Classification of Sialolithiasis by Location of Stones: Retrospective Review of 534 Cases

Lee, Jisoo; Han, Juho; Kim, Sunwook; Choi, Hyogeun; Park, Bumjung

Abstract

BACKGROUND AND OBJECTIVES
To investigate epidemiological features of patients with sialolithiasis and to evaluate the difference in outcomes depending on its location.
SUBJECTS AND METHOD
We included in the test 472 patients, or 534 cases, who were admitted to the Hallym University Sacred Heart Hospital between February 2006 and May 2017 with the diagnosis of sialolithiasis. The diagnosis of sialolithiasis was established by CT images; all of the cases were classified by the location of stones (orifice to stone/orifice to hilum: 0-0.25, type I; 0.25-0.5, type II; 0.5-0.75, type III; 0.75-1, type IV).
RESULTS
The average size of stone was 7.2±4.8 mm and the mean patient age was 36.1±17.4 years old. According to the method described above, 534 cases were classified into the following: type I consisted of 188 cases (35.2%), type II consisted of 55 cases (10.2%), type III consisted of 92 cases (17.2%) and type IV consisted of 199 (37.2%). When comparing these types, stones in Type I were significantly smaller than other groups. There was a significant difference in the surgical method depending on the location of stones. Different complications such as swelling, bleeding, tongue discomfort, ranula, recurrence, etc. have been reported and, together, they statistically show meaningful differences in the distribution depending on types.
CONCLUSION
The position of stone in Wharton's duct is important factor that can determine the method of surgical procedure or postoperative prognosis. We recommend 4 types classification of sialolithiasis and it can provide more specific diagnosis of disease and facilitate approach for treatment.