[Current status of minimally invasive treatment methods in sialolithiasis]

Newly available minimally invasive methods have changed established treatment of human sialolithiasis during the past several years. After basic in vitro and in vivo investigations, two systems of shockwave treatment proved to be useful for clinical application: extracorporeal shockwave lithotripsy (piezoelectric system) and intracorporeal laser lithotripsy (using a rhodamine-6G dye laser). Following our clinical experiences with these methods a differential scheme for managing sialolithiasis is recommended depending on localization of the calculi and their maximal diameters. Submandibular stones are best treated by extra-corporeal lithotripsy if the stone is located in intraglandular parts or in the gland hilum. Stones of the hilum can also be treated by laser lithotripsy. In the distal parts and near the duct orifice, papillotomy and stone extraction should be tried independent of the stone size. If the stone is located in the intraglandular parts of the duct system or in the hilum and its diameter is over 12 mm, submandibulectomy is necessary. Calculi of the parotid gland should only be treated by extracorporeal lithotripsy, regardless of size and location.