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