Endoscopic sialolith removal: orientation and shape as predictors of success

Abstract 

Purpose

To identify factors that may influence successful retrieval of salivary stones with interventional sialendoscopy.

Materials and methods

A retrospective chart review of sialendoscopy procedures performed in the Department of Otolaryngology at the University of Pittsburgh from July 2005 to August 2007 was conducted. We identified thirty consecutive cases of sialolithiasis treated with sialendoscopy.

Results

The mean age at presentation was 45 years (range, 7-77 years) with a male-to-female sex ratio of 1:1.5. The most common presentation was recurrent or persistent salivary gland swelling (53%), followed by salivary gland swelling associated with meals (37%). All these procedures were performed under sedation or general anesthesia. Size of the stones ranged from 0.2 to 1.2 cm. Our success rate for their endoscopic removal was 74% (14/19). Four patients (4/30) required a planned combined technique for stone removal.

Conclusions

Sialendoscopy is a reasonable minimally invasive option to treat sialolithiasis that avoids the need for salivary gland excision. Salivary stones larger than 4 mm for submandibular cases and 3 mm for parotid cases may be amenable to endoscopic removal provided their largest dimension is orientated favorably along the length of the duct.