Procedure
Sialendoscopies were performed using two types of endoscopes, the
‘modular Marchal scope’ (diagnostic 0.9 mm/therapeutic 1.6 mm) and the
‘Marchal all-in one scope’ with diameters of 1.1 mm, 1.3 mm and 1.6 mm
(Karl Storz, Tüttlingen, Germany). The most frequently used additional
tools were a basket for stone retrieval, a guidewire for stenosis cases,
and a Holmium-Yag laser (10 Hz, 0,50 J/pulse) for intraductal laser
fragmentation of stones (Rocamed, Monaco). Dilatation of stenosis was
practically done by introducing increasing diameters of sialendoscopes,
starting from with the 0.9 mm diameter, preferably over an initially
inserted guide wire. In the case of RPC and stenosis, an injection with
1ml long-acting corticosteroids (betamethason, acetate 3 mg/ ml;
betamethason, sodiumphosphate 4 mg /ml; Celestone ®, MSD, Kenilworth,
USA) was performed. If sialendoscopy alone was not successful, a
combined approach technique was performed. For parotid pathology, this
could be a combined approach with an external parotidectomy incision
approach or an intraoral semilunar incision anteriorly from the ostium
of Stensens’ duct. For submandibular pathology, an endoscope-guided
incision was made in the back of the floor of the mouth to find the
duct, while preserving the lingual nerve.13