Outcome after endoscopically assisted surgical retrieval of symptomatic parotid stones.
10% of symptomatic parotid stones cannot be removed by minimally invasive radiological or endoscopic techniques alone. In these cases endoscopically assisted surgical parotid sialolithectomy can be performed via an extraoral approach, reconstituting the duct and preserving functioning glandular tissue. Between 2003 and 2010, 55 consecutive patients underwent endoscopically assisted surgical removal of parotid stones from 57 glands, two having bilateral procedures. Outcome was assessed using a structured questionnaire. 39/55 patients (71%) patients were successfully contacted (40 procedures; one bilateral case). At median follow-up of 3.1 years 28 glands (70%) were symptomless, whilst 11 (28%) were much improved but causing mild or occasional residual symptoms. One patient required postoperative lithotripsy and basket retrieval of a retained stone, but was subsequently symptom free. A further patient was initially symptom free then relapsed, did not respond to lithotripsy and is awaiting further assessment. In 10% of cases a short-lived sialocoele developed postoperatively. No individual reported facial weakness and one had a scar of concern. 37/39 (95%) patients were pleased to have had the operation and would have the procedure contralaterally in similar circumstances. Endoscopically assisted surgical removal of parotid stones is a successful technique with low morbidity that is well received by patients.
Salivary Gland Service, Department of Oral and Maxillofacial Surgery, Guy's Hospital, London, UK. alexanderoverton@gmail.com
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A
Overton
J
J
Combes
M
M
McGurk
D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010305:Parotid Diseases / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011900:Ranula / Q000209:etiology; D012008:Recurrence; D012465:Salivary Duct Calculi / Q000601:surgery; D018987:Salivary Ducts / Q000601:surgery; D015494:Salivary Gland Calculi / Q000601:surgery*; D012677:Sensation / Q000502:physiology; D013524:Surgical Flaps; D014172:Transillumination; D016896:Treatment Outcome; D055815:Young Adult