Sialendoscopy in treatment of sialolithiasis — our own experience based on group of 95 patients
Journal Title: Otolaryngologia Polska - Year 2012, Vol 66, Issue 0
Abstract
SUMMARY Objectives: The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal due to sialolithiasis. The aim of the analysis was to assess the effectiveness of sialoendoscopy and combined approach in most difficult cases. Material and Methods: prospective study, tertiary university centre (Department of Otorhinolaryngology, Head and Neck Surgery, Poznan), between XII 2008 and V 2012, 207 sialendoscopies were performed in 197 patients. In this number 158 patients had obstructive pathology of salivary glands, 95 confirmed gland or duct sialolithiasis: parotid — 31 and submandibular — 64. Results: In the group of submandibular lithaiasis in 40 cases (62.5%) stones were removed endoscopically. Double approach (sialendoscopy and incision of mucosa of the floor of the mouth with removal of the stone was perfomed in 21 cases (32.8%). Only in 3 cases removal of submandibular gland was necessary. In the group of parotid sialolithiasis in 17 cases (54%) endoscopy was the definite treatment, in 9 Iitothrypsy (ESWL) were necessary and in 5 combined approach. This five patients who failed SE were treated by combined transcutaneous (open surgery) and endoscopic procedure. We observed no incidence of salivary fistuła after the incision of the duct; there was also no stenosis of the natural ostium due to the insertion of a stent. Conclusions: Sialoendoscopy is method of choice with high rate of success and gland preservation in smali and moderate stones.The combined approach is indicated for large stones, complications and where there is a contraindication to established minimally invasive procedures.
Authors and Affiliations
Tomasz Kopeć, Witold Szyfter, Małgorzata Wierzbicka, Anna Młodkowska, Jarosław Kałużny
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