Combined Endoscopic-Transcutaneous Approach for Management of Large Parotid Stones.

Area of Science:

• Otolaryngology
• Surgical Innovation
• Minimally Invasive Procedures

Background:

• Parotid stones (sialolithiasis) can cause significant discomfort and obstruction.
• Traditional stone removal methods may be less effective for large or impacted stones.
• Endoscopic techniques offer minimally invasive options but may have limitations.

Purpose of the Study:

• To evaluate the effectiveness and safety of a combined endoscopic-transcutaneous approach for parotid stone removal.
• To assess the outcomes in patients with large or impacted parotid stones.
• To determine the gland preservation rates associated with this combined technique.

Main Methods:

• A prospective study of 21 patients with parotid sialolithiasis from August 2012 to February 2017.
• The combined approach was indicated for failed endoscopic removal, large (>4mm), or impacted stones.
• Stone localization via endoscopic transillumination followed by transcutaneous incision and 3-week stenting.

Main Results:

• Successful stone removal in all 21 cases using either modified Blair's or linear incision.
• Two patients developed post-operative strictures at 5 and 3 months, respectively.
• Endoscopic dilation resolved strictures, rendering patients asymptomatic.

Conclusions:

• The combined endoscopic-transcutaneous approach demonstrates high success rates for parotid stone removal.
• This method is associated with a low complication rate, including manageable strictures.
• The technique facilitates high parotid gland preservation rates in patients with sialolithiasis.