[Combined approach for parotid lithiases: A 9 cases retrospective study].
BACKGROUND
Minimally invasive techniques (MIT), including sialendoscopy, extracorporeal lithotripsy and intraoral approach, have to be preferred in parotid stones removal. In case of MIT failure, a combined intra- and extra-oral approach can be achieved. The aim of our study was to evaluate the efficacy and the complications of these combined approaches.


METHODS
A retrospective study has been conducted on patients treated between 2006 and 2015. All adult patients presenting with one or more parotid stones and in whom TMI failed have been included. Age and sex of the patients, number, size and location of the stones, result of the procedure, occurrence of pain, swelling, or infection have been recorded.


RESULTS
Nine patients were included (mean age: 56). Mean follow-up was 48 months. Eighty-eight percent of patients had an unique stone. Nine stones were extracted by combined approach. Mean diameter of the stones was 8.5mm and 33% of them were located at the junction between middle and posterior third of parotid duct. All the patients suffered preoperatively from daily retention symptoms, such as pain (55%) and swelling (100%). Two patients had an infectious complication (duct and/or gland infection). Seventy-five percent (9/12) of stones were removed. Complications consisted of 1 fistula, 1 facial paresis, 3 recurrences. Seven of 9 patients (77%) had a total relieve after surgery.


CONCLUSIONS
Surgical combined approaches for parotid stones removals are indicated after failure of MIT when symptoms affect quality of life.
Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France.
M
M
Arnaud
Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France.
A
A
Gallucci
Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France.
N
N
Graillon
Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, AP-HM, 13915 Marseille cedex 20, France.
L
L
Guyot
Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France; CNRS, LPL UMR 7309, Aix-Marseille université, 13100 Aix-en-Provence, France.
C
C
Chossegros
Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, AP-HM, 13915 Marseille cedex 20, France; IFSTTAR, LBA UMR T 24, Aix-Marseille université, 13916 Marseille, France. Electronic address: jmfoletti@gmail.com.
J M
JM
Foletti
D000368:Aged; D003131:Combined Modality Therapy; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D020347:Lithiasis / Q000175:diagnosis / Q000601:surgery*; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D010305:Parotid Diseases / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000175:diagnosis / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods; D014172:Transillumination / Q000009:adverse effects / Q000379:methods
Chirurgie mini-invasive; Glande parotide; Lithiase salivaire; Minimally invasive surgical procedures; Parotid gland; Salivary gland calculi