title: Anatomical recovery of the duct of the submandibular gland after transoral removal of a hilar stone without sialodochoplasty: evaluation of a phase II clinical trial.
abstract: Transoral removal of stones for the treatment of submandibular sialolithiasis has been popularised, even for stones in the hilum. Without sialodochoplasty after surgical retrieval, the affected glands seem to recover well functionally, even without sialodochoplasty. However, the anatomical changes of structural recovery have not been fully studied. We investigated the outcomes and the changes to the salivary duct system after transoral removal of hilar stones using postoperative sialography. We enrolled 28 patients (29 sides) who had transoral removal of stones for submandibular hilar sialolithiasis without sialodochoplasty, and prospectively analysed the structural outcomes 3 months and 12 months postoperatively using sialography. We found 23 ducts (79%) recovered with a normal size, while 4 ducts (14%) developed saccular dilatation and one duct (3%) partially stenosed. Saccular dilatation developed after removal of stones larger than 10mm in diameter, but patients had no recurrent symptoms. By the 12 months' follow up, one stone had formed severe adhesions to the salivary duct that caused stenosis, and this patient had recurrent symptoms. Transoral removal of submandibular hilar stones without sialodochoplasty is an effective treatment with good anatomical restoration of the salivary duct and flow.
authors.affiliation: Department of Otolaryngology, Gyeongsang National University, Jinju, South Korea; Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Woo
authors.affiliation: Department of Otolaryngology, Gyeongsang National University, Jinju, South Korea.
authors.forename: Jin Pyeong
authors.initials: JP
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jong Sei
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: hansin.jeong@gmail.com.
authors.forename: Han-Sin
authors.initials: HS
authors.lastname: Jeong
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic / Q000209:etiology; D003287:Contrast Media; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012008:Recurrence; D018987:Salivary Ducts / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D015494:Salivary Gland Calculi / Q000601:surgery*; D012796:Sialography / Q000379:methods; D013364:Submandibular Gland Diseases / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
keywords: Salivary gland; Salivary gland calculus; Sialodochoplasty; Sialography; Transoral surgery