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Laser-Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes
Varun Rai1, Rohan R Walvekar2, Jatin Verma1
1Department of ENT, Sir Ganga Ram Hospital, New Delhi, India.
The Laryngoscope
|March 15, 2022
Summary
Laser-assisted sialolithotripsy (LAS) effectively resolves obstructive sialolithiasis symptoms. Early diagnostic sialendoscopy (DS) and follow-up improve outcomes, achieving high symptom resolution and clear ducts.
Area of Science:
- Otolaryngology
- Minimally Invasive Surgery
Background:
- Obstructive sialolithiasis significantly impacts quality of life.
- Laser-assisted sialolithotripsy (LAS) offers a minimally invasive approach for stone removal.
Purpose of the Study:
- To evaluate the long-term symptomatic and objective outcomes of LAS for obstructive sialolithiasis.
- To correlate symptomatic relief with diagnostic sialendoscopy (DS) findings.
Main Methods:
- Retrospective study of 50 patients undergoing holmium-YAG LAS.
- Symptom and endoscopic scoring at 6 weeks and 6 months post-procedure.
Main Results:
- 70% asymptomatic at 6 weeks, rising to 98% at 6 months.
- 88% had duct obstruction (stenosis/residual stones) at 6 weeks, with 82% clear ducts at 6 months.
- Intervention for residual obstruction led to high symptom resolution.
Conclusions:
- Holmium LAS is a viable treatment for intermediate salivary stones.
- Judicious use of LAS yields high stone fragmentation and symptom resolution rates.
- Vigilant postoperative protocols and early DS are crucial for managing residual issues.
