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[Results after shock wave lithotripsy for salivary gland stones]
M Reimers1, J Vavrina, C Schlegel
1Klinik für Hals-, Nasen-, Ohren- und Gesichtschirurgie, Kantonsspital Luzern.
Introduction:
Extracorporeal shock wave lithotripsy for salivary gland stones was not introduced until 1989 as a new treatment modality. Follow-up studies years after treatment are lacking.
Methods:
Follow-up study from February to March 2000 of 71 (91%) of all 78 patients who had extracorporeal shock wave lithotripsy for salivary gland stones at our clinic between March 1996 and November 1998.
Results:
Over 2 years after treatment (mean 27 months, range 12-48 months), 13 (48%) of 27 patients with parotid stones are free of stones and symptoms and 17 (63%) are free of symptoms. In 44 patients with submandibular stones, 13 (29%) are free of stones and symptoms and 23 (52%) are free of symptoms. For residual symptoms, 9 (20%) patients had submandibulectomy whereas no parotidectomy had to be performed. 5 patients with residual stones after treatment showed increased stone size in sonography, and one patient with a stone-free interval for 3 years had a local recurrence.
Discussion:
Extracorporeal shock wave lithotripsy is often the treatment of choice for parotid stones and the recommended conservative treatment option for smaller submandibular stones. Limitation to the common, larger submandibular stones diminishes the general value of this modality, which needs to be established in comparison with endoscopic techniques in further studies. Residual stones after treatment may cause new symptoms over time, but only in one case was renewed stone formation observed.
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