Long-term results of combined approach in parotid sialolithiasis

Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3533-8. doi: 10.1007/s00405-014-3391-x. Epub 2014 Nov 12.

Abstract

Combined sialendoscopic and transcutaneous approach in parotid sialolithiasis is a surgical option for large and impacted stones. The aim of this study is to assess the long-term results regarding postoperative stenosis, recurrent swellings and gland function. Prospective study in a tertiary referral center of patients with parotid sialolithiasis requiring combined approach. A total of 12 patients have been treated within a period of 3 years. Intraductal stents were placed in 9 of 12 cases. Scintigraphic evaluation of salivary glands and follow-up sialendoscopy performed 1 year postoperatively. In total, fourteen stones (two stones in two cases) were successfully removed along with two coexisted inflammatory polyps. Postoperative endoscopic evaluation revealed mild stenosis in 7 out of 12 cases without clinical significance as no recurrent swellings were reported. Scintigraphy showed normal gland function in 11 cases and mild hypofunction in 1 case with long-standing history of sialolithiasis. All patients were free of symptoms within the follow-up period of time (median follow-up 15.5 months). Combined approach is a safe, gland preserving and efficacious procedure in long term. The stenosis in the area of ductal surgical opening when present does not seem to be of clinical value.

Keywords: Parotid gland; Salivary glands; Sialendoscopy; Sialolithiasis; Transcutaneous.

MeSH terms

  • Adult
  • Aged
  • Constriction, Pathologic / etiology
  • Edema / etiology
  • Endoscopy / adverse effects
  • Endoscopy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parotid Diseases / surgery*
  • Polyps / surgery
  • Prospective Studies
  • Salivary Gland Calculi / surgery*
  • Salivary Gland Neoplasms / surgery
  • Salivary Glands / pathology
  • Stents