Treatment Of Salivary Stones Research Articles

Treatment of salivary stones by intraductal pneumatic lithotripsy: A preliminary presentation of the StoneBreaker with sterile bag covering.

Sialendoscopy has changed the management of obstructive sialadenitis. Nowadays, minimally invasive techniques evolve to preserve salivary gland function. Intraductal lithotripsy allows stones fragmentation and retrieval without opening the salivary duct. We report our experience with the StoneBreaker (SB), a new lithotripter with improvement using a sterile bag that permits reuse of the SB without passing to sterilization. The non-sterilized SB was used into a sterile camera sleeve in 5 patients, 3 submandibular lithiases and 2 parotid lithiases. Technique and outcomes were described with a review of the literature. An explanatory video of the procedure was performed. Complete fragmentation was achieved and all fragments were extracted without any ductal damage. Utilization of the sterile sleeve did not change the SB efficiency and the procedure duration. The use of a sterile bag allowed several consecutive procedures with a single non-sterilized handpiece. However, the gas cartridge change may be more delicate when more than 80 impacts are needed. Patients remained symptoms and stones free one month after surgery.

Modern treatment methods of sialolithiasis

Salivary stones (sialolithiasis) are diagnosed in 0.007% of the population and are the most common cause of submandibular and parotid salivary glands obstruction. In the past, sialolithiasis was the leading cause of submandibular gland resection. The dynamic development of medical technology has greatly expanded the range of therapeutic options used in the treatment of salivary stones. The introduction of ultrasound and endoscopic techniques to the process of salivary stones diagnosis has greatly facilitated the identification of salivary stones. Endoscopic methods have made it possible to perform surgeries on the salivary glands in an almost atraumatic way. The use of laser devices, piezoelectric or magnetostrictive effect have enabled the efficient crushing of large salivary calculus deposits (sialolithotrypsis) and removal of stones fragments through the lumen of salivary duct. Modern therapeutic methods have reduced the number of sialoadenectomies to a minimum. In addition, these methods are characterized by a small number of serious complications and a very high success ratio, reaching up to 97%.

Long-term evaluation of extracorporeal shock wave lithotripsy in the treatment of salivary stones

Extracorporeal shock wave lithotripsy is a rather new therapeutical method in the treatment of sialolithiasis. The objective was to evaluate retrospectively the results of the extracorporeal shock wave lithotripsy therapy performed with a Minilith SL 1 lithotripter on 167 out-patients with symptomatic stones (average size 5.94 mm) of the salivary glands over an observation period of seven years. A successful treatment with total stone disintegration was achieved in 51 (31 per cent) patients. In 92 (55 per cent) patients treatment was partially successful, with disappearance of the symptoms but a sonographically still identifiable stone. Treatment failure occurred in 24 (14 per cent) patients who then underwent surgery. The mean follow-up period was 35.6 months (minimum three, maximum 83), after which 83.2 per cent of the initially successfully treated patients were still free of symptoms.Therefore, extracorporeal shock wave lithotripsy, as a non-invasive treatment alternative with few side effects, is an efficient technique for the therapy of sialolithiasis in selected patients.

Treatment of salivary stones by extracorporeal lithotripsy

Purpose: This study was designed to evaluate the efficacy of extracorporeal lithotripsy (ECL) in the treatment of salivary stones. Patients and Methods: In a prospective study, an additional 15 patients suffering from sialolithiasis were treated by applying extracorporeally generated shock waves. No patients needed general anaesthesia, sedatives, or analgesics. Results: Treatment was effective in 80% of the 15 patients in this series (5 total efficacy and 7 partial efficacy). Only minor complications were observed. Conclusion: Lithotripsy is a promising nonsurgical therapy for the treatment of sialolithiasis.