Head and neck surgeon Dr. Ryan Osborne explains how a sialendoscopy is performed.
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Explaining a Sialendoscopy Dr. Drew Ordon: My colleague, Dr. Ryan Osborne, the director of the Osborne Head Neck Institute is here with us today along with his patient Heather. Dr. Ryan Osborne: Thank you very much for having us. Dr. Drew Ordon: Really the first time that we’re talking about salivary stones on the show so this is good stuff, and they hurt. They do. First of all, tell us what causes them. Dr. Ryan Osborne: We really don’t know. However, dehydration, if you have too much calcium in your diet, too much protein in your diet, nicotine, all these things have been shown to kind of the contributing factors, but we really can't say for sure, “This is going to lead to a stone.” Dr. Travis Stork: That’s why they just -- they happen. Dr. Drew Ordon: They happen. Dr. Travis Stork: Heather didn’t know any wrong. Dr. Ryan Osborne: No, not at ll. Dr. Drew Ordon: Alright. Dr. Ryan Osborne: She’s just living her life. Dr. Drew Ordon: So, we get a stone. In the past, how did you treat that condition? Dr. Ryan Osborne: Well, in the past we try to get people to manipulate the gland to see if the stone would eject itself. That never works. The next thing we offered them is surgery. The surgery will be to actually remove the gland. So in short, if you -- this kind of thing is like a plumbing problem -- if your sink or plumbing gets clogged up, we would say, “Well, rip your sink up.” Dr. Drew Ordon: Instead of trying to -- Dr. Ryan Osborne: Trying to clog the clog. Dr. Drew Ordon: Exactly, and that’s why you're here today. You have a new procedure that you're going to tell us all about right now. Dr. Ryan Osborne: Absolutely. The procedure is essentially a sialendoscopy. And it’s using a very small camera which is here. This is actually an endoscopic tool that we can put through the natural opening of the salivary gland duct. And we can actually see what’s actually happening in there. And, if there’s something blocking the flow of saliva, you simply grab it and unclog it just like when you call the plumber to unclog your toilet or your sink, nothing different. Dr. Drew Ordon: Well, show us what the inside of one of those ducts looks like. Dr. Ryan Osborne: Alright, this is an animation that’s showing normal salivary flow. The blue dots are a saliva flowing. And you’ll start to see some debris building up which is represented by the yellow calcification there. When that blocks up, the gland swells, it’s painful. What we do is we go into the natural opening in the mouth using this small camera. We identify the stone, pass a basket, rub it, and we extract it through the natural opening in the mouth with no incisions. When we do that, the normal flow of saliva is restored, the gland shrinks back down to normal size, the pain goes away. Dr. Travis Stork: That was an awesome animation. Thanks for walking us through it. Dr. Ryan Osborne: Thank you. Dr. Drew Ordon: You're welcome. So most importantly, Heather how are feeling? Heather: Amazing! It took about a week and a half, and I was eating everything and drinking and no pain. Dr. Drew Ordon: So, you’ve got a happy patient there. Dr. Ryan Osborne: Yeah. Dr. Drew Ordon: Good stuff. Dr. Travis Stork: And that’s what’s important. Thank you so much. Heather: Yes. Dr. Travis Stork: If you have a big swollen face, it could be a salivary stone. It could also be an abscess. Really, you need to go get it checked out because there are things that need to be done either way. It’s either decompressed stone removal or if it’s an abscess, we both -- we all three have seen those turn into a very serious like or an infection. Dr. Drew Ordon: Or a tumor mass in the process. Dr. Travis Stork: Exactly. Dr. Drew Ordon: That’s why you go see a Head Neck Surgeon trained like Ryan here.