Combined approach technique for the management of large salivary stones.

OBJECTIVES/HYPOTHESIS: To review our experience with the combined approach, which includes an internal (endoscopic) and open approach for the management of large salivary stones.

STUDY DESIGN

Retrospective.

METHODS

Clinical data was reviewed on patients who underwent combined approach for large salivary stones from July 2005 to August 2008 under an institutional review board approved protocol.

RESULTS

Of 106 patients who underwent sialendoscopy, 19 patients (18%) had 20 combined procedures. Thirteen patients (68%) were women and six men (32%) with a mean age of 52 years (range, 15-69 years). Operative times were shorter for submandibular stones (mean, 90 minutes) as compared to parotid stones (mean, 133 minutes). Stone removal was successful in 90% (18/20) with no major complications and minor complications in four patients (20%).

CONCLUSIONS

The combined procedure allows complete removal of large or impacted sialoliths without the need for removal of the entire gland with acceptable complication rates. We also recommend consenting patients for this approach when a difficult endoscopic removal is anticipated. Laryngoscope, 2009.