Transoral Removal of Submandibular Stone

Kim, Jeong Kyu; Park, June Sik

Abstract

BACKGROUND AND OBJECTIVES: Traditionally, the treatment of choice for submandibular calculi that lie in the proximal duct or gland parenchyme has been sialadenectomy despite its risk. Recently, minimally invasive techniques including lithotripsy, sialendoscope have been reported, although these techniques have some limitations on large, infected calculi. The aim of this present review is to assess the transoral removal of submandibular calculi.
SUBJECTS AND METHOD
The records of a hundred and sixty-three patients who underwent transoral removal of submandibular calculi between January 1, 1995 and July 31, 2004 were retrospectively reviewed.
RESULTS
The complete removal of calculi was observed in 147 (90.2%) patients, partial removal with residual calculi in 8 (4.9%) patients and failure of removal in 8 (4.9%) patients. The removal rate of palpable calculi was significantly high. The removal rate of anterior, infection-free calculi was higher than the posterior and infected calculi, but there was no statistical significance. The size of calculi was not related with the removal rate of calculi. A hundred fifty-two (93.3%) of 155 patients in whom some or all of calculi were removed were free of symptoms of calculi. Symptoms were recurred in 19 patients after 2-68 (median 24) months and in 13 patients calculi were removed transorally again.
CONCLUSION
The transoral removal of calculi is useful in preservation of the submandibular gland and effective in palpable calculi regardless of location, size, and combined infection.