Transoral sonographic diagnosis of submandibular duct calculi

Cho, Woojin; Lim, Dohyoung; Park, Hachoon

doi:10.1002/jcu.22063

Cited by 22 publications

(23 citation statements)

References 11 publications

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“…The stones, which were all clinically and ultrasonographically classified as intra-parenchymal, were successfully retrieved from all but seven patients, in whom the failure was due to the fact that the stone could not be separated from the gland tissue despite the use of dedicated elevators. This good result is in line with our initial experience 1 and what has been reported by other authors 4 6 16 , and demonstrate that the procedure is effective in removing deep submandibular stones. Most of these can be removed without using a sialendoscope but, in 9% of cases, the bright guidance of the sialendoscopic unit facilitated the search for residual parenchymal microliths that had cracked during removal of the main stone or migrated backwards to the peri-hilar region.…”

Section: Discussionsupporting

confidence: 92%

“…A trans-oral approach has recently been proposed as a gland-preserving alternative to sialadenectomy for deep and parenchymal stones 4 6 . The main limitations of previously published studies are that many also included stones located in the main submandibular duct, very few describe long-term surgical results and none considered patients' subjective perceptions or QoL factors.…”

Section: Discussionmentioning

confidence: 99%

“…Typical symptoms are recurrent swelling and pain at mealtimes. In many cases, careful palpation of the oral floor allows the exact position of a stone to be detected, and diagnosis can be confirmed radiologically by ultrasonography (US) 6 , conventional radiography, computed tomography (CT) and/or cone beam tomography (CBCT) 7 .…”

Section: Introductionmentioning

confidence: 99%

“…It has been shown that trans-oral removal of large (> 7 mm) and deeply located submandibular stones 10 11 , the spread of which has been favoured by the development of interventional sialendoscopy, is safe and effective 11 , and highly successful in terms of stone removal and symptom relief 6 11 . A sialendoscope-assisted procedure is useful because the brightness can help in detecting any residual intraparenchymal stones after removal of the main HPSMS 12 , thus ensuring the complete clearance of the ductal system and eliminating symptoms of mealtime syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Capaccio

Gaffuri

Rossi

et al. 2017

Acta Otorhinolaryngol Ital

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Come si evince dallanalisi della letteratura, lapproccio transorale ai calcoli prossimali e ilo-parenchimali della ghiandola sottomandibolare rappresenta una valida alternativa alla scialoadenectomia tradizionale. Lo scopo di questo studio è quello di valutare i risultati chirurgici, ecografici e soggettivi di questa tecnica conservativa. Tra Gennaio 2003 e Settembre 2015 sono stati trattati con lapproccio transorale scialoendoscopico-assistito 479 pazienti affetti da calcoli ilo-parenchimali sottomandibolari palpabili, non mobili, di dimensioni superiori ai 7 mm. Tutti i pazienti sono stati sottoposti ad un follow-up clinico, ecografico e ad una valutazione soggettiva delloutcome chirurgico per mezzo di un apposito questionario somministrato attraverso unintervista telefonica. Il successo chirurgico definito come completa asportazione del calcolo ilo-parenchimale è stato ottenuto in 472 pazienti (98.5%); in sette casi (1.5%) si è verificato un insuccesso chirurgico, riguardante esclusivamente calcoli parenchimali puri. Un anno dopo lintervento chirurgico, 408 pazienti (85.1%) non riferivano più sintomi ostruttivi, 59 pazienti (12.3%) riferivano sintomi ostruttivi ricorrenti e 12 (2.6%) infezioni ricorrenti. Dei 54 pazienti (11.2%) affetti da litiasi sottomandibolare ricorrente, 52 sono stati sottoposti ad una seconda procedura terapeutica, nello specifico in 29 casi a scialoendoscopia, in 2 casi a litotrissia pneumatica intracorporea, in 8 casi a chirurgia transorale, in 6 casi ad un ciclo di litotrissia extracorporea, in 7 casi a scialoadenectomia sottomandibolare. La maggior parte dei pazienti (75.2%) ha riferito un dolore post-chirurgico di grado lieve. Al termine del follow-up, i sintomi riferiti da 454 pazienti (94.8%) erano migliorati dopo il secondo trattamento e la ghiandola sottomandibolare affetta era stata preservata nel 98.5% dei casi. La chirurgia transorale scialoendoscopico-assistita dei calcoli ilo-parenchimali della ghiandola sottomandibolare rappresenta unopzione terapeutica sicura, efficace e conservativa e la preservazione del dotto e del parenchima ghiandolare permette di esplorare il sistema duttale attraverso lostio naturale in caso di ricorrenza della patologia. Lutilizzo combinato dellapproccio transorale e delle altre tecniche mini-invasive permette di trattare con successo la maggior parte dei pazienti affetti da litiasi ilo-parenchimale sottomandibolare.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Capaccio

