Management of giant sialoliths: review of the literature and preliminary experience with interventional sialendoscopy.
OBJECTIVE
To report our experience with management of giant salivary stones via a combined approach technique using salivary endoscopy (CA) and results of a review of current literature related to giant salivary stones.


METHODS
Retrospective case series.


METHODS
An institutional review board-approved chart review was performed on patients managed with a CA to treat giant salivary stones (≥15 mm). In addition, we reviewed the English literature from 1942 to 2009.


RESULTS
Table 1 consists of 54 stones; 47 of which were identified during the review of literature and 7 from our case series. Of those 47 stones, 23 were hilar in location, 23 were glandular in location, and 1 stone was missing data. The gland preservation rate in the 47 reported stones was 57% (17/30). Among patients where gland resection was reported, the majority of the patients (12/13) had hilar glandular stones. Only one patient with a ductal stone had a gland resection. In our series, CA enabled a gland preservation rate of 86% (6/7). Among these patients, stone location was hilar glandular in six (86%) and ductal in one (14%). The mean size of stones from the literature review was 35 mm and from our series was 19 mm.


CONCLUSIONS
Our review reflects current treatment recommendations for giant stones, i.e., transoral sialolithotomy for ductal stones and gland resection for hilar glandular stones. Our preliminary experience with CA for giant stones suggests improved gland preservation rates (86% vs. 57%) independent of stone location and with preservation of salivary function.
Wallace
Eric
E
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA.
Tauzin
Marcie
M
Hagan
Joseph
J
Schaitkin
Barry
B
Walvekar
Rohan R
RR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome