To Evaluate the Success of Sialendoscopy Assisted Intraoral Approach for Removal of Submandibular Hilar Stones

To assess the success of sialendoscopy assisted intraoral approach for removal of hilar stone of submandibular gland. To evaluate the ductal system for any concomitant pathology. Conventionally the treatment for submandibular hilar stones has been gland excision. Being an open procedure, sialadenectomy has its own range of complications. After the advent of sialendoscopy there has been a paradigm shift in the management of hilar stones. The current study was done to evaluate the success of sialendoscopy assisted intraoral approach for removal of submandibular hilar stones. The sample size was 30. A diagnostic sialendoscopy was performed followed by intraoral dissection using "the surgical triangle approach" defined by Park et al. The light of sialendoscope was used as a marker of intraoral incision which was given lateral to sublingual gland in the floor of mouth corresponding to the last three teeth. The surgical triangle was exposed which was bounded by the lingual nerve, medial border of mandible and posterior border of mylohyoid muscle. The hilum lies within this triangle and hence incision was given on the duct and stone retrieval was done. 88.8% of palpable submandibular hilar stones and 66.7% of the non palpable stones could be removed. 87.5% of hilar stones and 83.3% of hiloparenchymal stones could be removed. 86.7% of the glands can be preserved by this approach for management of large submandibular hilar and hiloparenchymal stones. Using this approach non palpable stones can also be removed.