Ultrasound-guided piezoelectric extracorporeal shock wave lithotripsy of parotid gland calculi.
OBJECTIVE
The introduction of piezoelectric extracorporeal shock wave lithotripsy (ESWL) has changed therapy for salivary calculi. This method seems especially suitable for treating calculi in the parotid gland. The purpose of this study was to evaluate ESWL in patients with such calculi.


METHODS
From November 1990 to November 1999, all patients with sialolithiasis of the parotid gland were treated with piezoelectric ESWL. Three different lithotriptors were used over the 9-year study period. Results were analyzed according to both the patients' clinical status and follow-up sonograms.


RESULTS
In total, 42 patients (21 women, 21 men; mean age, 59 years) were treated with ESWL. The mean follow-up period for all patients was 63 months (range, 7-96 months). After ESWL had been performed, 71% of the patients were completely free of symptoms, and 21% had marked improvement of their symptoms. Sixty-seven percent were completely free of calculi, and 27% had a marked reduction in the size of their calculi. Adverse effects of ESWL included temporary glandular swelling (4 patients), blood-tinged salivary secretions (9 patients), petechiae on the skin surface (3 patients), and parotid abscess (1 patient).


CONCLUSIONS
ESWL is an outpatient procedure that can be performed without anesthesia and with scarcely any discomfort for patients. Conventional surgical procedures such as subtotal parotidectomy may be almost entirely replaced by ESWL because of the excellent treatment results and a very low rate of complications associated with ESWL. ESWL should be considered the treatment of choice for parotid calculi.
Külkens
C
C
Department of Otolaryngology, Head and Neck Surgery, University of Marburg, Deutschhausstrasse 3, D-35037 Marburg, Germany.
Quetz
J U
JU
Lippert
B M
BM
Folz
B J
BJ
Werner
J A
JA
D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*