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Extracorporeal Lithotripsy for Salivary Calculi: A Long‐Term Clinical Experience
Author(s) -
Capaccio Pasquale,
Ottaviani Francesco,
Manzo Raffaele,
Schindler Antonio,
Cesana Bruno
Publication year - 2004
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200406000-00021
Subject(s) - medicine , extracorporeal shock wave lithotripsy , lithotripsy , univariate analysis , extracorporeal , surgery , ultrasonography , multivariate analysis , radiology
Objectives/Hypothesis: The objective was to assess in a large series of patients with a long‐term clinical follow‐up the validity of extracorporeal electromagnetic shock wave lithotripsy as a minimally invasive therapy for sialolithiasis. Study Design: Consecutive patient series. Methods: Three hundred twenty‐two consecutive symptomatic outpatients with single or multiple calculi in the submandibular (234 patients) or parotid (88 patients) gland underwent a complete extracorporeal electromagnetic shock wave lithotripsy treatment. Treatment results were classified into three groups: successful result with complete ultrasonographic elimination of the stone after lithotripsy, successful result with residual ultrasonographic fragments that were less than 2 mm in diameter, and unsuccessful result with residual ultrasonographic fragments that were greater than 2 mm in diameter. Univariate and multivariate statistical analyses were performed. Results: Complete elimination of the stone was achieved in 45% of patients. On ultrasonography, residual fragments (<2 mm in diameter) were detected in 27.3% of patients, and persisting fragments greater than 2 mm in diameter were assessed in 27.7% of patients. In 3.1% of patients, all with submandibular gland stones, sialoadenectomy was performed. Recurrence of calculi in the treated gland was observed during a median follow‐up period of 57 months in four patients with complete ultrasonographic clearance of the stone occurring 10 to 58 months after lithotripsy. Univariate analysis showed that a favorable treatment result was significantly associated with the younger age of the patients (≤46 y), parotid and intraductal localization of the stone, diameter of the stone (≤7 mm), and number of therapeutic sessions (≤6). On multivariate analysis, the age of the patient, parotid site of the stone, stone diameter, number of therapeutic sessions, and number of shock waves were associated with favorable outcome. Conclusion: Extracorporeal electromagnetic shock wave lithotripsy is to be considered an efficient, minimally invasive treatment modality for salivary calculi.