Modern management of salivary calculi

Background: The aim was to investigate the results of a minimally invasive approach to the management of salivary calculi. Methods: Four hundred and fifty-five salivary calculi (323 submandibular and 132 parotid) were treated using extracorporeal shock-wave lithotripsy (ECSWL), fluoroscopically guided basket retrieval or intraoral stone removal under general anaesthesia. The techniques were used either alone or in combination. Results: ECSWL achieved complete success (stone and symptom free) in 87 (39.4 percent) of 221 patients (84 of 218 primary and all of three secondary procedures; 43 of 131 submandibular, 44 of 90 parotid). Basket retrieval cured 124 (74.7 per cent) of 166 patients (103 of 136 primary and 21 of 30 secondary procedures; 80 of 109 submandibular, 44 of 57 parotid). Intraoral surgical removal was successful in a further 137 (95.8 per cent) of 143 patients with submandibular stones (99 of 101 primary, 3 6 of 3 8 secondary and two of four tertiary procedures). The overall success rate for the three techniques was 348 (76.5 per cent) of 455. Conclusion: A minimally invasive approach to the management of salivary calculi is to be encouraged. All three techniques described have low morbidity and afford the possibility of retaining a functional gland.