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UNC Salivary Disorders

The body has 6 major salivary glands (paired parotid, submandibular and sublingual glands), which supply a mixture of viscous and aqueous saliva to aid in dental health, taste and food di-gestion. These salivary glands are prone to tumors (benign and malignant), inflammation and functional obstruction resulting in pain, facial swelling, infections, and loss of saliva production – the latter of which can impact taste, dental health and diet. In addition, surgical therapy for these glands often place major delicate cranial nerves at risk, which control tongue taste/sensa-tion and hemi-facial motion. Therefore, treatment of salivary gland disorders can be complex, and requires skill to reduce patient morbidity from the disease and therapy alike.

The UNC Department of Otolaryngology offers the only Comprehensive Salivary Disorders Treatment Center in North Carolina. Dr. Trevor Hackman leads this program, which treats:

  • Benign and malignant salivary neoplasms
  • Autoimmune disorders such as Sjogrens
  • Sialadenitis – Infectious/Inflammatory
  • Radioactive iodine-induced salivary gland damage – thyroid cancer therapy
  • Sialorrhea (drooling)
  • Salivary obstruction – Strictures, Stones, Sialectasia
  • Ranula excision – transoral and external

While UNC performs a high volume of traditional salivary gland surgery (parotidectomy, sublin-gual gland resection and submandibular gland resection), for neoplasms, Dr. Trevor Hackman also offers minimally invasive outpatient drainless parotidectomy, and a high volume minimally invasive salivary practice both in the operating room and the office – including sialendoscopy, sialolithotomy and botox therapy.

What is Sialendoscopy?

Sialendoscopy – a minimally invasive endoscopic procedure for diagnosis and treatment of ob-structive and inflammatory salivary gland disorders. The procedure involves stretching (dilation) of the natural open (punctum) of the duct to the mouth. After punctal dilation, the endoscope is introduced into the duct and navigated towards the hilum of the gland under a salt water irriga-tion. In the office setting, a topical lidocaine solution is infused through the endoscope to pro-vide local anesthesia.

For diagnostic procedures, the smaller 0.8 mm endoscope is used with irrigation – picture

In cases of debris, stones or strictures. the larger endoscopes with a “working channel” are uti-lized for placement of guidewires, wire baskets, graspers and/or balloon dilators. – picture

Dr. Trevor Hackman has performed more than 300 minimally invasive salivary procedures (over 150 in the office), and continues to offer this service in the operating room and the UNC Proce-dure Clinic.