Interventional Sialendoscopy with Endoscopic Sialolith Removal Without Fragmentation

Abstract

We performed a retrospective analysis to review the results and complications of sialendoscopy and to identify the overall success rate of mechanical stone retrieval without fragmentation in our patients with sialolithiasis. Between 2009 and 2011, 33 patients with sialolithiasis underwent interventional sialendoscopy. Patients with sialoliths larger than 7 mm in the Wharton's duct and 5 mm in the Stensen's duct or intraparenchymal stones were not included in this study. Grasping forceps, wire baskets and graspers was used for stone removal. The mean age at presentation was 41.7 (range, 29-62) years with a male to female ratio of approximately 1:2. The average size of the stones ranged from 2 to 6 mm. The overall success rate for endoscopic stone retrieval was 78 % (26 of 33) and three patients required a combined approach with intraoral incisions for stone removal. The major complication rate was 3 % (1 of 33) caused by submandibular duct perforation. The endoscopic retrieval of salivary stones is a safe and effective technique in selected cases. As instruments for stone fragmentation are expensive and not available everywhere, selecting patients with small and medium sized stones could lead to successful results in majority of cases.

Submandibular Sialolithiasis: A Series of Three Case Reports with Review of Literature

“…There are speculations regarding the endoscopic approach since a general consensus is yet to arrive on either the maximum diameter of the stones that could be removed without fragmentation or whether impacted or hard stones could be managed effectively by endoscopy alone. 19 The general indication for the approach is the combination of sialendoscopy with extra-corporeal lithotripsy (Storz SL1 Minilith) using Thullium laser (Revolix) for the fragmentation of Lithiases between the range of 4 and 8mm.…”

Sialolithiasis and submandibular gland excision: Report of cases

“…During surgery, it was possible to clinically observe the aspect of an atrophied gland. Many studies have been presenting the sialendoscopy as a new form of management of these calculi, [1,2,4,10] but this technique requires an specific equipment and exists a risk of stone fracture during manipulation and dissemination of the calcified material into the gland, increasing the chance of recurrence. [2] To sialoliths located on the two anterior thirds of the Wharton's duct or those whose are palpable by intraoral, they can be removed by a linear incision on the oral mucosa along the duct or by transoral CO 2 laser.…”

Surgical Management of an Anterior Submandibular Gland Sialolithiasis

“…The CO 2 laser enables bloodless surgery and a clear vision of the operating site. 24,25,26 Sialolithiasis is a common salivary gland disorder. It is easy to diagnose on the basis of its clinical features.…”