Combined approach technique for the management of large salivary stones.
OBJECTIVE
To review our experience with the combined approach, which includes an internal (endoscopic) and open approach for the management of large salivary stones.


METHODS
Retrospective.


METHODS
Clinical data was reviewed on patients who underwent combined approach for large salivary stones from July 2005 to August 2008 under an institutional review board approved protocol.


RESULTS
Of 106 patients who underwent sialendoscopy, 19 patients (18%) had 20 combined procedures. Thirteen patients (68%) were women and six men (32%) with a mean age of 52 years (range, 15-69 years). Operative times were shorter for submandibular stones (mean, 90 minutes) as compared to parotid stones (mean, 133 minutes). Stone removal was successful in 90% (18/20) with no major complications and minor complications in four patients (20%).


CONCLUSIONS
The combined procedure allows complete removal of large or impacted sialoliths without the need for removal of the entire gland with acceptable complication rates. We also recommend consenting patients for this approach when a difficult endoscopic removal is anticipated. Laryngoscope, 2009.
Department of Otolaryngology and Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213 , USA.
Rohan R
RR
Walvekar
Steven R
SR
Bomeli
Ricardo L
RL
Carrau
Barry
B
Schaitkin
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D012465:Salivary Duct Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D013364:Submandibular Gland Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult