title: Minimally-invasive surgery in the management of symptomatic parotid stones.
abstract: Traditionally, large, symptomatic, parotid stones that were refractory to conservative treatment were usually managed by parotidectomy, with the attendant risk to the facial nerve. Microendoscopes have transformed the management of such stones. For large stones that are not amenable to retrieval with a basket the endoscope provides a new dimension to operative surgery. It can guide the surgeon on to the duct and stone without the need to remove the parotid gland. In 2005-2014, 111 consecutive patients underwent endoscopically-assisted operations for the removal of 132 parotid stones at Guy's Hospital. Removal was successful in all but three cases. Long-term follow up (mean (SD) 44 (30) months) was obtained by postal or online survey and telephone, and 92 patients (83%) said that they had no symptoms. Further endoscope-assisted surgery was required in four cases, with preservation of the gland in all patients. Sialocoeles developed postoperatively in 15% (n=17). Transient facial nerve weakness occurred in 4 cases (4%), and there was no case of permanent deficit. Endoscopically-assisted retrieval of parotid stones is a technique to preserve the gland that adds to the current minimally-invasive options for management of parotid calculi.
authors.affiliation: Guy's and St Thomas' NHS Trust, Oral Surgery Department, Floor 23 Tower Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT. Electronic address: meerasamani@hotmail.com.
authors.forename: Meera
authors.initials: M
authors.lastname: Samani
authors.affiliation: King's College London, Oral and Maxillofacial Department, Floor 3 Bermondsey Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT.
authors.forename: Alexander James
authors.initials: AJ
authors.lastname: Hills
authors.affiliation: King's College London, Oral and Maxillofacial Department, Floor 3 Bermondsey Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT.
authors.forename: Adam Matthew
authors.initials: AM
authors.lastname: Holden
authors.affiliation: King's College London, Oral and Maxillofacial Department, Floor 3 Bermondsey Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT.
authors.forename: Chang-Bon
authors.initials: CB
authors.lastname: Man
authors.affiliation: Guy's and St Thomas' NHS Trust, Oral and Maxillofacial Department, Floor 3 Bermondsey Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT.
authors.forename: Mark
authors.initials: M
authors.lastname: McGurk
mesh_terms: D004724:Endoscopy; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D010305:Parotid Diseases / Q000601:surgery*; D010306:Parotid Gland; D015494:Salivary Gland Calculi / Q000601:surgery*
keywords: Endoscope assisted surgery; Parotid Gland; Salivary Caluli; Sialolithiasis.