Salivary gland stones removed with minimally-invasive procedure


Seara Schoenbeck, 13, has enjoyed a healthy childhood until about two years ago when she started feeling terrible pain in her mouth.

"You know, I thought it was a cold sore, but then it kept on getting bigger and then it burst, and it kept on doing that over and over," said Schoenbeck.

A stone was stuck in one of her salivary glands. Traditionally, surgeons would remove the entire gland.

"I was so scared about them going inside my neck," said Schoenbeck.

The cause is unknown, but risk factors may include dehydration, poor eating and use of certain medications, such as antihistamines. Trauma to the salivary glands may also raise the risk for stones.

Traditional surgery meant possible nerve damage and a big scar. Schoenbeck's dad, Richard, found a minimally-invasive alternative called a sialendoscopy.

"We can leave the glands alone," said Dr. Gary Josephson, chairman of the Department of Surgery Nemours/Wolfson Children's Hospital.

Josephson enters the salivary duct and gland through the floor of the mouth using a diagnostic scope with a camera the size of a toothpick.

"While you're doing this, you're watching the monitor. So it looks to me like it is giant," said Josephson.

Once the camera is in, saline is run through the duct to keep it open while the surgeon sends in a tiny drill to break up the stone. If the pieces don't flush out with the saline, a tiny wire basket is used to catch and pull out the remains.

"When we're done with this, there's minimal pain and they're good to go," said Josephson.

Schoenbeck was put under anesthesia for the procedure, but left the hospital that same day. She was back to normal in less than 48-hours.

The standard procedure would require at least a one- to two-day hospital stay and a longer recovery due to the incision and removal of the gland. Insurance companies typically cover this procedure.

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