Objectives/hypothesis: For patients with submandibular sialolithiasis, there are many gland-preserving treatment options including sialendoscopy. Sialendoscopy, however, requires expensive instrumentation with limited availability, which may not be required for routine cases. The objective of this study is to compare the outcomes of patients with submandibular sialolithiasis undergoing sialendoscopy versus those undergoing transoral incisional sialithotomy.
Study Design: Longitudinal, prospective study of patient undergoing gland-preserving therapy for submandibular sialolithiasis.
Methods: The study was a prospective, nonrandomized trial of 30 patients with submandibular sialolithiasis who received gland-preserving treatment by either sialendoscopy-assisted techniques (Scope group; 14 patients) or transoral sialithotomy with or without dochoplasty (No Scope group; 16 patients). Factors analyzed between the two groups included age, race, gender, size of stone, location of stone, gland(s) involved, surgical method, and modified salivary Oral Health Impact Profile (sOHIP) scores before and after therapy.
Results: There were no significant differences between the Scope and No Scope groups regarding age, race, or gender. There was a significant difference in stone size between the groups, with the No Scope group having larger stones on average. Both treatments led to statistically significant symptomatic improvement in sOHIP scores. There was no statistically significant difference in salivary quality of life improvement between the Scope and No Scope groups (P = .33).
Conclusions: Sialendoscopy is an important diagnostic and therapeutic tool in the management of salivary disorders, but is not associated with improved outcomes in gland-preserving treatments for routine submandibular sialolithiasis. Transoral stone removal alone may have equivalent symptomatic outcomes in the management of select sialoliths.
Level Of Evidence: 3 Laryngoscope, 132:754-760, 2022.
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http://dx.doi.org/10.1002/lary.29815 | DOI Listing |
J Med Ultrasound
February 2024
Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan.
Sialolith-induced obstructive sialadenitis is a commonly encountered clinical scenario, yet the variations in the size and location of the stone can complicate immediate clinical assessment. Utilizing dynamic ultrasound imaging along with specific structural markers can provide valuable, immediate objective evidence in diagnosing submandibular sialolithiasis. This initial ultrasound evaluation streamlines the decision-making process by facilitating the timely scheduling of confirmatory computed tomography scans and guiding subsequent surgical interventions.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Oral and Maxillofacial Surgery.
Rationale: When gland-preserving treatments are unsuccessful, sialoadenectomy is typically conducted for patients afflicted with submandibular gland diseases. The definitive treatment modality for these individuals is the removal of both the gland and the associated ducts. During surgery, the gland and the majority of the ducts can be excised utilizing the lateral transcervical approach, with residual ducts unlikely to develop pathology.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Otolaryngology Department, İzmir Bozyaka Training and Research Hospital, İzmir City Hospital, Bahar, Saim Çıkrıkçı Cd. No: 59, 35170 Karabağlar, Izmir, Turkey.
Sialolithiasis is a common cause of salivary gland obstruction, leading to symptoms such as pain and swelling. In cases of intraparenchymal submandibular stones and proximal ductal stones larger than 7 mm, interventional sialendoscopy may fail, necessitating sialoadenectomy. As an alternative, intraoral stone extraction can be performed with CT-guided navigation.
View Article and Find Full Text PDFOral Surg Oral Med Oral Pathol Oral Radiol
October 2024
Department of Oral and Maxillofacial Surgery, The Baruch Padeh "Tzafon" Medical Center, Poriya, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Objective: To evaluate the efficacy and safety of transoral surgical management for complex submandibular gland (SMG) stones.
Study Design: A retrospective cohort study of 240 patients treated for sialolithiasis between 2015 and 2018, focusing on 57 cases of SMG stones that underwent stone removal procedures. Treatment methods, success rates, and complications were analyzed using Kaplan-Meier analysis, Cox proportional hazards regression, and multiple logistic regression.
J Craniofac Surg
December 2024
Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School of Stomatology, Wuhan University, Wuhan, Hubei, China.
Most sialolithiasis occurs in the submandibular glands, which are highly related to the anatomy and secretory function of the submandibular glands. The authors report an 18-year-old patient with multiple submandibular gland duct stones combined with submandibular neurilemmoma. The course of diagnosis and treatment is highlighted, and the causes of the formation of multiple stones in this patient are analyzed.
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