[Extracorporeal shockwave lithotripsy (ESWL) for salivary gland stones: a retrospective study of 1571 patients].

INTRODUCTION: The fragmentation of salivary stones by extracorporeal shockwave lithotripsy (ESWL) has been described since the 1990s. We wanted to assess its effectiveness through a retrospective study.

PATIENT AND METHODS: We reviewed the files of 1571 patients (801 women and 770 men, from 6 to 85 years of age) treated by ESWL between 1995 and 2010 for 1031 submandibular (65.6%) and 540 parotid gland sialolithiasis (34.4%). The treatment consisted in one or several sessions of ESWL distributed over 3 to 24 months. Three thousand to 6000 shockwaves were delivered by session, if there was no hemostatic disorder or infection. Ultrasound control examinations were performed regularly and systematically.

RESULTS: An average of six sessions was necessary. All the lithiases were fragmented, 1056 (67.2%) totally and 515 (32.8%) partially with residual fragments from 1 to 6mm in size. After treatment, 1446 patients (92%) were asymptomatic and 125 (8%) continued to present salivary symptoms, without residual fragments on ultrasound examination in 82% of the cases. The main adverse reaction was infection (628 patients, 40%) resolved thanks to antibiotic treatment or extraction of fragments under local anesthesia.

DISCUSSION: Developed for 20 years, LEC is an excellent alternative to conventional surgery as long as indications are respected. It seems very effective, but its drawbacks are the length of management and the difficulty of ultrasound localization of calculi, which requires an experienced operator.