How Sialendoscopy is done?

Local anesthesia is infiltrated around the papilla of the salivary duct in order to make the papilla taut and also to reduce the bleeding around the papilla. Smallest size probe (00 size) is introduced into the papilla. This papilla is then dilated with serial dilators of increasing size. If one find difficulty in identifying the papilla one may use microscope for this purpose or one may massage the gland to identify the saliva coming out of papilla. Then the diagnostic sialendoscope is introduced along with the sheath with continues irrigation so that while introducing the sialendocope the duct remains open. If there are any mucous plugs in the duct, they also get washed away with this irrigation. Once the inspections of all the branches of the duct is done, and if any pathology is seen then sialendoscope with the therapeutic sheath is introduced and treatment is done accordingly.