Endoscopic litectomy: optimizing the management of sialolithiasis

Area of Science:

• Otolaryngology
• Oral and Maxillofacial Surgery
• Endoscopic Surgery

Background:

• Sialolithiasis frequently affects major salivary glands, particularly the submandibular gland.
• Endoscopic lithotripsy has become a preferred treatment, decreasing the necessity for adenectomy.

Purpose of the Study:

• To evaluate the efficacy and outcomes of endoscopic lithotripsy for salivary stones.
• To assess the complication rates associated with this minimally invasive procedure.

Main Methods:

• Retrospective review of 77 patients with salivary gland stones (January 2020 - January 2024).
• Inclusion criteria: lithiasis smaller than 8 mm.
• Follow-up included clinical examination and CT scans, with a mean follow-up of 17 months.

Main Results:

• Successful stone extraction in 89.61% of patients (69 out of 77).
• Mean stone size was 6.68 mm, predominantly located in the hilum, median duct, or retrocaruncular region.
• Adenectomy was required in 10 patients due to procedure failure or postoperative stenosis; 6 patients experienced stenosis, with 3 resolved by endoscopic dilation.

Conclusions:

• Minimally invasive intraoral surgery for sialolithiasis demonstrates a high success rate.
• This approach significantly reduces the need for radical glandular surgery.
• The procedure is associated with a low rate of severe complications.