For years, Tina Truglio, 32, dealt with constant pain and infections in her salivary glands. Misdiagnosed for almost 10 years, the Arizona resident finally found herself back on her native Long Island to find a resolution.
After an initial CT scan showed three stones in Truglio’s right salivary gland, a condition that affects only about .5 to 1 percent of the population, she began researching treatment options.
“For the last year there was a stone that I could feel every day with my tongue, it was like an intruder that you could not get out no matter how hard you tried,” she said.
Ultimately, Truglio, who is originally from Farmingville, decided to pursue a treatment plan with Stony Brook University Hospital, one of the highest volume centers for salivary endoscopy in the country.
Stony Brook handles about 70 to 80 cases per year, according to Dr. Mark Marzouk, an assistant professor of surgery in the Division of Otolaryngology-Head and Neck Surgery with Stony Brook University Hospital.
Currently, Marzouk is one of only a few surgeons doing the procedure in the country.
“We have had people from across the U.S. come to Stony Brook for this procedure,” Marzouk said.
Minimally invasive, he explained that the procedure uses a camera and basket, inserted through the natural opening of the gland, to successfully retrieve the stones. “While having the picture on a monitor, we can navigate through that natural duct where the saliva gets transmitted to the mouth.”
Marzouk said the procedure is fairly straightforward, but having additional stones, as Truglio did, can complicate it. “The stone removal is a tedious procedure, so having multiple stones like in Tina’s case requires a higher level of expertise.”
The size of the stones can also complicate the operation, he said, which was a concern in Truglio's case but in the end was not an issue.
“If they were not able to harvest the stone using the scoping tool, Dr. Marzouk would have had to make a small incision by my right ear and go in that way to harvest the stone, which is very risky due to all of the facial nerves in that area,” Truglio said.
Truglio’s procedure went smoothly, without any complications, Marzouk said.
Common symptoms of the stones can include pain and discomfort around the ear or under the jaw, experiencing swelling with eating, and frequent infections of the salivary gland. Occasionally, as was the case with Truglio, the stones can even be felt from inside the mouth.
"If they are big enough, you can feel a small lump in the neck or under the tongue ... and that requires immediate attention -- the lump could also mean something else like cancer, so it is best to be seen by a physician," said Marzouk.
Typically about 5 percent of salivary stone patients will have a recurrence, he said, though he doesn't expect that of Truglio.
Truglio, who now lives in Arizona, is happy to be free of what she refers to as “stone sick.”
“After nine years of ENT specialists telling me they have no option other than antibiotics to kill the infections ... this resolution is like a miracle for me.”