title: Sialendoscopy-assisted transfacial surgical removal of parotid stones.
abstract: Minimally invasive surgical approaches to parotid stones (such as extra-corporeal shockwave lithotripsy and sialendoscopy) have proved to be effective in a high percentage of cases, although success depends on factors such as the localisation of the stone, its size and its mobility. The failure rate of 10% is largely due to large and impacted stones and, in such cases, a combined external and sialendoscopic approach can be used to avoid morbidity and the risks of more invasive superficial parotidectomy. We treated eight patients with large parotid stones (>7 mm) using a sialendoscopy-assisted transfacial surgical approach that was effective in all but one case, which was successfully solved by combining this procedure with extra-corporeal lithotripsy and operative sialendoscopy. Our results confirm that the combined approach is a valid alternative to parotidectomy for large parotid stones and should be added to other minimally invasive techniques aimed at restoring the function of the affected parotid gland.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Capaccio
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
authors.forename: Capaccio
authors.initials: C
authors.lastname: Pasquale
authors.forename: Michelle
authors.initials: M
authors.lastname: Gaffuri
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Gaffuri
authors.initials: G
authors.lastname: Michele
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: pasquale.capaccio@unimi.it.
authors.forename: Pignataro
authors.initials: P
authors.lastname: Lorenzo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004210:Dissection / Q000295:instrumentation / Q000379:methods; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010305:Parotid Diseases / Q000601:surgery*; D012463:Saliva / Q000378:metabolism; D012465:Salivary Duct Calculi / Q000601:surgery; D015494:Salivary Gland Calculi / Q000601:surgery*
keywords: Endoscopy assisted; Minimally invasive technique; Parotid stones; Sialolithiasis