Department of Otorhinolaryngology - Head and Neck Surgery

UT Health Medical School

ORL Progress Notes

ORL Progress Notes, our second on-line departmental newsletter, provides information about developments in the Department. The newsletter’s target audience includes physicians and health care professionals as well as patients and members of the general public.

Sialendoscopy: An Innovative Minimally Invasive Approach to the Treatment of Sialolithiasis

When Vida Smith Compton first saw otorhinolaryngologist Sancak Yuksel, M.D., in late summer 2013, she had pain and swelling beneath the ventral surface of her tongue on the right side, and in her neck under the mandible.

“I looked like I had the mumps under my right jaw, and I could hardly swallow,” says the 67-year-old Wharton, Texas, resident, who has a history of blocked salivary gland ducts going back to her teenage years. “Years ago, my ENT showed me how to manipulate the glands to release trapped saliva. But this time I was sore from my right ear all the way down to the middle of my chin, and it was too painful to touch.”
A CT scan revealed three large sialoliths – calcified masses also known as salivary stones – in the submandibular gland, the most common location. Sialoliths are found less commonly in the parotid gland, and rarely in the sublingual gland or minor salivary glands.

SY by-line“We suspect sialolithiasis if swelling occurs when salivary flow is stimulated by the sight, smell or taste of food,” says Dr. Yuksel, an assistant professor in the department of Otorhinolaryngology—Head and Neck Surgery at UTHealth Medical School. “If we’re lucky, we can see the swollen gland or locate the stones by palpating around the orifice of the gland duct or in the floor of the mouth. Otherwise, we rely on a CT scan to reveal density in the gland.”

The traditional method of treating sialolithiasis unresponsive to conservative management has been surgical excision of either the stone or the involved gland. Compton, however, was the beneficiary of a relatively new procedure called sialendoscopy. Used both diagnostically and therapeutically, sialendoscopy is a technically challenging procedure that allows endoscopic visualization of the gland and nonsurgical removal of stones small enough to fit through the duct, usually 5 millimeters or less in diameter.

Dr. Yuksel took Compton to the OR in October 2013. Using a very fine 1.1-millimeter endoscope equipped with a wire basket, he visualized the three stones, which ranged in size from 8 to 12 millimeters in diameter. “The stones were situated back to back like train cars and were so large that they were beyond the grasp of the basket,” he says. “I was able to maneuver the endoscope behind the farthest stone and use the basket to pull all three stones to the orifice of the duct.”

Sialendoscopy REV

After making a tiny nick in the orifice, Dr. Yuksel removed all three sialoliths successfully. He re-scoped to check for smaller stones, cleaned the entire duct system of debris and sutured a tiny piece of plastic tubing in place as a stent to hold the orifice open. “The beauty of sialendoscopy is being able to provide patients relief with no external scar, no nerve damage and a lower risk of surgery-related complications,” he says.
Compton, who healed quickly, believes her salivary stones may have been caused by dehydration. Other causes may include abnormalities in calcium metabolism, reduced salivary flow rate, altered acidity of saliva caused by oropharyngeal infections and receiving radioactive iodine.

“I think Dr. Yuksel was shocked when he saw how big my stones were,” says Compton, who says that bad situations bring out her sense of humor. “Personally, I think he’s a really, really good doctor and a very thorough surgeon. I feel truly blessed to have been referred to him for a problem that came up in a matter of days. After the surgery, I told him I wanted the stones back so I could make a necklace. They’re mine, after all. I made them.”

