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Combined approach to impacted parotid stones
Oded Nahlieli1, Daniel London, Ami Zagury
1Department of Oral and Maxillofacial Surgery, Barzilai Medical Center, Ashkelon, Israel. nahlieli@yahoo.com
Summary
This study introduces a combined endoscopic and ultrasound technique for removing impacted parotid stones. This minimally invasive approach successfully located and extracted parotid sialoliths that were inaccessible via traditional intraoral methods.
Area of Science:
- Otolaryngology
- Minimally Invasive Surgery
- Medical Imaging
Background:
- Parotid sialoliths impacting the Stensen's duct often require surgical intervention.
- Traditional intraoral approaches may be insufficient for calculi located in the posterior duct or parenchyma.
- Developing minimally invasive techniques is crucial for improving patient outcomes and reducing complications.
Observation:
- A combined endoscopic and ultrasound method was utilized for parotid stone identification and removal in 12 patients.
- Procedures were primarily conducted under local anesthesia in an outpatient setting.
- Indications included posterior ductal stones, ductal obstruction, large calculi, and intraparenchymal stones.
Findings:
- Complete stone removal was achieved in 75% of cases (9 out of 12 patients).
- Seven glands regained function post-procedure, while three became asymptomatic and atrophic.
- All patients reported satisfactory aesthetic results with no major complications.
Implications:
- The combined endoscopic and ultrasound approach offers a viable, minimally invasive alternative for treating impacted parotid sialolithiasis.
- This technique enhances the ability to locate and remove stones not amenable to intraoral extraction.
- Successful outcomes suggest potential for broader application in managing complex parotid duct stones.