Long-term Study of Sialodochoplasty for Preventing Submandibular Sialolithiasis Recurrence

Abstract

ObjectivesThe transoral removal of stones by sialodochoplasty has been popularized in the treatment of submandibular sialolithiasis. However, the effectiveness of sialodochoplasty is controversial, and there are no reports on the long-term outcomes of this procedure. The purpose of this study was to assess the effectiveness and long-term outcomes of sialodochoplasty in patients with submandibular sialolithiasis.MethodsWe conducted a cross-sectional study that included retrospective chart reviews and prospective telephone or interview surveys of 150 patients treated for submandibular sialolithiasis from March 2001 to January 2008. The patients were treated with two different procedures by two different surgeons. One surgeon performed a transoral sialolithectomy without sialodochoplasty in 107 patients (SS group), and the other surgeon performed a transoral sialolithectomy with sialodochoplasty in 43 patients (SP group).ResultsThe success rate of transoral sialolithectomy was 98.1% in the SS group and 93% in the SP group. The recurrence rates of symptoms or stones were 1.9% and 4.7% in the SS and SP groups, respectively. The incidence of postoperative transient hypoesthesia was 13.1% in the SS group and 34.9% in the SP group. The mean operating times were 29.79 and 47.44 minutes in the SS and SP groups, respectively. The mean percentage of general anesthesia was 42.1% in the SS group and 83.7% in the SP group.ConclusionSialodochoplasty in addition to transoral sialolithectomy for submandibular sialolithiasis did not affect the rate of symptom or stone recurrence, but did increase the postoperative hypoesthesia incidence and general anesthesia percentage.

Factors affecting long‐term outcome of transoral surgery for submandibular stones: a follow‐up study of 125 patients

“…After removal of stones, sialodochotomy can be left without any suture, it can be closed with or without stent, or sialodochoplasty can be performed to prevent recurrence of symptoms or stone. It was reported that sialodochoplasty showed no significant effects on reducing symptom recurrence . Direct incision over the stone and leaving the duct without any suture were the preferred methods in this study.…”

“…It was reported that sialodochoplasty showed no significant effects on reducing symptom recurrence. 10,11 Direct incision over the stone and leaving the duct without any suture were the preferred methods in this study. In our experience, it is believed that minimal manipulation of duct would lead to best recovery of duct function.…”

Robot‐assisted sialolithotomy with sialendoscopy for the management of large submandibular gland stones

“…Sialendoscopy was used to identify any additional sialoliths, remaining stone fragments, or areas of ductal stenosis. Following sialendoscopy, Wharton's duct was not routinely stented nor was the sialolithotomy repaired …”

“…Following sialendoscopy, Wharton's duct was not routinely stented nor was the sialolithotomy repaired. 11,21,22 The English literature was reviewed for articles regarding CA, or any similar technique that used a combined sialendoscopic and transoral approach for the management of SMG stones following data collection from our cohort. The PubMed Central search was used to accomplish this portion of the study, using keywords that included: combined transoral sialolithotomy, combined approach technique, sialendoscopy, submandibular gland stone, and sialolithiasis.…”

Fístula extraoral asociada a sialolitiasis en el conducto de Wharton. Reporte de un caso

“…Marchal & Dulguerov (25) indican que otra técnica es combinar la sialolitectomía con una sialodocoplastía o marsupialización, realizando una incisión para extraer el sialolito, y suturar los bordes del conducto en los bordes de la herida lo cual permitiría el drenaje del conducto formando un nuevo orificio que funcione como baipás (en inglés bypass) del flujo salival. Se ha reportado que este tratamiento puede evitar la recurrencia de cálculos salivales, aunque en otros se menciona que la existencia de una sialolitectomía no depende de realizar una sialodocoplastía según Park et al (30). Kopec et al (19) apuntan que también se puede colocar un catéter o estent (del inglés stent) de pequeño calibre en el conducto salival para evitar su estenosis; aunque ésta es una práctica que está descrita principalmente para el tratamiento de cálculos en el conducto de Stensen de la glándula parótida.…”