Modern management of salivary calculi

Abstract

Abstract Background The aim was to investigate the results of a minimally invasive approach to the management of salivary calculi. Methods Four hundred and fifty-five salivary calculi (323 submandibular and 132 parotid) were treated using extracorporeal shock-wave lithotripsy (ECSWL), fluoroscopically guided basket retrieval or intraoral stone removal under general anaesthesia. The techniques were used either alone or in combination. Results ECSWL achieved complete success (stone and symptom free) in 87 (39·4 per cent) of 221 patients (84 of 218 primary and all of three secondary procedures; 43 of 131 submandibular, 44 of 90 parotid). Basket retrieval cured 124 (74·7 per cent) of 166 patients (103 of 136 primary and 21 of 30 secondary procedures; 80 of 109 submandibular, 44 of 57 parotid). Intraoral surgical removal was successful in a further 137 (95·8 per cent) of 143 patients with submandibular stones (99 of 101 primary, 36 of 38 secondary and two of four tertiary procedures). The overall success rate for the three techniques was 348 (76·5 per cent) of 455. Conclusion A minimally invasive approach to the management of salivary calculi is to be encouraged. All three techniques described have low morbidity and afford the possibility of retaining a functional gland.