European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
Parotid gland sialolithiasis: a comprehensive systematic review and meta-analysis : Title page.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Salzano Giovanni, Scocca Veronica, Committeri Umberto, Troise Stefania, Vaira Luigi Angelo, Lechien Jerome R, Abbate Vincenzo, Orabona Giovanni Dell'Aversana
Аннотация
PURPOSE: Parotid sialolithiasis represents unique diagnostic and therapeutic challenges due to the anatomy of the gland and the proximity of the facial nerve. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of various treatment modalities for parotid gland stones.
METHODS: A systematic review was conducted in accordance with the PRISMA guidelines. Eligible studies were identified by searching PubMed/MEDLINE, the Cochrane Library, Scopus and Google Scholar. Eligible observational studies and clinical trials reporting on patients with parotid stones were included. The outcomes assessed included stone-free rate, symptom improvement and the presence of any complications. A single-arm random-effects meta-analysis was performed, focusing on endoscopy-only, endoscopy-assisted and extracorporeal shock wave lithotripsy (ESWL). Bias risk was assessed using the Newcastle-Ottawa Scale.
RESULTS: A total of 42 studies involving 1,559 patients were analyzed. Endoscopy-assisted removal showed the highest stone-free rate (93%, 95%CI: 90-96) and symptom improvement (91%, 95%CI: 92-99) (p < 0.05). Combined endoscopic-external approaches were effective for complex stones but had higher complication rates (24%, 95% CI: 14-37). ESWL had a lower stone-free rate (58%) but aided long-term symptom control (p < 0.05). CT-navigation did not significantly enhance clearance (80%). Most complications were minor; no permanent facial nerve injuries were reported. The quality of the evidence was limited by heterogeneity and the lack of any randomized trials.
CONCLUSIONS: Endoscopy-assisted and combined approaches offer effective, gland-preserving options for parotid sialolithiasis. ESWL and laser techniques remain adjunctive but warrant further research. Prospective, standardized trials are needed to define any optimal management strategies.
METHODS: A systematic review was conducted in accordance with the PRISMA guidelines. Eligible studies were identified by searching PubMed/MEDLINE, the Cochrane Library, Scopus and Google Scholar. Eligible observational studies and clinical trials reporting on patients with parotid stones were included. The outcomes assessed included stone-free rate, symptom improvement and the presence of any complications. A single-arm random-effects meta-analysis was performed, focusing on endoscopy-only, endoscopy-assisted and extracorporeal shock wave lithotripsy (ESWL). Bias risk was assessed using the Newcastle-Ottawa Scale.
RESULTS: A total of 42 studies involving 1,559 patients were analyzed. Endoscopy-assisted removal showed the highest stone-free rate (93%, 95%CI: 90-96) and symptom improvement (91%, 95%CI: 92-99) (p < 0.05). Combined endoscopic-external approaches were effective for complex stones but had higher complication rates (24%, 95% CI: 14-37). ESWL had a lower stone-free rate (58%) but aided long-term symptom control (p < 0.05). CT-navigation did not significantly enhance clearance (80%). Most complications were minor; no permanent facial nerve injuries were reported. The quality of the evidence was limited by heterogeneity and the lack of any randomized trials.
CONCLUSIONS: Endoscopy-assisted and combined approaches offer effective, gland-preserving options for parotid sialolithiasis. ESWL and laser techniques remain adjunctive but warrant further research. Prospective, standardized trials are needed to define any optimal management strategies.