title: Sialendoscopy in the diagnosis and treatment of sialolithiasis: a study on more than 1000 patients.
abstract: OBJECTIVE
  Sialendoscopy and other gland-preserving techniques such as extracorporeal shockwave lithotripsy (ESWL), transoral stone removal, and combinations of these methods have fundamentally changed the therapeutic approach to salivary stones. Since 2003, all patients presenting with sialolithiasis have been diagnosed and treated with the same algorithm and routine salivary gland endoscopy (SGE).
  
  
  METHODS
  Case series with chart review of patients with sialolithiasis treated between 2003 and 2008 using an algorithm for gland preservation.
  
  
  METHODS
  Tertiary referral academic medical center.
  
  
  METHODS
  A total of 1154 patients with suspected sialolithiasis were identified and reviewed. Factors analyzed included stone location, size, surgical method, rate of stone clearance, complications, and rate of short- and long-term symptom resolution. Successful treatment was defined as freedom from symptoms at follow-up.
  
  
  RESULTS
  Diagnostic sialendoscopy confirmed 221 parotid stones and 812 submandibular stones, of which 206 and 736, respectively, were treated. Transoral stone removal was the most frequently used method to remove submandibular stones (92%), with a smaller percentage able to be removed by SGE alone (5%) with long-term success rates ≥90%. Only 4% (29/736) required submandibular gland removal. Parotid stones were removed by SGE (22%), combined SGE and incisional technique (26%), or ESWL (52%), with long-term success rates of 98%, 89%, and 79%, respectively. Only 8 of 206 (4%) patients eventually required parotidectomy.
  
  
  CONCLUSIONS
  Salivary gland endoscopy is an important diagnostic and therapeutic tool in the management of sialolithiasis but must be combined with additional techniques to ensure a high rate of stone clearance, symptom resolution, and gland preservation.
authors: Department of Otolaryngology-Head and Neck Surgery, University of Erlangen-Nuremberg, Germany. Johannes.Zenk@uk-erlangen.de
authors: Johannes
authors: J
authors: Zenk
authors: Michael
authors: M
authors: Koch
authors: Nils
authors: N
authors: Klintworth
authors: Barbara
authors: B
authors: König
authors: Katharina
authors: K
authors: Konz
authors: M Boyd
authors: MB
authors: Gillespie
authors: Heinrich
authors: H
authors: Iro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000175:diagnosis* / Q000628:therapy*; D055815:Young Adult