return to: Sialendoscopy
see also: Salivary Gland Anatomic Anomalies and Foreign Bodies Lecture AHNS April 9 2013
History: Retained 20 gauge angiocatheter in submandibular duct placed after ductoplasty with stone removal. Time frame below:
May-June: Firm swelling right submandibular gland with pain intensified with meals associated with 'slimy type of strong salty taste in mouth'
June 22: Transoroal right submandibular sialodochoplasty under local anesthesia with heavy sedation. Placement of 20 gauge angiocatheter until stone encountered, incision over angiocatheter into duct through floor of mouth mucosa with removal of stone. Angiocatheter secured with purse-string suture
perceived reaction to suture material with loss of control of stent recessed into duct; symptoms of swelling and pain markedly improved
July 13: Transoral right submandibular duct exploration under local anesthesia with sedation in effort to remove retained angiocatheter. Cannulation of duct orifice successful as was entry into duct through floor of mouth incison through previous scar overlying previous entry site into duct. Intra-operative radiography identified successive images demonstrated further postioning of catheter tip deeper into gland
no further acute swelling or pain of the gland but noting once a week or so perception of discomfort identifying that 'all is not right with that gland'
Nov 26: Referral to the U of Iowa - options discussed: observation / submandibular gland resection / sialendoscopy with transoral endoscopic removal
Dec 5: Right submandibular sialodochoplasty with duct dilation and removal of 3 cm foreign body (20 gauge angiocatheter tip)
shortened, edited video of removal:
short version foreign body smg
also, over three minute video more accurately identifying difficulties in removal:
long version foreign body smg