Salivary Duct Stones and Strictures Nonoperative treatment
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Nonoperative Removal of Sialoliths and
Sialodochoplasy of Salivary Duct Strictures
Robert (Byung) H. Kim, MD
(262) 835-1338
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Reprinted from the Archives of Otolaryngology -- Head & Neck Injury
September, 1996 Volume 122
Copyright 1996, American Medical Association

Arch Otolaryngology Head Neck Surgery 1996;122:974-976

  • Objective- To describe the nonsurgical removal of sialoliths and treatment of salivary duct strictures.
  • Design- Case series.
  • Setting- Two 200-bed general community hospitals.
  • Patients- Twelve consecutive patients from April 1985 to November 1994 - 8 with calculi, 3 with salivary duct strictures, and 1 with calculi and strictures.
  • Results- Successful nonoperative removal of calculi in 7 of 9 patients. All four sialodochoplasties were successful. All 10 patients with successful procedures had no recurrent symptoms. Seven patients have been symptom-free for 10 months to ten years. Communication with 3 patients has been impossible recently, although these patients were symptom-free for at least 3 years. To date we have successfully treated twenty-five of twenty-eight patients for salivary duct calculi removal and dilatation of strictures.
  • Conclusions- These methods of nonsurgical sialolith removal and sialodochoplasty were highly successful and should be used as the initial therapies for patients with these conditions.
SIALOLITHIASIS and salivary duct strictures are common pathological conditions of the salivary glands and their ducts. They produce similar symptoms of swelling, pain, and infection as a result of duct obstruction. Swelling and pain usually occur during meals, when salivary secretion is stimulated.

Until recently, surgery has been the standard therapy for these conditions. This approach is invasive with important unavoidable risks and complications. Potential risk of damage to the facial nerve is high during parotid gland surgery.

Recently, extracorporeal shock wave lithotripsy has been introduced as an alternative treatment of sialolithiasis. Miniature lithotriptors have been developed and show some promise. However, these units are not generally available and their success rates have been variable.

The mechanical removal of sialoliths and sialodochoplasty for duct stricture have been our initial approach for these diseases. These minimally invasive procedures are highly effective and avoid the known complications of surgery and anesthesia. Combining these methods with extracorporeal shock wave lithotripsy promises to further increase success rates.

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