Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy

Schapher M, Koch M, Schapher M, Mantsopoulos K, von Scotti F, Goncalves M, Iro H (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Abstract

OBJECTIVES: To assess results after treatment of difficult/complex sialolithiasis with extracorporeal shock-wave lithotripsy (ESWL) and intraductal pneumatic lithotripsy (IPL). STUDY DESIGN: Retrospective study in a tertiary referral center. METHODS: Altogether, 63 stones were diagnosed in 38 patients with difficult/complex sialolithiasis. Forty-nine stones were treated with fragmentation using both ESWL and IPL. Stones accessible with the sialendoscope were treated primarily with IPL in multiple sialolithiasis. RESULTS: Seventy-one ESWL procedures and 57 IPL were performed in our patients. Forty-nine stones were treated by 67 ESWL procedures and 52 IPL. ESWL converted sialoliths from sialendoscopically untreatable into sialendoscopically treatable cases in 94.7%; the treatment then was completed by a total of 52 IPL procedures. ESWL was performed before IPL (81.6%), in combination with IPL (7.9%) and after (10.5%). Complete fragmentation was achieved in 97.9%. Four stones each were treated with ESWL and IPL alone in multiple sialolithiasis. Altogether, 53 stones were treated by 57 IPL procedures. Complete fragmentation was achieved in 98.1% of the 53 stones. ESWL and IPL were the dominant treatment modalities in 84.1% of all 63 stones treated. Of all 38 patients, 92.1% became stone-free and all became symptom-free. All the glands were preserved. Multiple stones were treated in 34.2% of the patients; of these, 92.3% became stone-free. CONCLUSION: These results show that patients with difficult and complex sialolithiasis can be treated with high success rates of > 90% using a multimodal, minimally invasive, and gland-preserving treatment approach. ESWL and IPL played a key role in this multimodal treatment regime in > 80% of stones. LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

Authors with CRIS profile

Mirco Schapher Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Heinrich Iro Lehrstuhl für Hals-Nasen-Ohrenheilkunde

How to cite

APA:

Schapher, M., Koch, M., Schapher, M., Mantsopoulos, K., von Scotti, F., Goncalves, M., & Iro, H. (2017). Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy. Laryngoscope. https://doi.org/10.1002/lary.27037

MLA:

Schapher, Mirco, et al. "Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy." Laryngoscope (2017).

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