Sialendoscopy: towards organ preservation surgery

This article reviews the clinical evolution and therapeutic efficacy of sialendoscopy as a minimally invasive technique shifting the paradigm toward organ preservation surgery in the management of obstructive salivary gland diseases. Historically, recurrent sialadenitis caused by sialolithiasis or ductal strictures frequently necessitated complete sialadenectomy, exposing patients to significant morbidities such as facial nerve injury, Frey's syndrome, and permanent xerostomia. The advent of interventional sialendoscopy allows for direct visualization, diagnostic accuracy, and immediate micro-instrumental intervention within the salivary ductal system. By utilizing specialized baskets, micro-forceps, and laser lithotripsy, this technique successfully removes obstructions while preserving the structural and functional integrity of the major salivary glands. This paper analyzes the success rates, patient satisfaction, and complication profiles of gland-preserving protocols, demonstrating that sialendoscopy serves as a highly effective, gland-sparing primary intervention that drastically reduces the need for radical organ extirpation.