Complete evaluation of salivary gland disorders

Common salivary gland symptoms and what they mean

• Swelling during meals: Often suggests obstruction from a sialolith or duct stenosis
• Persistent pain or tenderness: Can reflect infection (sialadenitis) or deep obstruction
• Dry mouth (xerostomia): Medication side effects, dehydration, or autoimmune disease
• Recurrent cheek or jaw swelling: Think parotid duct obstruction or submandibular blockage
• Lump or mass: Requires careful assessment to rule out tumours

Step 1 - History and examination

We document symptom timing, triggers, hydration, medications (anticholinergics, antihistamines), prior infections, dental issues, and autoimmune features (dry eyes, joint pain). Examination includes gland palpation, duct orifice inspection under the tongue/cheek, and glandular massage to assess saliva quality and flow.

Step 2 - First-line imaging: ultrasound

Ultrasound is quick, radiation-free, and excellent for detecting stones and ductal dilation. It also helps identify cysts (ranula), abscesses, or masses requiring further work-up. In experienced hands, ultrasound guides care on the first visit.

Step 3 - Cross-sectional imaging when needed

• CT scan: Best for calcified stones (tiny saliva crystals/parotid calcifications), mapping complex stones, and surgical planning (parotid duct stone CT when indicated).
• MRI / MR sialography: Superior for soft tissue, inflammation, autoimmune disease, and characterising masses.

Step 4 - Diagnostic sialendoscopy

If obstruction is suspected, sialendoscopy gives a definitive look inside the duct. We can remove stones, dilate stenosis, and irrigate debris in the same sitting. This avoids delays and often resolves the problem without open surgery.

Step 5 - Laboratory tests (when indicated)

Autoimmune panel (e.g., for suspected Sjögren's), inflammatory markers, cultures if pus is expressed, and baseline bloods for surgical planning.

Differential diagnosis: not every swelling is a stone

• Obstructive: Salivary stone, mucus plugs, submandibular duct calculus, sublingual duct stone
• Infective: Acute bacterial sialadenitis, viral parotitis (e.g., mumps)
• Autoimmune: Sjögren's syndrome and related disorders
• Neoplastic: Benign (pleomorphic adenoma, Warthin's) and malignant tumours
• Miscellaneous: Sialadenosis (non-inflammatory enlargement), cysts, ranula

Personalised treatment plan

After evaluation, we discuss options:

• Sialendoscopic removal of stones (with or without laser lithotripsy)
• Duct dilation and intraductal therapy for stenosis
• Interventional radiology assistance in complex cases
• Surgery when minimally invasive methods are not feasible
• Preventive strategies: hydration, saliva stimulation, oral hygiene, and targeted massage salivary gland techniques

Costs and access in New Delhi

We provide a clear plan and transparent estimate. Sialendoscopy cost in India varies with complexity; ultrasound is often performed in-house to speed diagnosis.

If you have persistent symptoms of a blocked salivary duct, book a comprehensive evaluation. Early, accurate diagnosis prevents complications and preserves gland function.