Sialendoscopy for Salivary Gland Stones Removal at University Hospital Rechts der Isar Munich

At the University Hospital Rechts der Isar, the removal of salivary stones has evolved from a traditional "open" surgery into a high-precision engineering feat. Within our department of oral and maxillofacial surgery, we approach the salivary duct system with the same anatomical rigor used in complex facial reconstructions. Led by specialists who bridge the gap between dentistry and medicine, our team utilizes sialendoscopy to navigate the intricate drainage pathways of the submandibular and parotid glands. This "inner-space" surgery allows us to treat chronic obstructive sialadenitis, the painful "mealtime syndrome", without external scarring or the risk of nerve damage associated with total gland removal. The surgical hallmark of our Maxillofacial approach is the use of semi-rigid ultramicro-endoscopes. These devices, often thinner than a needle (0. 8 mm to 1. 1 mm), are introduced directly through the natural ductal openings inside the mouth. Once inside, our surgeons utilize high-definition monitors to "fly" through the ductal branches, identifying not only stones (sialoliths) but also the structural narrowings (stenoses) that often cause recurrent infections. By using the mouth as a natural surgical corridor, we eliminate the need for skin incisions, preserving the aesthetic integrity of the face and protecting the nearby marginal mandibular nerve. For stones too large to be removed in one piece, our department uses interventional fragmentation. Using a specialized "micro-basket" or a laser fiber passed through the endoscope’s working channel, we can break the stone into smaller, manageable pieces. In complex cases where a stone is "impacted" deep within the gland, our maxillofacial surgeons may perform a "combined-approach" technique. This involves using the endoscope to illuminate the stone from the inside, allowing for a microscopic, targeted incision inside the mouth to release the blockage. This hybrid method ensures that even the most stubborn stones are removed while keeping the salivary gland fully functional and intact. The recovery process at Rechts der Isar is characterized by immediate functional restoration. Because the procedure is minimally invasive and performed via the oral cavity, post-operative swelling is typically minor and "internal. " Most patients experience an instant relief from the pressure and "colic" pain that previously accompanied eating. Our maxillofacial team provides a specialized ductal rehabilitation, including "sialagogues" (substances that stimulate saliva) and manual massage techniques to ensure the duct remains flushed and patent, preventing the formation of new calcifications. Our technical and clinical framework within the maxillofacial unit includes:Micro-Basket Extraction. Use of nitinol "Tipless" baskets to safely capture and retrieve stones without damaging the delicate ductal lining. 3D-Ultrasound Mapping. Pre-operative high-resolution imaging to determine the exact coordinates and depth of the stone within the gland. Laser Lithotripsy. Integrated Holmium-laser systems for the bloodless "shattering" of large salivary stones. Oral Medicine Synergy. Coordination with our dental specialists to address underlying oral hygiene or occlusal issues and prevent recurrence. Choosing the department of oral and maxillofacial surgery at University Hospital Rechts der Isar, Munich, for your sialendoscopy means opting for a team that views your face and mouth as a functional work of art. We combine the delicacy of micro-optics with the structural expertise of maxillofacial surgery to provide a scarless, organ-sparing solution. In the heart of Munich, we ensure that your salivary health is restored with academic precision and a focus on long-term comfort.