title: Sialoendoscopy with and without holmium:YAG laser-assisted lithotripsy in the management of obstructive sialadenitis of major salivary glands.
abstract: Obstructive sialadenitis is a major cause of dysfunction of the salivary glands, and increasingly sialoendoscopy is used in both diagnosis and treatment. At present the limit of the endoscopic approach is the size of the stone as only stones of less than 4mm can be removed. Endoscopic laser lithotripsy has the potential to treat many stones larger than this with minimal complications and preservation of a functional salivary gland. The holmium:YAG laser has been widely and safely used in urology, and its use has been recently proposed in salivary lithotripsy for the removal of bigger stones. We describe our experience with sialoendoscopy for stones in the parotid and submandibular glands and assess the feasibility and the efficacy of holmium:YAG laser lithotripsy. We have used the procedure 50 times for 43 patients with obstructive sialadenitis; 31 patients had sialolithiasis, 15 of whom (48%) had stones with diameters between 4 and 15mm (mean 7). Total extraction after fragmentation was possible in 14 of the 15 patients without complications. Intraductal holmium:YAG laser lithotripsy is effective and safe, and allows the treatment of large stones in Stensen's and Wharton's ducts.
authors.affiliation: Department of Otorhinolaryngology, AOU, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124 Cagliari, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sionis
authors.affiliation: Department of Otorhinolaryngology, AOU, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124 Cagliari, Italy.
authors.forename: R A
authors.initials: RA
authors.lastname: Caria
authors.affiliation: Department of Otorhinolaryngology, AOU, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124 Cagliari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Trucas
authors.affiliation: Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Brennan
authors.affiliation: Department of Otorhinolaryngology, AOU, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124 Cagliari, Italy. Electronic address: puxeddu@unica.it.
authors.forename: R
authors.initials: R
authors.lastname: Puxeddu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003251:Constriction, Pathologic / Q000628:therapy; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D017602:Lithotripsy, Laser / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000628:therapy; D010309:Parotitis / Q000628:therapy; D012189:Retrospective Studies; D012449:Safety; D012465:Salivary Duct Calculi / Q000628:therapy; D015494:Salivary Gland Calculi / Q000628:therapy*; D012793:Sialadenitis / Q000628:therapy*; D013364:Submandibular Gland Diseases / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Holmium:Yag laser; Lithiasis; Salivary glands; Sialoendoscopy