Diagnosis and treatment of strictures and kinks in salivary gland ducts

Purpose: This article describes the use of sialoendoscopy for diagnosis and treatment of strictures and kinks in the major salivary glands ducts. Patients and Methods: Thirty-four salivary glands with. obstruction were di agnosed as having ductal kinks or strictures. Strictures were diagnosed by sialography and sialoendoscopy, kinks were diagnosed mainly by sialography, whereas endoscopy was used to rule out other pathology and to locate the k ink. There were strictures in 25 salivary glands (14 male and 11 females; a ged 25 to GO years), 14 in the parotid and 11 in the submandibular gland, a nd kinks in 3 salivary glands (5 males 4 females; aged 40 to 55 years). Sev en kinks were found in the submandibular gland and 2 in the parotid. Treatment of strictures was performed by dilatation procedures with saline under pressure, balloon techniques, and forced manipulation. After these pr ocedures, a polyethylene stent was inserted for 2 weeks. Kinks were treated by advancement ductoplasty and balloon contouring to overcome the acute an gle. Results: Twenty of 25 cases of stricture became completely asymptomatic in a follow-up of 8 to 36 months after treatment. In 4 cases, further revision al dilatation was needed, and in 1 case treatment failed and the gland had to be removed. All 3 cases of kinks became completely asymptomatic in a fol low-up of G to 24 months after treatment. Conclusion: Strictures and kinks should be considered when salivary gland o bstruction is present without sialolithiasis. (C) 2001 American Association of Oral and Maxillofacial Surgeons.