Laser-Assisted Lithotripsy With Sialendoscopy: Systematic Review of YO-IFOS Head and Neck Study Group

Introduction: Sialolithiasis is the most common cause of symptomatic obstructive sialadenitis. Sialendoscopy represent a minimally invasive technique that has evolved significantly in the last 2 decades, with high success rates in managing sialolithiasis and allowing gland preservation. Lithotripsy...

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Published in:Ear, nose, & throat journal nose, & throat journal, 2021-02, Vol.100 (1_suppl), p.42S-50S
Main Authors: Chiesa-Estomba, Carlos Miguel, Saga-Gutierrez, Carlos, Calvo-Henriquez, Christian, Lechien, Jérome Rene, Cartier, César, Mayo-Yanez, Miguel, Larruscain-Sarasola, Ehkiñe, Ayad, Tareck, Walvekar, Rohan R.
Format: Article
Language:English
Subjects:
Adult
Calcification
Endoscopy - methods
Exocrine glands
Female
Humans
Lasers
Lithotripsy
Lithotripsy, Laser - methods
Male
Parotid Gland - surgery
Prospective Studies
Retrospective Studies
Salivary Ducts - surgery
Salivary Gland Calculi - surgery
Sialadenitis - surgery
Submandibular Gland - surgery
Systematic review
Treatment Outcome
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Summary:Introduction: Sialolithiasis is the most common cause of symptomatic obstructive sialadenitis. Sialendoscopy represent a minimally invasive technique that has evolved significantly in the last 2 decades, with high success rates in managing sialolithiasis and allowing gland preservation. Lithotripsy assisted or not by laser represents the fragmentation of stone or lithiasis within the salivary duct followed immediately by removal of the fragmented pieces. Material and Methods: A systematic review investigating the role of laser-assisted lithotripsy with sialendoscopy (LAS) in the treatment of sialolithiasis was performed. Results: Sixteen papers meet inclusion criteria. The mean maximum diameter of lithiasis was 7.11 mm (min: 2 mm/max: 17 mm; standard deviation [SD]: 2.33; 95% CI = 1.573-4.463). Success rate described ranging from 71% to 100% with a mean of 87.3% (SD: 7.21; 95% CI: 5.326-11.158) and the gland preservation rate was 97%. Considering only “non retrievable–non floating stones” studies that include both parotid and submandibular stones: Eight clinical retrospectives, nonrandomized studies and 1 prospective, nonrandomized study report results from parotid and submandibular gland lithiasis. According to this, the most common gland involved was the submandibular gland (n = 153; 65.1%), in comparison to the parotid gland (n = 82; 34.8%). Conclusion: The current evidence supports LAS as a conservative, efficient, safe, and gland-preserving alternative technique, in experienced hands, for management of mid-size sialolith removal from major salivary glands, when the indication is appropriate.
ISSN:0145-5613
1942-7522
DOI:10.1177/0145561320926281