If the salivary gland duct is obstructed by either a stone or a duct narrowing (stenosis) it can cause swelling of the gland when salivary flow is stimulated. Swelling is therefore often noticed at mealtimes and subsequently settles within an hour or so.
Minimally invasive techniques are available to remove salivary gland stones and often gland removal can be avoided.
Small stones can be removed by an endoscope which measures less than 2mm in diameter and the use of a small wire basket. The procedure can usually be carried out under a local anaesthetic.
Larger stones can often be fragmented with a small wire drill or by lithotripsy where shock waves break the stone into fragments which can then be removed by a basket. This may require more than one treatment.
The largest stones or multiple stones are often best removed by the use of an endoscope in combination with gland preserving surgery under a general anaesthetic.
A stricture in a salivary gland duct is essentially a narrowing of the duct. When salivary flow is stimulated the duct may be too narrow to allow it to pass through quickly and act as a bottle neck. The saliva builds up and causes a swelling of the salivary gland in a similar way to a stone causing a local blockage. The swelling usually settles within an hour or so.
Strictures often affect the parotid gland and can be treated by stretching the duct with an endoscope or a balloon. This is usually carried out under a local anaesthetic.
Both treatment of stones and strictures can often be managed by the use of sialdensocopy which is a specialist procedure undertaken regularly by very few surgeons in the UK.