Answers to common questions about sialendoscopy, salivary stones (sialolithiasis), gland swelling, and minimally invasive treatment at Sir Ganga Ram Hospital, Delhi. Last updated 12 June 2026.
Salivary glands (parotid, submandibular, and sublingual) produce saliva through narrow ducts. Salivary stones (sialoliths) are calcified deposits that block these ducts, causing meal-time swelling, pain, infection (sialadenitis), or pus discharge.
Sialendoscopy is a minimally invasive endoscopic procedure where a miniature scope is passed into the salivary duct to diagnose and treat stones, strictures, and mucus plugs—preserving the gland without facial scars.
Common sialolith symptoms include swelling under the jaw or in the cheek during meals, pain while eating or chewing, dry mouth on one side, foul taste, pus from the duct opening, and recurrent gland infections.
Sialendoscopy cost in India varies by case complexity, anesthesia type, and whether laser lithotripsy is needed. Dr Varun Rai's team provides a transparent estimate after clinical evaluation and imaging at Sir Ganga Ram Hospital.
For most ductal stones and strictures, sialendoscopy is preferred because it removes the obstruction while preserving gland function and avoiding facial scars. Gland removal (sialadenectomy) is reserved for failed endoscopic attempts or suspected tumors.
Dr Varun Rai, Senior Consultant ENT and Head-Neck Surgeon at Sir Ganga Ram Hospital, pioneered private-sector sialendoscopy in North India in 2015 and has performed over 2,000 successful procedures.
Meal-associated swelling usually indicates obstructive sialadenitis from a salivary duct stone, stricture, or mucus plug. Saliva backs up behind the blockage when you eat, stretching the gland and causing pain.
Yes. Most submandibular duct stones (Wharton's duct) and parotid duct stones (Stensen's duct) can be removed via sialendoscopy using micro-baskets, forceps, or laser lithotripsy—often as a same-day outpatient procedure.
Seek medical care for antibiotics if infected, stay hydrated, use warm compresses, and massage the gland. After the acute episode resolves, see an ENT specialist to identify and treat the underlying duct obstruction.
Dr Varun Rai consults at Sir Ganga Ram Hospital, Room F-77, First Floor, OPD Block (Old Building), New Delhi. OPD hours: Tuesday, Wednesday, Friday, and Saturday, 4 PM to 6 PM.
Salivary glands are glands located in and around the oral cavity which secrete saliva into the mouth to facilitate lubrication of the mouth during chewing and also partially digest the food. There are three pairs of major glands, the parotid, submandibular and the sublingual glands. They all secrete saliva of slightly different consistency into the oral cavity through narrow tubes called ducts. It is these ducts and their potential problems separate from the gland and our understanding which has revolutionised the treatment of glands and brought about the technique of Sialendoscopy.
There are three major salivary gland groups present on either side. These are the parotid, submandibular and the sublingual glands. The parotid glands are located in front of and below the ear. The submandibular glands are present just below the jaw bone on either side midway between the chin and angle of the jaw. The sublingual glands are small glands present completely in the oral cavity below the loose tissue under the tongue.
If you have a sharp pain and swelling in one or more glands then you probably have an infected gland which is called sialadenitis. This is usually thought to occur secondary to any obstruction in the ductal outflow of the affected gland. Primary treatment consists of antibiotics to resolve the infection, painkillers for the pain and hydration for good orodental hygiene. Any nearby tooth infection must also be shown to your nearest dentist. Once the attack has subsided we recommend all to visit your ENT doctor specialising in salivary gland disorders to rule out any mechanical cause of ductal obstruction which then is addressed to prevent any future attacks.
The cause of infection of the glands or sialadenitis is thought to be either ductal, glandular, systemic or due to infection spread from nearby sites. The various ductal causes can be stones, narrowing of ducts, kinks of the duct, polyps or generalised swelling of the duct leading to outflow obstruction. The glandular causes could be viral or bacterial in origin. There are various systemic conditions which can also cause swelling of one or more salivary glands. Some of them are dehydration, radiation therapy, syndromes which decrease the saliva production like Sjögren's syndrome or xerostomia. Dental infection can also preclude to salivary gland infection, particularly the submandibular glands.
Tips to prevent gland infection include: Adequate hydration, good orodental hygiene, avoid excessive dehydrating beverages like tea, coffee or soft drinks, and gland massage in case of chronic sluggish glands.
Stones are thought to form in salivary gland ducts usually due to stasis of secretions which over time organise to form small debris. This debris is allowed to remain in the duct for long, lead to progressive calcium deposition which over time lead to stone formation.
Sialendoscopy or salivary gland duct endoscopy is a novel way to tackle non-cancer conditions of the parotid and submandibular gland. It is based on the premise that gland infections are usually due to ductal outflow obstruction and on the removal of the duct obstruction the gland reverts back to normal. Sialendoscopes are miniature endoscopes of varying diameters ranging from below a millimetre to 4 mm to address all ductal sizes. Miniature instruments like forceps, baskets and dilators have also been devised to not just diagnose the ductal conditions but also treat it in the same sitting.