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Treating Blocked Salivary Glands

October 1, 2014

Sialendoscopy Offers Relief For Patients

For almost a year, when Timothy Pratt would eat, he would experience a swelling on the left side of his face below his ear.

“My wife would notice this visible swelling, but as we talked, it would usually go down, and it was only slightly painful,” says the 53-year-old Pratt. “I thought my ear was clogged, but I wasn’t certain what was wrong.”

After some encouragement from his wife, he decided to see a doctor. In fact, he saw several doctors until he was referred to Allison Ogden, MD, a Washington University otolaryngologist, (ear, nose and throat specialist), at Barnes-Jewish West County Hospital.

Dr. Ogden recommended a CT scan, by which she discovered a stone that had developed in one of Pratt’s major salivary glands. The swelling was occurring because when he ate, the stone blocked the secretion of saliva.

Saliva is produced by three major salivary glands (parotid, submandibular and sublingual) on each side of the face and about a thousand minor glands spread throughout the mouth, explains Dr. Ogden. She says it is not really known why people develop stones in their salivary glands, but when they do, they can often cause pain, inflammation, scarring and even infection if not treated.

Fortunately, Dr. Ogden is a leader in the removal of blockages found in salivary glands using a procedure known as sialendoscopy, or salivary endoscopy.

“Traditionally, when there was a stone or blockage of a submandibular gland, the gland was removed, which meant there was a risk of dry mouth or risk to the nerve that controls movement of the lower lip,” Dr. Ogden says.

“With the advent of the salivary endoscope, there is now an option that is less invasive and patients are very happy with this procedure. We have moved from an approach of gland removal to one of preservation and recovery of normal function.”

It was in 2009 after seeing a number of patients with blocked salivary glands that Dr. Ogden, along with her Washington University colleague Brian Nussenbaum, MD, traveled to Switzerland, where they trained with Francis Marchal, MD, who developed the sialendoscopy technique.

Since then, Dr. Ogden has done more than 250 sialendoscopy procedures involving a variety of issues for patients first at Barnes-Jewish Hospital and since 2013 at Barnes-Jewish West County Hospital.

When the stone was discovered in Pratt’s gland, Dr. Ogden explained that although his stone was rather deep in the gland, she believed a sialendoscopy would be the best option for his case.

“The procedure was much more appealing to me because it was not surgery and I was told it would take very little time,” says Pratt, who had the procedure at Barnes-Jewish West County Hospital in March 2014. “Everything went very smoothly. It took about two hours, and I was then home resting. In three or four days, I was recovered, and it was just recommended that I stay away from acidic or spicy food at first. Today, I can now eat whatever I like.”

Pratt says he was very pleased with his care at the hospital, where he was a first-time patient, and appreciated the accessibility and thoroughness of everyone involved. “Dr. Ogden is very knowledgeable, and she did exactly what she said she’d do,” he says. “She really is a leader in the field, and she’s very tenacious and got the stone out.”

A sialendoscopy is performed under general anesthesia as an outpatient procedure, Dr. Ogden explains. The specially designed endoscopes are tiny, ranging in size from 0.8mm to 1.6 mm in diameter. The endoscopes are introduced into the saliva gland through its duct (tube) inside the mouth and used to identify and correct blockage or obstruction from stones or scarring. Often, no incisions are needed and recovery is generally quick with little discomfort.

Barnes-Jewish West County Hospital and the staff have been very responsive to supporting and learning this new technique and are excellent in their care of patients, both in the operating room and post-operative recovery rooms, Dr. Ogden adds. “This is one more procedure that allows us to offer a full scale of otolaryngology services to the community,” she says.

To schedule an appointment with Dr. Allison Ogden, or a physician at Barnes-Jewish West County Hospital, please call 314.542.WEST (9378).

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