Outcomes of Pneumatic Lithotripsy Versus Holmium Laser-Assisted Lithotripsy With Sialendoscopy in Management of Submandibular Sialolithiasis.

Abstract

This study aimed to comparatively analyze the indications, treatment outcomes, and reliability levels of the intraductal pneumatic lithotripsy (IPL) and holmium laser-assisted lithotripsy (HLL) methods that are used to sialendoscopically separate stones into smaller pieces in submandibular gland sialolithiasis (SMGS) patients. To the best of the author's knowledge, there is no study that compared these 2 methods in the literature in English. The retrospectively designed study included 51 patients with SMGS. The IPL was used to break up 32 stones in 28 patients, while HLL was used to break up 28 stones in 23 patients. The stones could be completely extracted in 95.6% of the patients in the HLL group, 92.8% of those in the IPL group and 94.1% of all patients. The complete and partial recovery rates of the patients were respectively 91.3% and 8.7% in the HLL group and 92.8% and 7.2% in the IPL group. There was no significant difference based on the lithotripsy method that was used in the patients' laterality of stones, location of stones, stone diameter, operation time, need of papillotomy and silicone stent, complete removal status of stones and the symptomatic assessments of the patients in the 6th postoperative month. This study showed that both HLL and IPL treatments are effective, minimally invasive, and promising methods in difficult/complex SMGS treatments which may provide success rates of higher than 90% when they are performed by an experienced surgeon and by selection of appropriate patients.