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Transoral Removal of Submandibular Stones
Johannes Zenk, MD;
Jannis Constantinidis, MD;
Basel Al-Kadah, MD;
Heinrich Iro, MD
Arch Otolaryngol Head Neck Surg. 2001;127:432-436.
Objective To assess transoral treatment of submandibular lithiasis.
Design Study of a series of patients with submandibular stones undergoing transoral
removal of the sialoliths. Duration of follow-up: 6 months to 7 years.
Setting Department of Otorhinolaryngology, Head and Neck Surgery, University
of Erlangen-Nuremberg, Erlangen, Germany, center for treatment of salivary
stones.
Patients Two hundred thirty-one patients (127 females, 104 males) suffering from
submandibular lithiasis had a mean age of 41.7 years (age range, 12-86 years).
Stone location was distal to the edge of the mylohyoid muscle in 115 patients
and proximal to the gland in 102 patients (mean size of sialoliths, 6.3 mm
[range, 2-30 mm]). Fourteen other patients had 2 separate stones, one within
the hilum and a smaller more proximal one within the gland.
Interventions Transoral removal of the stones under local anesthesia and preservation
of the submandibular gland.
Main Outcome Measures Complete removal of the stones, complications, and recurrence of the
stones.
Results All 115 patients with distal stone location, 93 (91%) of 102 patients
with stones of the perihilar region, and 9 (64%) of the 14 patients with 2
separate stones in the hilum and parenchyma were free of stones. Submandibulectomy
had to be carried out in 4 patients (1.7%). Recurrence of lithiasis and damage
to the lingual nerve remained below 1%.
Conclusions Transoral removal should be the treatment of choice in patients with
submandibular stones that can be palpated bimanually and localized by ultrasound
within the perihilar region of the gland.
From the Department of Otorhinolaryngology, Head and Neck Surgery,
University of Erlangen-Nuremberg, Erlangen, Germany.
Corresponding author: Johannes Zenk, MD, Department of Otorhinolaryngology,
Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstrße 1
D-91054, Erlangen, Germany (e-mail: johannes.zenk{at}hno.imed.uni-erlangen.de).
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