[Extracorporeal lithotripsy in the treatment of salivary lithiasis. A prospective study apropos of 27 cases].
In a prospective study, we evaluated the efficacy of extracorporeal lithotripsy (ECL) in the treatment of salivary stones. We define the indications for the treatment of submaxillary and parotid stones, depending on the diameter and the location of the stone. Twenty-seven patients were treated by ECL. All had a unique stone, in the salivary duct, with a diameter greater than 2 mm; the site was the parotid gland for ten cases, the submaxillary gland for seventeen cases. After six months, the results from a clinical and ultrasonography point of view, were the following: total efficacy or complete desintegration of the stone: 9 cases; partial efficacy or fragmentation of the calculi, with residual fragments with a diameter of less than 2 mm, which could be flushed out with possible spontaneous clearance: 10 cases; failure or the lack of the reduction in the size of the stone or partial fragmentation into concrements with a diameter of more than 2 mm: 8 cases. Based on our experience and the results reported in the medical literature, we propose an therapeutic approach to symptomatic salivary stones. ECL is the most preferable treatment for stones of the parotid duct or parotid gland. The treatment of stones of the submaxillary gland depends on the site and the size of the calculi; ECL should be proposed as first-line treatment when the stone diameter ranges from 2 to 10 mm and when it is situated in the pelvis of the duct or in the proximal duct; surgical resection of the submandibular gland is indicated when the stone is situated in the gland itself or when the diameter is more than 10 mm; when it is situated in the distal duct, a marsupialization should be performed.
Schlegel
N
N
Service d'ORL et de Chirurgie Maxillo-Faciale Pr J. P. Monteil, 1, avenue Claude Vellefaux, 75475 Paris.
Brette
M D
MD
Cussenot
I
I
Monteil
J P
JP
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D000075202:Contraindications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015494:Salivary Gland Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D012737:Sex Factors; D013997:Time Factors; D014463:Ultrasonography