Salivary gland surgery · UK
Sialendoscopy, the gland-preserving alternative.
A day-case endoscopic treatment for salivary duct stones and strictures. A fine fibre-optic scope, a laser and a basket, no external incision, and the gland stays. In specialist ENT and maxillofacial units, London-wide.
Why patients choose us
- 01
A named salivary endoscopist, not a general ENT list
A consultant who does sialendoscopy weekly, in a unit with the 1.1 to 1.6 mm scopes, holmium and diode lasers and a Dormia basket rack ready.
- 02
The right technique for the stone
Not every stone comes out through the scope alone. We match small mobile stones to basket extraction, larger stones to lithotripsy, and impacted intraglandular stones to a combined or open approach.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private sialendoscopy costs in the UK.
Indicative ranges across our partner ENT and maxillofacial units. Send the ultrasound report and we quote firm figures.
In short
A private sialendoscopy in our network: £3,500 to £9,500, home the same day.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Diagnostic sialendoscopy (one gland) | £3,500 to £5,000 | 30 to 45 min | Same visit |
| Therapeutic sialendoscopy with basket extraction | £4,500 to £6,500 | 45 to 60 min | Same visit |
| Sialendoscopy with laser lithotripsy (holmium or diode) | £5,500 to £8,500 | 60 to 90 min | Same visit |
| Combined endoscopic and intra-oral stone removal | £6,500 to £9,500 | 75 to 120 min | Same visit |
| Balloon dilation of duct stricture | £4,000 to £6,000 | 45 to 60 min | Same visit |
| Second-opinion review of ultrasound and sialogram | £250 to £450 | 30 min | 48 hours |
Prices vary by unit, by which consultant does the case, by whether laser lithotripsy is used, and by whether a stent or combined intra-oral extraction is needed. We come back with a firm quote within one working day.
The journey
From ultrasound to gland preservation, what happens, in order.
One team from first message to the 6-week follow-up.
- 01
Before
You send us the ultrasound or scan
A short confidential form. Which gland, how many stones, size in millimetres, and any previous drainage or antibiotics.
- 02
Before
We come back with a recommendation
Within one working day: whether sialendoscopy alone will clear it, whether a combined intra-oral approach or laser lithotripsy is needed, or whether the gland is too damaged to save.
- 03
Before
We arrange the procedure
Usually within one to two weeks. LA plus sedation for simple duct work, GA for complex or bilateral cases. Antibiotics reviewed.
- 04
On the day
Arrival at the day-surgery unit
Consent and a chat with the surgeon and anaesthetist. The duct papilla is identified, dilated with lacrimal probes and the scope is introduced.
- 05
On the day
The sialendoscopy itself
30 to 60 minutes per gland. Duct irrigation, stone visualisation, Dormia basket extraction, holmium or diode laser lithotripsy for larger stones, balloon dilation of strictures.
- 06
On the day
Home the same day
A short recovery, written aftercare and home within a few hours. A soft duct stent is sometimes left for 2 to 4 weeks.
- 07
After
Follow-up and gland preservation
Sialagogues, gland massage, warm compresses. Review at 4 to 6 weeks with repeat ultrasound if needed.
When it helps
When sialendoscopy is the right step.
Meal-related gland swelling, palpable duct stones, recurrent gland infection and inflammatory strictures. Assessment usually starts with ultrasound of the salivary gland with duct evaluation, an XR for radio-opaque stones, sialography or CT / MRI sialogram if the anatomy is complex, and blood tests to exclude Sjogren\'s and IgG4 disease.
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Sialolithiasis, Wharton's duct (submandibular)
About 80% of salivary stones sit in the submandibular duct. Recurrent post-meal swelling and pain, sometimes with a palpable stone in the floor of mouth.
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Sialolithiasis, Stensen's duct (parotid)
About 20% of stones are parotid. Meal-related cheek swelling, sometimes with a thin discharge at the intra-oral papilla opposite the upper second molar.
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Chronic obstructive sialadenitis
Recurrent gland infection without a visible stone, driven by duct stenosis, kinks or inspissated mucous plugs.
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Inflammatory or post-radiotherapy strictures
Duct narrowing after infection, trauma or head-and-neck radiotherapy. Balloon dilation and short-term stenting.
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Recurrent juvenile parotitis
Repeated childhood parotid swelling. Duct irrigation and steroid instillation at sialendoscopy reduces attack frequency.
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Sjogren's or IgG4-related sialadenitis
Diagnostic sialendoscopy with duct washout can settle symptoms and confirm the pattern of chronic ductal change.
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Diagnostic sialendoscopy
When ultrasound and sialogram cannot explain recurrent swelling, direct duct inspection maps stones, plugs and strictures in one sitting.
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Red flag: firm painless lump
A firm painless salivary lump, facial-nerve weakness or a fixed mass needs an urgent head-and-neck cancer pathway, not a private booking.
Procedure options
Sialendoscopy is a family of techniques.
What each option involves, and which fits which stone or stricture. Open sialadenectomy is reserved for cases where endoscopic salvage genuinely cannot work.
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Diagnostic sialendoscopy
A 1.1 to 1.6 mm fibre-optic scope with an irrigation channel is passed through the natural duct opening. Maps stones, plugs and strictures without any external incision.
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Dormia basket extraction
For mobile stones under 4 to 5 mm the surgeon threads a wire basket past the stone, opens it, snares the stone and withdraws it whole through the papilla.
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Holmium or diode laser lithotripsy
Stones from 5 to 10 mm are fragmented in the duct with a fine laser fibre. Fragments are then flushed out or lifted with the basket. Gland preserving.
