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Cannulation of the left submandbibular duct (the patient is oriented laying supine) is performed after topical lidocaine is placed in the floor of mouth and usually employs a 0.015" guidewire (also dipped in viscous lidocaine) placed into the duct orifice with microscopic guidance. Initial dilation may be done by serially placing initially a 24 gauge (plastic tapered yellow angiocatheter) followed by a 22 gauge (blue) as demonstrated in sequential images.

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