NGage nitinol stone extractor. Photo courtesy of Cook Medical Inc.

Bloomington, Ind.-based Cook Medical Inc. has introduced a suite of salivary duct access products that offer minimally invasive options for the treatment of obstructive salivary gland disease. Minimally invasive treatment of obstructive salivary gland disease can reduce the need for invasive open surgery, according to an article published in a German medical journal last year.

The devices in the product line include a soft-tip wire guide, a serial dilator set, the Kolenda Salivary Access Introducer Set and the NGage and NCircle salivary stone extractors.Physicians use these products in sialendoscopy, a minimally invasive procedure for visualizing and treating obstructive salivary gland disorders through the salivary ducts.Sialendoscopy can be performed in the physician’s office in an outpatient procedure and has been shown to reduce the risks of facial nerve paralysis and morbidity.

The salivary duct access products are available to doctors internationally and are among the new minimally invasive devices that Cook Medical has launched as part of its new Otolaryngology—Head and Neck Surgery (OHNS) clinical division. Initially, Cook Medical OHNS will focus on products that are used to treat salivary gland disease, chronic sinusitis, vocal cord paralysis and obstructive sleep apnea, as well as products used for soft-tissue repair and in interventional airway and esophageal procedures.

The most prevalent obstructive salivary gland disease is obstruction by salivary duct stones. Salivary duct stones account for approximately 50 percent of major salivary gland diseases. Obstruction by salivary duct stones is known as sialolithiasis and affects men (generally, middle-aged males) twice as often as women. If sialolithiasis is not treated, the obstructed area can become infected.

Cook Medical’s new salivary duct access tools are designed to create a working channel through which physicians can treat obstructive salivary gland disease. The soft-tip wire guide is used to access the salivary duct through the duct opening and maintain ductal access throughout the procedure. Flexible serial dilators are introduced over the wire to expand the opening and prepare the salivary duct for the introduction of procedural instruments. The Kolenda introducer sheath is passed over the wire to create an open working channel into the salivary duct. The sheath serves to protect the ductal wall and allow for easy insertion and removal of the procedural instruments.

The stone extractors, including the NGage and the NCircle, have baskets that are made of nitinol shape-memory wire, which allows the baskets to retain their shape following torsion. The baskets are used to manipulate and remove salivary stones.

Cook Medical makes medical devices, biologic grafts and cell therapies across a range of applications.