|
Sialolithiasis is the presence of stones in the ducts of the salivary glands. Most episodes are unique, and 60-80%
are located exclusively in the main excretory duct. The main clinical manifestations are swelling and pain typically
before, during or after meals that decreases if the obstruction is not complete. The highest prevalence of lithiasis
is in the submandibular gland -87%-, whose secretion is more viscous, followed by the parotid gland -10%- and
finally the sublingual gland -3%-. The most significant consequences are caused by the prolonged blockage of the
duct by a stone, which can produce a persistent ductal dilatation with a swelling that does not subside, and could
lead to the complete degeneration of the parenchyma, becoming a hot spot where secondary infections may occur,
leading to acute bacterial sialadenitis or glandular abscesses.
Treatment options range from a single probing extraction, extraction with sialographic control using the sialoen
-
doscope, LASER intraductal lithotripsy, lithotripsy extracorporeal shock wave (ESWL), to the surgical techniques
combining open duct with endoscopic or glandular removal. We propose, with regard to a case, the use of a simple
piezoelectric device which, tunnelling through the glandular channel by the ostium, allows stone fragmentation, wi
-
thout damaging the surrounding soft tissue. Stone removal by this less invasive method reduces the need for more
complex and expensive techniques. The postoperative course without retraction of the ostium, and the regaining of
functionality is favourable.
|