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Balloon duct dilation
A small angioplasty balloon opens inflammatory or radiation-related strictures. A soft silicone stent may be left for 2 to 4 weeks to hold the lumen open.
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Combined endoscopic and intra-oral
For large or hilar submandibular stones the surgeon uses the scope to locate the stone, then makes a small intra-oral cut over it, extracts it, and repairs the duct.
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Interventional sialogram
A fluoroscopic road-map used alongside the scope for complex parotid duct anatomy, especially after previous surgery.
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Open sialadenectomy (avoid where possible)
Formal submandibular gland excision or superficial parotidectomy. Definitive, but sacrifices the gland and carries facial-nerve or marginal-mandibular nerve risk. Reserved for failed endoscopic salvage.
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Second-opinion review
A specialist review of your ultrasound, sialogram and any prior operation note. Sometimes the answer is medical management, not another procedure.
Our vetted UK network
A small panel of salivary gland surgeons.
Consultant ENT and maxillofacial surgeons with dedicated sialendoscopy training, based at Guy\'s and St Thomas\', King\'s College Hospital, HCA The Portland, the Royal National Throat Nose and Ear and other London and regional centres.
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Consultant ENT or maxillofacial surgeons with dedicated sialendoscopy training
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BAO-HNS, BAOMS or BAHNO registered, with regular salivary gland case volumes
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Full endoscopic kit on site: 1.1 and 1.6 mm scopes, holmium and diode lasers, baskets and balloons
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Combined intra-oral and open sialadenectomy pathway available if endoscopic salvage fails
Safety and recovery
What to expect afterwards, honestly.
Sialendoscopy is well established. The things worth planning are the anaesthetic, a day or two of gland swelling, and realistic expectations about stone size and success rates.
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Sedation or general anaesthetic
Simple duct work is done under LA plus sedation. Bilateral cases, laser lithotripsy or a combined intra-oral approach are usually under a light GA.
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Duct perforation is uncommon
Around 1 to 2%. Recognised at the procedure and managed with a soft stent for a few weeks. Rarely needs open repair.
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Post-procedure gland swelling
A day or two of gland swelling from irrigation fluid is normal. Warm compresses, sialagogues and simple analgesia settle it.
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Ranula or lingual nerve irritation
Very occasional after intra-oral submandibular stone removal. Usually settles; a small proportion need further review.
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Stricture recurrence
Some inflammatory strictures re-narrow. A short course of stent placement or repeat balloon dilation is the usual fix.
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Antibiotics only when needed
Prophylactic antibiotics are not routine. A short course is given for active infection or after prolonged instrumentation.
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Realistic success rates
85 to 95% clearance for stones under 5 mm, 75 to 85% for stones 5 to 10 mm, lower for larger or deeply intraglandular stones which may need a combined or open approach.
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Gland preservation
The main win: symptom relief without losing the gland or risking the facial or marginal-mandibular nerve, which open sialadenectomy would.
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Red flags after discharge
Severe swelling with fever, pus at the papilla, facial-nerve weakness or airway compromise: call the unit or attend A and E the same day.
FAQs
The questions patients ask us.
Straight answers, in plain English.
What is sialendoscopy?
Sialendoscopy is a minimally invasive endoscopic procedure that uses a very fine 1.1 to 1.6 mm fibre-optic scope, passed through the natural opening of the salivary duct, to diagnose and treat obstructive salivary gland disease. It can remove stones, dilate strictures and washout inflamed ducts without any external skin incision, preserving the gland.
Is sialendoscopy better than removing the gland?
For most stones and strictures, yes. Open sialadenectomy (submandibular gland excision or superficial parotidectomy) is definitive but sacrifices the gland and carries a real risk of facial-nerve or marginal-mandibular nerve injury. Sialendoscopy preserves the gland and its function, and is now first line for most obstructive salivary disease before surgeons consider gland removal.
How much does private sialendoscopy cost in the UK?
Diagnostic sialendoscopy per gland is around £3,500 to £5,000. Therapeutic sialendoscopy with basket extraction runs £4,500 to £6,500, and with holmium or diode laser lithotripsy £5,500 to £8,500. Complex combined endoscopic and intra-oral extraction is £6,500 to £9,500. We confirm a firm quote within one working day.
Will the procedure be painful?
Simple duct work under local anaesthetic and sedation feels like pressure rather than pain. Laser lithotripsy, bilateral or combined procedures are usually done under a short general anaesthetic. Mild gland swelling and discomfort for a day or two afterwards is normal and settles with warm compresses and simple analgesia.
What are the success rates for stone removal?
For stones under 5 mm, clearance rates are 85 to 95%. For stones 5 to 10 mm, 75 to 85%. Stones over 10 mm, or those sitting deep inside the gland substance, often need a combined endoscopic and intra-oral approach, and a small minority still need open gland removal. Even where clearance is partial, sialendoscopy usually improves symptoms.
Where is private sialendoscopy done in London?
Salivary endoscopy is offered at specialist ENT and head-and-neck units including Guy's and St Thomas' Private Head and Neck, King's College Hospital Private, HCA The Portland Hospital ENT and the Royal National Throat Nose and Ear Private, as well as maxillofacial and ENT consultants elsewhere with dedicated sialendoscopy training. NHS services are available at the same tertiary centres.
Ready to save the gland?
Send us the ultrasound. We come back with a plan.
A named consultant, an indicative price, and an honest read on whether sialendoscopy alone will fix this or whether you need a combined approach.