title: Combined external lithotripsy and endoscopic techniques for advanced sialolithiasis cases.
abstract: OBJECTIVE
  To assess a combined external lithotripsy-sialoendoscopy method developed for advanced salivary gland sialolithiasis.
  
  
  METHODS
  A total of 94 patients (43 males and 51 females) underwent these treatment methods. Of these 94 patients, 60 had pathologic features in the submandibular gland and 34 in the parotid gland. A miniature external lithotripter was used, combined with multifunctional sialoendoscopes and endoscopic-assisted techniques, to achieve effective removal/elimination of the stones in these difficult cases.
  
  
  RESULTS
  Total elimination of the stone using lithotripsy alone was achieved in 32% of the cases; in 29%, intraductal endoscopic assistance was needed. In the remaining 39%, the removal of a stone was achieved with the help of an endoscopy-assisted extraductal approach (37 cases). At 6 months of follow-up, all patients who had undergone lithotripsy or lithotripsy plus intraductal endoscopy had an absence of symptoms. Of the 37 patients who had undergone an endoscopy-assisted extraductal approach, 35 (95%) remained asymptomatic.
  
  
  CONCLUSIONS
  Lithotripsy plus intraductal or extraductal endoscopic treatment of sialolithiasis is a highly effective surgical method of eliminating/removing salivary stones, especially those attached to the surrounding tissue and in the secondary ducts. This method helps to avoid resection of the salivary glands and represents an additional development of minimal invasive surgical techniques.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Barzilai Medical, Center, Ashkelon, Israel. nahlieli@yahoo.com
authors.forename: Oded
authors.initials: O
authors.lastname: Nahlieli
authors.forename: Rachel
authors.initials: R
authors.lastname: Shacham
authors.forename: Ami
authors.initials: A
authors.lastname: Zaguri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003131:Combined Modality Therapy; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000601:surgery*; D011446:Prospective Studies; D020127:Recovery of Function; D015494:Salivary Gland Calculi / Q000601:surgery*; D013364:Submandibular Gland Diseases / Q000601:surgery*; D055815:Young Adult