Transoral and transcutaneous approach for removal of parotid gland calculi: a 10-year endoscopic experience.

OBJECTIVE

The aim of the study was to evaluate the safety, effectiveness, and long-term gland function of endoscopy-assisted lithectomy for extraction of parotid gland calculi.

STUDY

DESIGN

Overall, 116 consecutive patients with parotid gland calculi underwent endoscopy-assisted lithectomy at our center. The immediate safety and effectiveness were evaluated. After surgery, the patients were followed up, and gland function was analyzed on the basis of clinical manifestations and sialography.

RESULTS

Complete stone extraction was achieved in 110 cases (110 of 116 [94.8%]) by using a transoral (95 cases) or transcutaneous (15 cases) approach. At a median follow-up of 3 years, clinical outcomes were excellent in 86 cases (78.2%), fair in 16 cases (14.5%), and poor in 5 cases (4.5%). Postoperative sialographic appearance in 30 stone-free patients was categorized into 3 types: (1) normal (13 cases); (2) ectasia or stenosis in the main duct but no persistent contrast, as seen on functional films (10 cases); and (3) ectasia or stenosis in the main duct and persistent contrast evident on functional films (7 cases).

CONCLUSIONS

In the absence of lithotripsy, appropriate application of various minimally invasive endoscopic procedures has confirmed safety and effectiveness for stone extraction in patients with parotid calculi. Sialography is a viable method for the evaluation of postoperative gland function.