique.

Dr. Ryan Osborne is currently performing 15-20 outpatient procedures per week on patients from across the globe saving many patients from unnecessary invasive surgeries, hospitalizations, and facial nerve paralysis.  If you are interested in treatment for salivary gland stones and do not want to have surgery to remove your entire salivary gland or are concerned about facial paralysis associated with traditional surgical techniques please see the basic information below about salivary gland stone treatment and fill out the contact form to schedule a call back from our office.  Most patients fly into Los Angeles, have their procedure and fly out the next day.  Remember it is no longer necessary to remove your entire salivary gland if the stones are removed in a timely fashion. Contact us now.
View frequently asked questions.

DR. OSBORNE EXPLAINS  SIALENDOSCOPY ON “THE DOCTORS”

Salivary Stone Extractions

We have removed stones, of ALL sizes, from ALL glands

We keep the stones, you keep your gland

NO surgery, NO neck incision, NO risk of facial paralysis

Salivary Stone Library:

These are cases of Sialendoscopy procedures performed on patients with salivary gland stones of varying sizes and quantities at the Osborne Head & Neck Institute. The CT scan (right) highlights the salivary gland, duct and stones. The stones are displayed (left) after removal from the patient with ruler to demonstrate size.

Most patients were told that their stones could not be removed without having neck surgery and removing the entire gland. All patients below had their stones removed without external surgery.

Extraction of Small Salivary Stones

sialendoscopy
Figure: Stone - Axial CT - Right parotid gland duct.

Extraction of Large Salivary Stone

procedure-to-remove-salivary-stones
Figure: Stone - Axial CT - Right submandibular gland.

Extraction of Small Salivary Stone

Figure: Stone - Axial CT - Right parotid gland.
Figure: Stone - Axial CT - Right parotid gland.

Extraction of Small Salivary Stone

Figure: Stone - Axial CT - Right parotid gland.
Figure: Stone - Axial CT - Right parotid gland.

Extraction of Small Salivary Stones

Figure: Stone - Axial CT - Right parotid gland duct.
Figure: Stone - Axial CT - Right parotid gland duct.

Extraction of Small Salivary Stones

Figure: Stone - Axial CT - Right parotid gland.
Figure: Stone - Axial CT - Right parotid gland.

Extraction of Large Salivary Stone

Figure: Stone - Axial CT - Left parotid gland duct.
Figure: Stone - Axial CT - Left parotid gland duct.

Extraction of Small Salivary Stone

Figure: Stone - Axial CT - Right parotid gland.
Figure: Stone - Axial CT - Right parotid gland.

Extraction of Small Salivary Stone

Figure: Stone - Axial CT - Right parotid gland duct.
Figure: Stone - Axial CT - Right parotid gland duct.

Extraction of Small Salivary Stones

Figure: Stone - Axial CT - Right submandibular gland
Figure: Stone - Axial CT - Right submandibular gland

Extraction of Small Salivary Stone

Figure: Stone - Axial CT - Right submandibular gland.
Figure: Stone - Axial CT - Right submandibular gland.

Extraction of Small Salivary Stones

Figure: Stone - Axial CT - Left submandibular gland.
Figure: Stone - Axial CT - Left submandibular gland.

Extraction of Large Salivary Stone

Figure: Stone - Axial CT - Right submandibular gland duct.
Figure: Stone - Axial CT - Right submandibular gland duct.

Extraction of Large and Small Salivary Stones

Figure: Stone - Axial CT - Left submandibular gland.
Figure: Stone - Axial CT - Left submandibular gland.

Extraction of  Small Salivary Stones

Figure: Stone - Axial CT - Left submandibular gland and duct.
Figure: Stone - Axial CT - Left submandibular gland and duct.

Extraction of  Small Salivary Stone

Figure: Stone - Axial CT - Left submandibular gland.
Figure: Stone - Axial CT - Left submandibular gland.

Extraction of  Small Salivary Stone

Figure: Stone - Axial CT - Left submandibular gland duct.
Figure: Stone - Axial CT - Left submandibular gland duct.

Extraction of  Large Salivary Stone

Figure: Stone - Axial CT - Left submandibular gland duct.
Figure: Stone - Axial CT - Left submandibular gland duct.

Extraction of  Small Salivary Stones

Figure: Stone - Axial CT - Left submandibular gland.
Figure: Stone - Axial CT - Left submandibular gland.

