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Balloon catheter sialoplasty: a safety and feasibility pilot study

      Abstract

      Obstructive sialoadenitis is the most common non-neoplastic disorder of the salivary glands. With advances in the use of diagnostic and interventional sialoendoscopy in the major salivary glands, operations can often be less invasive and treatment can spare the gland and restore normal function. By using an expandable balloon catheter to dilate ductal stenosis during sialoendoscopy it is possible to dilate a stenotic duct and remove large stones with or without a basket. However, the use of different angiocatheters or dedicated balloons is still empirical. In this pilot study we assessed the feasibility and safety of balloon dilatation of the submandibular gland (Wharton's duct). We did balloon catheter sialoplasty on four ducts from two fresh adult cadavers. We used a non-compliant dilating balloon catheter 6 mm in diameter at a pressure of 12 × 105 Pa for a total of three minutes and then examined the ducts histologically. There was no damage to the wall of Wharton's duct. Although this is a small study, we have shown the safety of balloon catheter sialoplasty for the first time as assessed histologically after dilatation of the duct. By virtue of the technique histological assessment is not possible after dilatation in patients. Long-term follow up is clearly required in this rapidly evolving area of surgery.

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