UAMS First in Arkansas to Remove Salivary Stones Endoscopically

By Spencer Watson

The procedure, known as sialoendoscopy, began more than a decade ago in Europe and has slowly made its way into the states. Emre Vural, M.D., a professor in the Department of Otolaryngology – Head and Neck Surgery in the UAMS College of Medicine, is the first doctor in Arkansas to offer the procedure for removal of obstructions in the salivary gland.

Sialoendoscopy uses microscopic scopes and tools to remove stones in the salivary glands and address other disorders in the form of kinks, strictures, thick secretions and mucus plugs. Salivary gland disorders affect about one in every 10,000 people. Most obstructions occur in the parotid gland, located in front of each ear, or the submandibular gland, located under the jaw bone on each side.

“This procedure allows us to preserve the gland and help the patient avoid an invasive, time-consuming surgery that carries a higher risk of complications,” said Vural. “We are trying to move away from the older techniques, which often prove to be inadequate. This new procedure puts UAMS at the forefront of salivary gland disorder treatment.”

Traditionally, salivary gland disorders are treated with conservative approaches, including warm compresses, the increase of salivary flow, antibiotics and anti-inflammatory medicine. If those approaches do not work, surgery to remove the affected gland is considered.

“Removing the major glands may not affect the future production of saliva, however, the surgery can result in nerve damage as the invasive procedure requires surgeons to negotiate nerves and its branches,” said Vural. 

Nerve-damage symptoms, depending on which gland is being removed, include the inability to move the eyebrow, eyelid, cheek or lips, in addition to the inability to move or sense the tongue. These symptoms can also be seen in sialodochotomy, a procedure that removes stones while preserving the gland by directly cutting into the ducts inside the mouth.

“Sialoendoscopy helps surgeons avoid these nerve-damage issues,” said Vural. “The tiny scopes, which measure between .8 mm and 1.6 mm can be introduced through the opening points of the out-flow ducts of the major salivary glands. By dilating the openings, we can see the problem and address it without performing an invasive surgery.”



UAMS is the state's only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute and Institute for Digital Health & Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS' clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,275 students, 890 medical residents and fellows, and five dental residents. It is the state's largest public employer with more than 12,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children's, the VA Medical Center and Baptist Health. Visit or Find us on Facebook, X (formerly Twitter), YouTube or Instagram.