RESULTS
Of the 349 patients who underwent sialendoscopy from March 2017 to July 2019, 27 patients (35 glands) had type 2 stenosis of the Stensen duct. Among them, 13 patients (13 glands) underwent combined transoral sialodochoplasty and were finally enrolled. Patient ages ranged from 13–68 years (median 52 years), and there were seven males (54%) and six female patients (46%). All 13 patients presented with swelling of the affected salivary gland, which was accompanied by pain in one patient and discomfort in two patients. At 3 months post-operation, six (46.2%) patients reported no remaining symptoms (complete resolution), and seven (53.8%) patients reported partial improvement of symptoms (partial resolution). All of the patients were observed to have neo-papillae that became epithelized on the buccal mucosa. The size of neo-orifices decreased over time, but was patent as a neo-orifice during follow-up (Fig. 2). At 3 months post-operation, MR sialography was performed again to evaluate changes in the stenotic portion and accompanying megaduct (Fig. 3). Megaduct diameters between pre- and postoperative MR sialography significantly decreased after transoral sialodochoplasty (8.05 ± 2.675 vs. 4.15 ± 2.400, P = 0.028). In addition, we found that saliva excretion was improved after the combined sialodochoplasty, as the distal ducts were visualized with sialagogues postoperatively (Fig. 3). However, saliva stasis mostly remained in the dilated ducts, probably because the thin walls of the megaducts could not fully recover their contraction ability, even after the operation.