title: The use of sialendoscopy for the treatment of multiple salivary gland stones.
abstract: OBJECTIVE
  The purpose of this study is to document our experience with sialendoscopy for the treatment of multiple calculi of the salivary ducts, as well as to discuss the technique and indications for the procedure.
  
  
  METHODS
  In this retrospective non-interventional study, 530 consecutive cases of sialolithiasis were investigated, and the cases with multiple calculi were selected for further analysis. These selected cases were analyzed from clinical and surgical aspects.
  
  
  RESULTS
  Multiple calculi were detected in 37 of 530 consecutive investigated sialolithiasis cases. The gender distribution was 15 men and 22 women, with a mean age of 40.4 years. Among these patients, the submandibular gland was affected in 33 cases (right in 13 and left in 20) and the parotid gland was affected in 4 cases (right in 3 and left in 1). As for complications, 1 patient had a postoperative infection and 2 other patients had postoperative ranulas that were considered minor complications. Among all 37 cases, we had 3 cases in which preoperative imaging (sonography in 1 and radiography in 2) showed a single sialolith in the duct, but failed to show further sialoliths that were discovered later by sialendoscopy.
  
  
  CONCLUSIONS
  The use of sialendoscopy allows a better diagnosis and minimally invasive treatment for multiple calculi. Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision or surgical removal of the gland even in cases with multiple calculi. Sialendoscopy allows exploration of the ductal system in detail. This technique helps to discover additional stones in the ductal system that could not have been identified with the conventional imaging modalities available.
authors.affiliation: Director of Sialendoscopy and Minimal Invasive Surgery Service, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel; Lecturer, European Sialendoscopy Training Center, Geneva, Switzerland. Electronic address: surgery@gmail.com.
authors.forename: Leon
authors.initials: L
authors.lastname: Ardekian
authors.affiliation: Senior Doctor, Sialendoscopy and Minimal Invasive Surgery Service, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel; Lecturer European Sialendoscopy Training Center, Geneva, Switzerland.
authors.forename: Hila H
authors.initials: HH
authors.lastname: Klein
authors.affiliation: Senior Doctor, The Baruch Padeh Medical Center, Poria, Iarael.
authors.forename: Sharif
authors.initials: S
authors.lastname: Araydy
authors.affiliation: Professor, Department of Otolaryngology Head and Neck Surgery, University of Geneva, Switzerland; Director of European Sialendoscopy Training Center, Geneva, Switzerland.
authors.forename: Francis
authors.initials: F
authors.lastname: Marchal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation; D003251:Constriction, Pathologic; D004106:Dilatation / Q000295:instrumentation; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D010305:Parotid Diseases / Q000601:surgery; D011183:Postoperative Complications; D011900:Ranula / Q000209:etiology; D012189:Retrospective Studies; D012465:Salivary Duct Calculi / Q000601:surgery*; D018987:Salivary Ducts / Q000473:pathology; D013364:Submandibular Gland Diseases / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology; D055815:Young Adult