Oral and Maxillofacial Surgery in London

Miss Katherine George is one of a few surgeons in the UK who has trained in minimally invasive techniques to manage benign salivary gland tumours, stones and strictures. She is part of the highly specialised Multidisciplinary Salivary Gland Team at Guys Hospital and  has set up a sialendoscopy service at Kings College Hospital, London offering techniques which reduce the need for salivary gland removal by 97%. 

In many centres, salivary gland removal will be advocated for a benign tumour of the parotid gland.  However, a much smaller operation is possible, removing just the growth and sparing the rest of the gland.  This approach reduces the overall risks of surgery.

A blocked salivary gland can lead to facial swelling usually worse at meal times and also infection.  The cause can be either be a salivary gland stone or a stricture.

Salivary gland stones can be treated by minimally invasive techniques such as sialendoscopy and basket retrieval either under local anaesthetic or by a day case procedure under a general anaesthetic.  Sometimes stones can be broken down into smaller fragments by a technique known as lithotripsy.  These smaller fragments may then pass out of the gland naturally or facilitate removal with a small basket.

Narrowing of the salivary gland ducts can lead to intermittent swelling of the salivary glands which is often painful.  These can be stretched with a small balloon introduced into the gland opening or by other minimally invasive techniques.

This is a procedure that is used to examine the ducts of the salivary glands by use of a miniature endoscope; a very fine filament introduced into the natural gland opening in the mouth.  This allows the gland ducts to be examined and explored and also allows small instruments to be inserted into the duct to remove any small stones or debris that may be present.  It also allows the gland to be washed out with saline (salty water) or other medications such as steroids and antibiotics.  This is usually carried out under local anaesthetic as an out-patient procedure.