Sialolithiasis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Overview

Many cases of sialolithiasis may not be cured by using medical therapy alone; invasive, or open surgery methods can be used for the salivary gland stones. Most common used methods are sialoendoscopy, laser lithotripsy, and stone removal with wire basket. If all of above methods fails, open surgical intervention should be used.

Surgery

Minimally invasive management

Sialoendoscopy^[1]

Sialoendoscopy can be used in the diagnosis of small stones, and differentiate them from polyps.

In the case of no response to medical management, sialoendoscopy can be done. The treatment result using sialoendoscopy, mostly depends on the size of the stone.

Laser lithotripsy^[2]

Can be used before sialoendoscopy in order to fragment salivary stones.

Stone removal with wire basket^[3]

Removal of stones using a wire basket extractor under fluoroscopic guidance

Surgical intervention

If all of above methods fails, surgical intervention can be used.^[4]

For the submandibular stones, a transoral approach can be used.
In some proximal submandibular stones, a combination of sialoendoscopic and open intraoral techniques, may be used.
For parotid stones, if sialoendoscopy did not worked, open surgery should be done.

Videos

Laser lithotripsy:

Sialendoscopic salivary gland stone lithotripsy and removal:

References

↑ Gallo A, Benazzo M, Capaccio P, De Campora L, De Vincentiis M, Fusconi M, Martellucci S, Paludetti G, Pasquini E, Puxeddu R, Speciale R (2015). “Sialoendoscopy: state of the art, challenges and further perspectives. Round Table, 101(st) SIO National Congress, Catania 2014”. Acta Otorhinolaryngol Ital. 35 (4): 217–33. PMC 4731883. PMID 26824208.
↑ Capaccio P, Torretta S, Pignataro L, Koch M (2017). “Salivary lithotripsy in the era of sialendoscopy”. Acta Otorhinolaryngol Ital. 37 (2): 113–121. doi:10.14639/0392-100X-1600. PMC 5463518. PMID 28516973.
↑ Drage NA, Brown JE, Escudier MP, McGurk M (2000). “Interventional radiology in the removal of salivary calculi”. Radiology. 214 (1): 139–42. doi:10.1148/radiology.214.1.r00ja02139. PMID 10644113.
↑ Wallace E, Tauzin M, Hagan J, Schaitkin B, Walvekar RR (2010). “Management of giant sialoliths: review of the literature and preliminary experience with interventional sialendoscopy”. Laryngoscope. 120 (10): 1974–8. doi:10.1002/lary.21082. PMID 20824782.

[pmid26824208-1] Gallo A, Benazzo M, Capaccio P, De Campora L, De Vincentiis M, Fusconi M, Martellucci S, Paludetti G, Pasquini E, Puxeddu R, Speciale R (2015). “Sialoendoscopy: state of the art, challenges and further perspectives. Round Table, 101(st) SIO National Congress, Catania 2014”. Acta Otorhinolaryngol Ital. 35 (4): 217–33. PMC 4731883. PMID 26824208.

[pmid28516973-2] Capaccio P, Torretta S, Pignataro L, Koch M (2017). “Salivary lithotripsy in the era of sialendoscopy”. Acta Otorhinolaryngol Ital. 37 (2): 113–121. doi:10.14639/0392-100X-1600. PMC 5463518. PMID 28516973.

[pmid10644113-3] Drage NA, Brown JE, Escudier MP, McGurk M (2000). “Interventional radiology in the removal of salivary calculi”. Radiology. 214 (1): 139–42. doi:10.1148/radiology.214.1.r00ja02139. PMID 10644113.

[pmid20824782-4] Wallace E, Tauzin M, Hagan J, Schaitkin B, Walvekar RR (2010). “Management of giant sialoliths: review of the literature and preliminary experience with interventional sialendoscopy”. Laryngoscope. 120 (10): 1974–8. doi:10.1002/lary.21082. PMID 20824782.

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