UT ORL Progress Notes Archives

  1. A Gift of Hearing
  2. Breath of Fresh Air
  3. Current Pediatric Guidelines for Tonsillectomy
  4. Profile in Caring: José Elías, RN, CORLN
  5. Amber Luong, MD, PhD, Awarded CCTS Grant in Support of Continued Chronic Rhinosinusitis Investigations
  6. Two ORL Faculty Members Named to Top Doctor Lists
  7. Sialendoscopy: An Innovative Minimally Invasive Approach to the Treatment of Sialolithiasis
  8. Physicians’ Mission Satisfied
  9. A Second Pair of Ears
  10. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  11. More Than 100 People Participate in UTHealth Otorhinolaryngology’s Annual Free Cancer Screening Clinic
  12. Etan Weinstock, MD, Selected Faculty Member of the Year
  13. Amber Luong, MD, PhD, Named Fellow of American College of Surgeons and Promoted to Associate Professor
  14. Memorial Hermann and UTHealth Welcome New Team Members
  15. Texas Hill Country ENT Symposium Recap
  16. Internationally Renowned Expert in Facial Cosmetic Surgery Speaks at 2014 ORL Frontiers
  17. Congratulations to Graduating Residents and Fellows
  18. Samer Fakhri, MD, Chairs Rhinology Program at Middle East Conference in Dubai, Serves as Invited Faculty in Tehran
  19. TORS-L: Transoral Robotic Surgery with CO2 Laser Offers Greater Precision for Surgeons and De-intensification of Adjuvant Therapies for Patients
  20. Reevaluating Anaplastic Thyroid Cancer: Aggressive Treatment May Extend Life and Improve Its Quality
  21. UTHealth Audiology Offers Widex Zen Therapy for Tinnitus Management
  22. MicroSeismic, Inc. Gives Pediatric Patients the Gift of Hearing
  23. In Memoriam: Robert Jahrsdoerfer, MD
  24. Simultaneous Bilateral Cochlear Implants in an Infant After Meningitis
  25. Laryngotracheal Reconstruction Using Anterior Cricoid Suspension in a Three Year Old
  26. Single-Incision Minimally Invasive Parathyroidectomy
  27. Advanced Technology and a Strong Focus on Convenience Improve the Patient Experience
  28. Multidisciplinary Virtual Pre-surgical Planning Optimizes the Outcome for an Ameloblastoma Patient
  29. Dr. Fakhri Receives Regents’ Outstanding Teaching Award
  30. IL-33-responsive Innate Lymphoid Cells Are an Important Source of IL-13 in Chronic Rhinosinusitis with Nasal Polyps
  31. Randomized, Double-Blind, Controlled Trial of Oral Antifungal for the Treatment of Fungal-sensitive Chronic Rhinosinusitis with Nasal Polyps
  32. Dr. Fakhri Promoted to Professor of Otolaryngology-Head and Neck Surgery
  33. TLR4 Signaling in the Pathophysiology of Allergic Fungal Rhinosinusitis
  34. Two ORL Faculty Members Named to Texas Super Doctors 2013 List
  35. Transoral Robotic Surgery for the Treatment of Obstructive Sleep Apnea
  36. Lone Star Rhinology Course Attracts a National Audience
  37. Internationally Renowned Otolaryngologist Speaks at 2013 ORL Frontiers
  38. ORL Welcomes New Recruits
  39. UTHealth Otorhinolaryngology Holds Free Cancer Screening Clinic
  40. Two ORL Team Members Named Fellows of the American College of Surgeons
  41. Faculty Named Among Texas Super Doctors Rising Stars
  42. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  43. Translational Science Program Working to Identify Therapeutic Targets in Chronic Rhinosinusitis
  44. Preventing Surgical Fires: UTHealth Otolaryngologist Provides Expert Advice for a New FDA Safety Initiative
  45. Improving Survivorship in Head and Neck Cancer: UTHealth Department of Otorhinolaryngology and Institute of Molecular Medicine Partner on CPRIT Research Award
  46. Using Intraoperative Staining to Identify the Parathyroid Adenoma
  47. Otorhinolaryngologists Named to 2012 Best Doctors in America List
  48. Four Studies Evaluate the Effectiveness of Optical Rhinometry
  49. A Collaborative Approach Offers Patients a Less Invasive Alternative for Surgical Excision of Pituitary Tumors
  50. Internationally Renowned Otolaryngologist Speaks at 2012 ORL Frontiers
  51. Ron Karni, MD, Selected Faculty Member of the Year by Graduating Residents
  52. Samer Fakhri, M.D., Receives AAO Foundation Honor Award
  53. Two Audiologists Join UTHealth Otorhinolaryngology
  54. 2012 Residency and Fellowship Update
  55. Five UTHealth Medical Students Matched to Top Choice Otorhinolaryngology Residency Programs
