Swiss doctor uses new technique to remove salivary stones

Mumbai: Two young women and a middle-aged man, who have been suffering from excruciating mouth pain due to salivary calculi (stones) or `Sialolithiasis`, and also salivary strictures for the last few months heaved a sigh of relief after they underwent a minimally invasive Sialendoscopy procedure here.

This minimal invasive technique can be performed in most cases as an ambulatory, outpatient procedure under local anaesthesia resulting in an avoidance of glandular excision caring and better cosmetic results, Prof Francis Marchal, Consultant ENT Surgeon and associate professor, University Hospital, Geneva, Switzerland, told PTI.

"This is a technique I developed since 15 years and we have been training doctors all across the world in Switzerland for the last eight years. I would like to have training centres in India too," Marchal who performed the procedure on the three patients at a day-long workshop yesterday said.

"The stones (calcium phosphate and calcium oxalate) and strictures were treated today at the P D Hinduja hospital where we performed three live cases -- a middle aged man and two young women," Marchal said.

Sialolithiasis is a rare painful condition seen in 1 out of 10,000 patients caused by calculi or stones formation in the salivary glands blocking the saliva secretion from the products causing intense pain during eating.

If an infection occurs, the gland becomes tense, swollen, very painful, and sore to the touch. Due to obstruction of the saliva, the mouth becomes dry and can give rise to cavity formation, Marchal said.

"The pain is so severe that she cringes in fear at the sight of food and prefers to go hungry. The pain usually subsides over several hours leaving an unusual gritty taste to the saliva," he said.

This condition usually remains undiagnosed in patients who neglect the pain and swelling in their glands. Sometimes these stones are not palpable on physical examination and can only be confirmed radiologically or by this technique.

Cause though unknown, poor oral hygiene might play an important role in salivary calculi formation. Sialolithiasis accounts for 30 per cent of salivary diseases, Marchal said.

Sialendoscopy, a latest technique, is ideal for stones situated deep within glands without removal of the glands.

"The flexibility of the endoscope with its varying diameters can easily remove stones that are less than 3mm to 4mm in diameter without damaging the ducts or the surrounding nerves," Marchal, the founder and Director of the European Salivary Gland Training Center (ESTC).

At present, around 600 physicians from 58 countries have been trained in Geneva, and so far more than 100 affiliated Sialendoscopy centers are active in 35 countries.

"In India GTB hospital has a centre in Delhi under Dr P P Singh and we may establish similar one at Hinduja in the near future, with the help of Dr Kirtane, a famous ENT surgeon who has extensive experience in training courses," he said.

When asked how many Indian doctors will be exposed to this technique during his stay here, he said, "After training around 100 doctors from Delhi and 100 in Mumbai, I will be going to Surat. But in Geneva we have a big set up by the Karl Storz company where doctors get training on humans and animals."

Sialendoscopy is widely used to treat non ? neoplastic conditions like stenosis, strictures and has shown excellent results not only in children suffering from Juvenile Recurrent Parotitis, (an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans), but also swellings caused by other diseases or radiation exposure, Marchal added.


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