Extraction of  Large and Small Salivary Stones

Figure: Stone - Axial CT (top) and Coronal CT (bottom) - Left submandibular gland.
Figure: Stone - Axial CT (top) and Coronal CT (bottom) - Left submandibular gland.

Extraction of  Small Salivary Stone

Figure: Stone - Axial CT - Right submandibular gland.
Figure: Stone - Axial CT - Right submandibular gland.

Extraction of  Small Salivary Stone

Figure: Stone - Axial CT - Left submandibular gland duct.
Figure: Stone - Axial CT - Left submandibular gland duct.

Extraction of  Large and Small Salivary Stones

Figure: Stone - Axial CT - Left submandibular gland and duct.
Figure: Stone - Axial CT - Left submandibular gland and duct.

 

View Animated Procedures

Sialendoscopy: Submandibular

Sialendoscopy: Parotid

Frequently Asked Questions

What is a salivary gland stone?

When flow of saliva through the salivary gland slows down, material in the duct can form stones.  These stones block the outflow of saliva, causing swelling and pain in the gland.

Where does this happen?

Stones can form in any of the major salivary glands.  These include the parotid gland and the submandibular gland.

What are the symptoms?

  • Pain (parotid causes cheek pain, submandibular stones cause jaw and mouth pain)
  • Swelling of the face
  • Pain with eating

How do I know if I have stones?

Symptoms suggestive of stones should be evaluated by an Ear, Nose, and Throat physician that specializes in salivary gland disease.  You should have a careful examination and may also have a CT scan done to confirm the presence of a stone.

What are the traditional treatment options?

Traditionally, the only treatment option for persistent salivary gland stones associated with inflammation was surgery.  Surgery could include removal of the entire salivary gland and duct or marsupialization of the duct with stone removal.

Other methods of treatment focused on prevention.  These include:

  • sialogogues substances that naturally increase salivary flow
  • hydration to increase the amount of saliva, preventing stasis and build-up of stones in the duct system
  • massage of the gland to manually move stones through the system, preventing large stone formation
  • antibiotics to prevent infection from duct obstruction

Although these methods are helpful, they are only temporary measures and eventually patients find themselves faced with surgical resection of the entire gland to stem their symptoms.

Salivary gland surgery has many potential complications. Salivary glands are located close to nerves that are critical for normal facial movement, taste, and sensation.  Complications associated with injuries to these nerves include:

  • Loss of oral sensation
  • Loss of taste
  • Facial weakness
  • Scarring associated with surgical incisions
  • Facial deformity
  • Occasionally, if the duct is not removed completely, recurrent symptoms may occur

What is sialendoscopy?

Sialendoscopy involves the use of miniature endoscopes (1-3mm wide) to enter the small ducts of the salivary system in search of disease. The most common disease processes obstructing the salivary gland duct are stones (or calculi) and/or stenosis of the duct from chronic inflammation.  Once the problem is identified, it can be treated by a variety of methods, all of which spare total gland removal. This would include stone removal to relieve blockage or duct dilation to prevent recurrent obstruction.  The overall success rate of the procedure is over 90%.

What are the benefits of sialendoscopy?

  • No surgery, No incision, No scar
  • No risk of nerve damage
  • No risk of bleeding
  • Fast recovery time
  • Preservation of normal salivary gland and duct
  • Same day procedure in a safe outpatient setting
  • Early return to normal diet

How is the recovery?

After the procedure, you are discharged home the same day.  There is minimal pain and you are able to consume liquids for the first day. You will gradually increase to a normal diet over a few days.  You will be instructed to use certain measures that increase salivary flow for the first few days, to improve healing.  A follow up appointment will be scheduled for you within a week of the procedure, to ensure that healing is progressing.

How do I maintain normal gland function after my procedure?

Patients who suffer from sialadenitis or recurrent salivary gland stones will need to modify their lifestyle after sialendoscopy to help prevent recurrence.  These lifestyle changes will improve hydration, decrease the risk of recurrent stone formation and infection, and help prevent repeat procedures in the future.

After your procedure, you will receive Dr. Osborne’s specialized salivary gland care protocol.  The steps in this plan are crafted to help prevent recurrence of your salivary gland disease.  These include instructions about hydration, diet modification, early warning signs and symptoms, and clues for prevention.

Do not risk having your salivary glands removed unnecessarily. Come for a consultation to see how you can improve your quality of life with thislow risk, minimally invasive procedure.

CONTACT OHNI