Treatment and prognosis of large submandibular calculi

Abstract

Abstract: PURPOSE: Recently, different minimally invasive techniques have been developed for the management of submandibular calculi. This retrospective study summarized our experience in transoral management of large submandibular calculi with sialendoscopy. METHODS: During a period of 10 years from 2002, patients with swelling symptom in submandibular gland were confirmed with large calculi (≥10 mm) by routine methods. All cases were evaluated in regard to the degree of symptom by VAS, and patients with long history (more than 1 year) were further assessed with uptake and excretion function by 99mTc pertechnetate scintigraph. Large calculi were removed by transoral approach (with gland preservation) combined with sialendoscopic management. Failed cases underwent removal of the glands. Evaluation of the results included VAS assessment after large calculi removed successfully. RESULTS: One hundred and six cases had large calculi in the submandibular duct (anterior 33, posterior 73). 19 cases were evaluated by scintigraphic examination, 6 cases (31.6%) almost lost total function, and 9 cases lost partial function, 4 cases had normal function. Transoral sialolithectomy was successfully performed in 101 cases (101/106, 95.3%). Residual calculi were detected in distal duct in 29 cases under sialendoscopy, and 23 cases were removed successfully by forceps or basket simultaneously. Most cases after management had relieved symptom by VAS evaluation. CONCLUSIONS: Large submandibular calculi can be removed transorally by gland-preserving procedure and most cases were asymptomatic after joint management with sialendoscopy. Supported by National Natural Science Foundation of China (81100766), Key Project of Shanghai Municipal Health and Family Planning Bureau(2014035), Research Fund of Science and Technology Committee of Shanghai Municipality (08DZ2271100), Program for Innovative Research Team of Shanghai Municipal Education Commission, and Medical Guiding Foundation of Shanghai Jiao Tong University (YZ1024).

Key words: Sialolithiasis, Large submandibular sialolith, 99mTc scintigraphy

CLC Number:

R781.7.5

SHI Huan, YU Chuang-qi, ZHENG Ling-yan, PU Yi-ping, XIE Li-song, WANG Zhi-jun. Treatment and prognosis of large submandibular calculi[J]. China Journal of Oral and Maxillofacial Surgery, 2014, 12(3): 228-232.

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