Dual Approach for Large Submandibular Calculi

Abstract

Sialolithiasis is the most common cause of inflammatory disease of large salivary glands and occurs in about 1.2 % of the population. It most often occurs in the submandibular gland (87 %); followed by the parotid gland -(10 %) and the sublingual gland -(3 %). The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal due to sialolithiasis. Sialoendoscopy is the method of choice with a high rate of success and gland preservation in small and medium stones. The combined transoral and endoscopic approach is indicated for large stones in the submandibular gland. In order to stabilise the duct and prevent the formation of a secondary stenosis, it is appropriate to insert a stent. Long term follow up shows that this dual approach surgery can be performed with a high rate of success.