  56. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  57. Chair of Otorhinolaryngology Named to Texas Super Doctors 2012 List
  58. Minimally Invasive Surgery for Skull Base Cancer
  59. UTHealth/Memorial Hermann Physician Joins a Medical Mission to Honduras
  60. Online Patient Access Library Offers Medical Information About ENT Diseases & Conditions to Patients
  61. Facial Reanimation Surgery Brightens a Young Boy’s Future
  62. Morphoproteomics: Driving a Shift to Personalized Care for Sinonasal Undifferentiated Carcinoma
  63. Internationally Renowned Otolaryngologist to Speak at 2012 ORL Frontiers
  64. UTHealth Otorhinolaryngology Department Exceeds the National Averages in Quality and Safety
  65. Rhinologist Invited to Serve as Board Examiner in the Middle East
  66. Dr. Citardi Named to the 2011 Texas Super Doctors List
  67. Make Your Voice Count!
  68. Research Update
  69. Advanced Rhinology Concepts CME Attracts a National and International Audience of Otolaryngologists
  70. Outside the Box with Chronic Rhinosinusitis
  71. The Vargas Case: Excision of a Large Benign Goiter
  72. The Reverend Williams Regains His Voice
  73. Nihal Uddin’s Journey to 360-Degree Hearing
  74. Residents Receive Research Grants
  75. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  76. Otorhinolaryngologists Named to Best Doctors in America List
  77. Russell Kridel, MD, Reelected to AMA Council Position
  78. From Bench to Bedside: Physician Researcher Amber Luong, MD, PhD Blends Basic Science with Clinical Care
  79. 2011 Advanced Rhinology Concepts Scheduled for November
  80. Internationally Renowned Otolaryngologist Speaks at 2011 ORL Frontiers
  81. Michael Byrd, MD Recruited to UTHealth and Memorial Hermann
  82. UT Physicians Opens Facial Plastic Surgery Clinic in Southwest Houston
  83. UTHealth Audiology Program Expands
  84. 9 UTHealth Medical Students Match in Otorhinolaryngology
  85. Residency and Fellowship Update
  86. Ron Karni, MD Invited to Speak in Panama
  87. Finding the Unknown Primary in Head & Neck Cancer
  88. A Meta-Analysis of Topical Amphotericin B for the Treatment of Chronic Rhinosinusitis
  89. Cytokine Profile Comparison Between Inflamed Sinus Mucosa and Sinonasal Polyps from Chronic Rhinosinusitis
  90. The Distribution of Normal Saline Delivered by Large-Particle Nasal Nebulizer versus Large-Volume/Low-Pressure Squeeze Bottle
  91. Averting the "Limping Larynx" with a Multidisciplinary Approach
  92. Repair of Nasal Obstruction with Functional Septorhinoplasty
  93. Definitive Endoscopic Resection of Inverted Papilloma
  94. Facial Reanimation and Facelift for Facial Paralysis
  95. Mometasone Furoate Gel: A Novel In-Office Treatment of Recalcitrant Postoperative Chronic Rhinosinusitis
  96. Rhinologic Applications of Radiofrequency Coblation
  97. Rhinoplasty for Nasal Obstruction
  98. Producing Quality Outcomes in Thyroid Surgery
  99. Functional Rhinoplasty: Repairing Nasal Valve Obstruction
  100. A Cancer Patient Regains His Voice
  101. Soham Roy, M.D., Named Director of Pediatric Otorhinolaryngology
  102. From Bench to Bedside with New Treatments for Chronic Sinus Disease
  103. Comprehensive Rhinology Program Offers State-of-the-Art Care for Patients with Chronic Rhinosinusitis Refractory to Standard Treatments
  104. Rhinology Update: Advanced Rhinology Concepts CME Scheduled for November
  105. The Comprehensive Voice Program: From Advanced Office-Based Procedures to Community Outreach
  106. Designing the Future: ORL’s New Office Space Features High-Tech Tools
  107. Welcome!

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ORL Update UT ORL Update, our first on-line departmental newsletter, summarizes current topics in otorhinolaryngology. The newsletter’s target audience includes both physicians and other healthcare providers, although subscriptions are not limited to members of these groups.

ORL Progress Notes ORL Progress Notes, our second on-line departmental newsletter, provides information about developments in the Department. The newsletter’s target audience includes physicians and healthcare professionals as well as patients and members of the general public.

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