title: Transoral Stensen's Duct Approach: A 22-case retrospective study.
abstract: BACKGROUND
  Parotid gland duct lithiasis is preferentially managed using minimally-invasive techniques such as sialendoscopy and lithotripsy. However, these 2 techniques cannot remedy all obstructions and other techniques such as the Transoral Stensen's Duct Approach (TSDA) may sometimes be helpful.
  
  
  METHODS
  A retrospective study of patients treated with TSDA was conducted to evaluate this procedure between 2006 and 2013. Criteria for inclusion were: failures for lithiases (22 patients and 28 lithiases) treated with sialendoscopy and/or lithotripsy for parotid gland duct obstruction. Mean follow-up was 47.4 months. Pain intensity, swelling and occurrence of infectious episodes were evaluated immediately and after middle-term and long-term follow-up (up to 36 months).
  
  
  RESULTS
  The best results were obtained for anterior lithiasis, with an 87.5% immediate success rate. Morbidity was low with 2 transient facial nerve upper buccal branch palsies and 2 post-operative stenoses.
  
  
  CONCLUSIONS
  TSDA is an easy-to-perform and safe technique that can be recommended in cases of sialendoscopy or lithotripsy failure for anterior-third parotid duct lithiasis. Even if this technique has shown limitations for more posterior lithiases, or other causes of obstruction (stenosis, megaduct), it requires no specific material and may be useful. It may avoid an external combined approach or a parotidectomy.
authors.affiliation: APHM (Head: Cyrille Chossegros), CHU de la Conception, Pôle PROMO, Service de chirurgie Maxillo-Faciale, 13005 Marseille Cedex 5, France. Electronic address: jmfoletti@gmail.com.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Foletti
authors.affiliation: APHM (Head: Cyrille Chossegros), CHU de la Conception, Pôle PROMO, Service de chirurgie Maxillo-Faciale, 13005 Marseille Cedex 5, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Wajszczak
authors.affiliation: APHM (Head: Cyrille Chossegros), CHU de la Conception, Pôle PROMO, Service de chirurgie Maxillo-Faciale, 13005 Marseille Cedex 5, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Gormezano
authors.affiliation: APHM (Head: Cyrille Chossegros), CHU de la Conception, Pôle PROMO, Service de chirurgie Maxillo-Faciale, 13005 Marseille Cedex 5, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Guyot
authors.affiliation: APHM (Head: Cyrille Chossegros), CHU de la Conception, Pôle PROMO, Service de chirurgie Maxillo-Faciale, 13005 Marseille Cedex 5, France.
authors.forename: Narcisse
authors.initials: N
authors.lastname: Zwetyenga
authors.affiliation: APHM (Head: Cyrille Chossegros), CHU de la Conception, Pôle PROMO, Service de chirurgie Maxillo-Faciale, 13005 Marseille Cedex 5, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Chossegros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods; D010306:Parotid Gland / Q000601:surgery*; D012189:Retrospective Studies; D012465:Salivary Duct Calculi / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Minimally-invasive surgery; Parotid; Salivary duct calculi; Sialendoscopy; Stenosis