Comparison between Sialendoscopy and Conventional Methods in the Treatment of Sialolithiasis

Abstract

Background: Sialendoscopy is gaining in popularity in treating calculus disease. The delicacy of the instrument and the diameter of the salivary ducts are factors that limit the ability to achieve complete success. There is also continued speculation regarding the utility of the procedure, especially among clinicians who are masters of conventional methods like sialadenectomy and sialodochotomy.Objective: To assess the efficacy of sialendoscopy over conventional methods in treating sialolithiasis.Methods: A prospective case control study was conducted in a tertiary care centre; this study involved 50 patients of sialolithiasis, and it extended over a 36-month period. All had undergone treatment, either by conventional methods or interventional sialendoscopy. All patients with nonpalpable calculi smaller than 6 mm underwent interventional sialendoscopy. Failed sialendoscopies and larger nonpalpable calculi were removed through sialadenectomy. The outcome variables studied included calculus removal, postoperative symptoms, and gland preservation.Results: The success rate in terms of calculus removal by sialendoscopy was 88%, versus 100% by sialadenectomy. The salivary gland was preserved in 88% of the cases in the sialendoscopy group. Only 12% of patients were symptomatic.Conclusion: Sialendoscopy was effective in removing calculi of various sizes; it was definitely superior to conventional methods. Sialadenectomy should be reserved for cases either not suitable for sialendoscopy or in which there was an intervention failure.

Outcomes of Submandibular Stone Removal With and Without Salivary Endoscopes

“…It is effective in up to 86% to 100% of cases, with success largely dependent on the stone size, location, presence of associated stenosis, and consistency of surrounding tissue. 8,[12][13][14][15][16] In general, patients with nonimpacted stones less than 5 mm in size located in the distal duct have the highest likelihood of successful removal with sialendoscopy 6,12,[15][16][17][18] although larger stones can be routinely removed using sialendoscopy-assisted combined (incisional) approaches. The senior author has found sialendoscopy to be particularly helpful in cases with multiple stones to reduce the risk of missing one intra-operatively, as well as mobile and/or nonpalpable stones.…”

Recurrent Submandibular Sialolithiasis in a Child

“…Similarly in our patient, CT scan was able to accurately localize multiple calculus and delineate the salivary gland anatomy. Sialoendoscopy is an upcoming procedure that can be utilized either as a diagnostic or therapeutic option [ 8 ].…”

Contemporary Review of Submandibular Gland Sialolithiasis and Surgical Management Options

“…Only 2% to 5% of patients with submandibular sialolithiasis require submandibular gland excision [ 6 , 61 ]. Today, sialadenectomy for submandibular sialolithiasis is primarily reserved for cases where combined or minimally invasive approaches are unsuccessful.…”