Outcome of minimally invasive management of salivary calculi in 4,691 patients.
OBJECTIVE
To evaluate the application of minimally invasive techniques in the management of salivary stones.


BACKGROUND
The incidence of salivary calculi is 60 cases/million/year, with most stones situated in the mid or proximal duct. The current treatment of these stones is adenectomy. This paper reports the results of minimally invasive methods of stone removal that avoid gland excision.


METHODS
Observational study of 5,528 consecutive patients treated by lithotripsy, endoscopy, basket retrieval, and /or surgery in five centers from 1990 to 2004 inclusive. A total of 567 cases were excluded, leaving 4,691 patients (parotid n = 1,165, submandibular n = 3,526) for analysis.


RESULTS
Salivary calculi were eliminated in 3,775/4,691 (80.5%) of cases and partly cleared in 782/4,691 (16.7%). Salivary glands were removed in 134/4,691 (2.9%) of patients with symptoms in whom treatment failed.


CONCLUSIONS
Minimally invasive techniques move treatment of salivary calculi to an outpatient or a day case setting. They are reliable ways of both retrieving stones and eliminating symptoms, and mean that the gland rarely has to be removed.
Iro
Heinrich
H
University Erlangen-Nürnberg, Erlangen, Germany. heinrich.iro@uk-erlangen.de
Zenk
Johannes
J
Escudier
Michael P
MP
Nahlieli
Oded
O
Capaccio
Pasquale
P
Katz
Philippe
P
Brown
Jackie
J
McGurk
Mark
M
D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D015494:Salivary Gland Calculi / Q000628:therapy*; D016896:Treatment Outcome