Gaffuri

Rossi

et al. 2017

Acta Otorhinolaryngol Ital

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“…Eighty percent of the submandibular sialolithiasis is in the Wharton's duct, and 20% of it is in the gland. Its size may differ from a few millimeter to a few centimeter (5). The salivary gland stones are thought to grow approximately up to 1-1.5 mm in a year (6).…”

Section: Discussionmentioning

confidence: 99%

Submandibular Sialolithiasis Perforating the Floor of Mouth: A Case Report

Kurtoğlu¹,

Durmuşoğlu²,

Ecevit³

2015

Turk Arch Otolaryngol

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Calculus formation in salivary glands (sialolithiasis) is one of the most common diseases of the salivary glands and is most commonly seen in the submandibular gland. Not only can the stones be small and inside the duct, they may also get larger and reside inside the gland. We can easily see submandibular sialolithiasis perforating the floor of the mouth in cases having sialolithiasis for decades and not having any treatment and its transoral removal as we look in the medical literature. A 52-yearold lady who had rejected surgical treatment for submandibular sialolithiasis for 25 years is presented as a case in this study. Treatment of the case was performed effectively by taking out the calculus transorally with a simple intervention whose examination revealed that the calculus was seen to perforate the floor of the mouth. It is aimed to stress with this case that transoral removal of submandibular sialolithiasis that perforates the floor of the mouth without performing external approaches is a method that has to be thought in the first step.

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Value of Sonography in the Diagnosis of Sialolithiasis: Comparison With the Reference Standard of Direct Stone Identification

Goncalves

Mantsopoulos

Iro

et al. 2017

J of Ultrasound Medicine

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Objectives The aim of this study was to assess the effectiveness of sonography for diagnosing sialolithiasis in comparison with the existing reference standard of direct identification of a stone. Methods A total of 659 glands with signs of obstructive sialadenopathy were evaluated retrospectively. Sonographic examinations of the large head salivary glands had been performed initially in all cases. Direct depiction of a stone during sialoendoscopy or transoral ductal surgery or observation of stone fragmentation with discharge of concrements after extracorporeal shock wave lithotripsy, was regarded as definitive evidence and as the reference standard for the presence of sialolithiasis. The sonographic results were compared with those for direct identification of stones. Results The sensitivity of sonography was 94.7%, with specificity of 97.4%, a positive predictive value of 99.4%, and a negative predictive value of 79.6%. Stones that were not diagnosed correctly on sonography were most often located in the distal area of the duct. Conclusions These results show that sialolithiasis can be diagnosed by sonography with a high degree of certainty. Sonography thus appears to be highly appropriate as the examination method of choice.

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Transoral sonographic diagnosis of submandibular duct calculi

Cited by 22 publications

References 11 publications

Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Sialendoscope-assisted transoral removal of hilo-parenchymal sub-mandibular stones: surgical results and subjective scores

Submandibular Sialolithiasis Perforating the Floor of Mouth: A Case Report

Value of Sonography in the Diagnosis of Sialolithiasis: Comparison With the Reference Standard of Direct Stone Identification

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