title: Thulium-YAG laser sialendoscopy for parotid and submandibular sialolithiasis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of thulium-YAG laser in sialendoscopic fragmentation of salivary lithiasis.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Sixty-three patients treated by interventional sialendoscopy with thulium-Yag laser fragmentation between 2003 and 2010 at Edouard Herriot Hospital were included in the study. The laser was used for non-floating or large lithiasis (>4 mm).
  
  
  METHODS
  The sialendoscopic thulium fiber laser was used in a pulsed mode with an average power output of 2-8 W to fragment and facilitate extraction of salivary stones. Several variables were studied: success rate, total number of procedures, total energy per procedure, size and number of salivary stones removed, and complications.
  
  
  RESULTS
  Our series of 63 cases includes 40 cases of parotid lithiasis and 23 cases of submandibular lithiasis. In nine cases, two sessions of laser were performed. Stone size was evaluated pre-operatively by ultrasound and varied between 2 and 18 mm. Laser fragmentation was possible in every case. Complete extraction of the lithiasis was possible in 51 cases (73.9%) and partial extraction in eight cases (12.6%). Extraction failed in four cases (6.3%). Mean stone size was 5.4 mm (5.7 mm for parotid glands and 5.0 mm for sub-mandibular glands) and mean energy per procedure was 1,450 J (range: 1,400-1,800 J). Ductal perforations were observed in 12.7% of the cases. 65.1% of patients were free of symptoms with a mean follow-up of 18 months.
  
  
  CONCLUSIONS
  Thulium-YAG laser appears to be an effective and safe technique in the treatment of salivary lithiasis.
authors.affiliation: Hospital Edouard Herriot, 3 Place d'Arsonval, 69437 Lyon, France. mickael.durbec@chu-lyon.fr
authors.forename: M
authors.initials: M
authors.lastname: Durbec
authors.forename: E
authors.initials: E
authors.lastname: Dinkel
authors.forename: S
authors.initials: S
authors.lastname: Vigier
authors.forename: F
authors.initials: F
authors.lastname: Disant
authors.forename: F
authors.initials: F
authors.lastname: Marchal
authors.forename: F
authors.initials: F
authors.lastname: Faure
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000628:therapy*; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000628:therapy*; D013364:Submandibular Gland Diseases / Q000628:therapy*; D013932:Thulium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013932:Thulium