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Background and Objectives Proximal submandibular stone is not a rare disease. The aim of this study is to evaluate the surgical outcomes of 3 different ways to treat proximal submandibular stone: intraoral removal of stone (IORS) with sublingual gland (SLG) resection, IORS without SLG resection and submandibular gland (SMG) resection.Subjects and Method We prospectively reviewed the surgical outcomes of IORS with SLG resection group (22 patients), IORS without SLG resection group (35 patients) and SMG resection group (22 patients). To evaluate the surgical outcomes, we analyzed the location and size of stones, mean operation time, mean hospital stay, mean postoperative degree of pain based on a visual analog scale (0–10), and incidence of complications.Results There were no significant differences between the mean diameter of stones and length from the hilum to stones. The mean operation time was shorter in the IORS without SLG resection group than that in IORS without SLG resection group, and was significantly shorter than that of the SMG resection group. The mean hospital stay of the IORS without SLG resection group was also shorter than that of IORS with SLG resection group, and was significantly shorter than the SMG resection group. IORS without SLG resection group felt less pain than IORS with SLG resection group and SMG resection group. Four patients who underwent IORS without SLG resection experienced transient and mild SMG swelling, and mild paresthesia was noted on the same side. All patients recovered within 3 months. Intraoral removal of proximal SMG stones exhibited several advantages over SMG resection in terms of hospital stay, mean operation, time and postoperative pain.Conclusion Based on our results, we suggest that IORS without SLG resection be selected as the primary procedure for the removal of proximal submandibular stones rather than SMG resection.

korean journal of otorhinolaryngology-head and neck surgery

Clinical Comparison of Transoral Removal with Sublingual Gland Preservation versus without Sublingual Gland Preservation versus Submandibular Gland Resection for Proximal Duct Stone of Submandibular Gland: Prospective Study