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Nemours Pediatric ENT Performs Minimally Invasive Procedure on South Florida Boy at Wolfson Children’s Hospital in Jacksonville, FL
Date:6/20/2013

Jacksonville, Florida (PRWEB) June 21, 2013

Nemours Children’s Clinic pediatric otolaryngologist Gary Josephson, MD, sees his share of unusual cases in his specialty. He has become an expert in performing a number of minimally invasive procedures for small children, including one to remove salivary gland stones.

Called a sialendoscopy, the procedure was first performed in Europe and only recently brought to the United States to just a few centers. The procedure is used in adults with salivary gland stones. These stones, while very small, can lead to neck swelling, mouth pain, and in the worst cases, neck infections.

Because of a child’s much smaller anatomy, removal of a tiny stone from a very small gland in the neck that drains your saliva through a tiny duct opening in the mouth is difficult. Before this minimally invasive procedure was available, a salivary gland stone in a young child would require removal of the entire gland through a one- to one-and-a-half inch incision in the neck that is near critical structures, such as the nerves that control the lips and tongue. The open surgical procedure, still performed at most children’s hospitals in the U.S., is more invasive, leaves a scar, requires a two-day hospital stay, and there is more recovery pain.

With the minimally invasive sialendoscopy procedure available at Wolfson Children’s Hospital, Dr. Josephson enters the duct and gland at the entrance in the floor of the mouth using a small a 0.8mm diagnostic scope with a very tiny camera. He then uses a slightly larger 1.1 mm scope with a working port which allows instruments that include a grasper used to grab the stone or another instrument to grind the stone into smaller pieces; the stone or fragments are then placed into a tiny metallic wire basket for removal, or once broken up are flushed out of the duct and gland. Very few surgeons in the country are experienced in this procedure, particularly i
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