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Sialendoscopy for Stenosis: Complications
Introduction
Ductal stenosis produces symptoms of obstruction once luminal diameter is reduced below 1.6 mm (~30% loss of diameter) when fully dilated. Unlike stones, ductal stenosis is more common in the parotid gland (75% of cases) possibly due to the smaller dilated diameter of Stensen's duct compared with Wharton's duct (2.5 mm vs 3.0 mm), and the increased predilection of inflammatory and autoimmune disorders to affect the parotid gland. Overall, complications related to endoscopic treatment of salivary stenosis are similar to those of stones (see Chapter 26 ).
Stenosis-Related Complications
Patients who present with obstructive symptoms with meals but without a visible stone will likely have some degree of duct stenosis. Sialendoscopy for stenosis typically involves visualization of the stenosis, followed by serial dilation with hydrostatic pressure, basket, scope tip, guidewire, and malleable bougies, or balloon ( 
).
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