gms | German Medical Science

84th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

08.05. - 12.05.2013, Nürnberg

Gland-preserving treatment of huge sialoliths of the submandibular glands

Meeting Abstract

  • corresponding author presenting/speaker Nils Klintworth - Hals-Nasen-Ohren Klinik, Kopf- und Halschirurgie, Universitätskliniukum Erlangen, Erlangen, Germany
  • author Johannes Zenk - Hals-Nasen-Ohren Klinik, Kopf- und Halschirurgie, Universitätskliniukum Erlangen, Erlangen, Germany
  • author Michael Koch - Hals-Nasen-Ohren Klinik, Kopf- und Halschirurgie, Universitätskliniukum Erlangen, Erlangen, Germany
  • author Konstantinos Mantsopoulos - Hals-Nasen-Ohren Klinik, Kopf- und Halschirurgie, Universitätskliniukum Erlangen, Erlangen, Germany
  • author Heinrich Iro - Hals-Nasen-Ohren Klinik, Kopf- und Halschirurgie, Universitätskliniukum Erlangen, Erlangen, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 84th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Nürnberg, 08.-12.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13hno34

doi: 10.3205/13hno34, urn:nbn:de:0183-13hno340

Published: July 30, 2013

© 2013 Klintworth et al.
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Outline

Text

Introduction: Sialolithiasis is nowadays preferably treated with gland-preserving techniques like sialendoscopy, lithotripsy, or transoral stone removal. The question arises whether huge stones (“megaliths” of more than 15 mm) can be treated effectively in this way.

Methods: Retrospective analysis of patients treated between January 2003 and June 2009 at our department for a sialolithiasis of the submandibular glands.

Results: In 73 of 732 cases the diameter of the stone was 15mm or more (“megalithiasis”). In 70 cases the stone was removed transorally by duct slitting, ESWL was performed in one single case only, and two patients underwent primary submandibuletcomy. Duct slitting resulted in complete stone removal in 77%, in 23% a stone fragment remained. However, persisting complaints were recorded in only one case with a remaining fragment.

After a mean follow-up period of three years, 56 patients could be contacted 23% of which reported an occasional recurring of complaints (swelling or pain) since the treatment. In 9 cases (16%) a recurrent sialolithiasis was diagnosed.

Conclusions: In case of huge sialoliths of the submandibular gland, transoral stone removal by duct slitting is the gland-preserving procedure of choice. It is an effective technique regarding the patient’s symptoms; however, a complete stone removal is not always possible. The risk of a recurrent sialolithiasis is increased compared to cases with smaller stones. The patient should be informed appropriately about possibilities and limitations in these cases.