Abstract
Objective: 1) Describe a surgical technique of ultrasound-guided, transfacial, gland-preserving resection of difficult parotid stones. 2) Review outcomes in treated patients. Method: Study design: Case series with chart review. Time frame: 2008 through 2011. Disease: Parotid sialolithiasis. Subjects: Patients with parotid sialolithiasis unmanageable with endoscopy alone. Setting: Tertiary care university hospital. Intervention: Ultrasound-guided, transfacial resection. Outcome measurements: Stone size, stone location, complications, and symptom relief. Results: Eleven cases of transfacial ultrasound-guided gland-preserving surgery were performed from 2008 to 2011. There were 8 palpable stones and 3 nonpalpable stones. Mean stone size was 8 mm. Eight patients had single stones and 3 had multiple stones. Localization was performed by ultrasound in 5 cases, by endoscopy in 2 cases and combined in 4 cases. The facial nerve was visualized in 2 cases. One patient developed a postoperative salivary fistula. Seventy-five percent (9/12) were symptom free at follow-up, and 25% (3/12) were improved with mild obstruction. Conclusion: Transfacial ultrasound-guided surgery for parotid sialoliths provides a safe and effective method of treating difficult parotid stones while avoiding total parotidectomy.
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