Management of giant sialoliths: review of the literature and preliminary experience with interventional sialendoscopy.
ABSTRACT To report our experience with management of giant salivary stones via a combined approach technique using salivary endoscopy (CA) and results of a review of current literature related to giant salivary stones.
Retrospective case series.
An institutional review board-approved chart review was performed on patients managed with a CA to treat giant salivary stones (≥15 mm). In addition, we reviewed the English literature from 1942 to 2009.
Table 1 consists of 54 stones; 47 of which were identified during the review of literature and 7 from our case series. Of those 47 stones, 23 were hilar in location, 23 were glandular in location, and 1 stone was missing data. The gland preservation rate in the 47 reported stones was 57% (17/30). Among patients where gland resection was reported, the majority of the patients (12/13) had hilar glandular stones. Only one patient with a ductal stone had a gland resection. In our series, CA enabled a gland preservation rate of 86% (6/7). Among these patients, stone location was hilar glandular in six (86%) and ductal in one (14%). The mean size of stones from the literature review was 35 mm and from our series was 19 mm.
Our review reflects current treatment recommendations for giant stones, i.e., transoral sialolithotomy for ductal stones and gland resection for hilar glandular stones. Our preliminary experience with CA for giant stones suggests improved gland preservation rates (86% vs. 57%) independent of stone location and with preservation of salivary function.
- Journal of oral surgery (American Dental Association: 1965) 10/1973; 31(9):710-1.
Article: Giant submandibular gland calculi.Journal of Oral and Maxillofacial Surgery 06/1985; 43(5):384-5. · 1.33 Impact Factor
Article: The gigantiform salivary calculus.[show abstract] [hide abstract]
ABSTRACT: The size of salivary calculi may range from small particles to large concrements of several centimetres. One case of a gigantiform salivary calculus located in the Wharton duct of a 48-year-old man is presented. After surgical removal of the 3.6 cm long concrement, it was split into 4 parts. The different parts were used for routine histological studies, production of microradiographs of ground sections and for scanning electron microscopy. Decalcified sections disclosed a specimen made of a homogeneous central nucleus and a peripheral lamellation. The same morphological picture was seen on the microradiographs, where the nucleus showed dense mineralization, and the peripheral part alternating rings of high and low mineral content. Microorganisms, mostly thread-like organisms, were found throughout the entire calculus in specially stained sections. Scanning electron microscopy confirmed the histologic and microradiographic findings. The presence of microorganisms also in the nucleus of the calculus seems to be one important aetiological factor favouring the formation of this gigantiform concrement.International Journal of Oral Surgery 05/1982; 11(2):135-9.