11/52. Combined approach to impacted parotid stones. PURPOSE: This article describes the use of combined endoscopic and ultrasound approach to locate and to extract impacted parotid stones, which cannot be retrieved by intraoral approach alone. patients AND methods: A total of 12 parotid glands from 7 women and 5 men (age range, 35 to 62 years) with parotid sialoliths were treated with the combined method. Eleven of 12 of the procedures were performed under local anesthesia in an outpatient clinic. The identification of the calculi was done in 5 patients with 1.3-mm sialoendoscope (Nahlieli Sialoendoscope; Karl Storz, Tuttlingen, germany) in 6 patients with the aid of high-resolution ultrasound, and in 1 patient the location was combined endoscopy and ultrasound. The removal of the calculi was performed extraorally via minimal incision. The indications for the combined approach were 1) calculus in the posterior third of the Stensen's duct with too narrow duct anterior to it, 2) obstruction of the posterior or middle third of the Stensen's ducts leading to the calculus, 3) large (>5-mm) stones in the middle or posterior part of the duct that cannot be dilated for intraductal removal, and 4) intraparenchymal stones. RESULTS: Of the 12 patients, 9 had complete removal (75%); in 1 case with 3 sialoliths, we removed 2 and the gland remained asymptomatic. In 7 cases, the glands returned to function, 3 glands became atrophic with no function, but the gland remained asymptomatic. The aesthetic results were satisfactory in all cases, no major complications were noted. CONCLUSIONS: Combined endoscopic ultrasound approach is another minimal invasive technique for identification and removal of impacted parotid sialolithiasis. ( info) |
12/52. Non-operative removal of a parotid duct stone with a balloon angioplasty catheter. We illustrate a rapid and simple method for removal of a stone from the parotid duct using a balloon angioplasty catheter and digital subtraction imaging. No anaesthesia or surgical intervention is necessary. ( info) |
13/52. Multiple sialolithiasis in the parotid gland with sjogren's syndrome and its sonographic findings--report of 3 cases. We present 3 cases of sjogren's syndrome in which multiple sialolithiasis were observed in the parenchyma of the parotid gland. The sonographic examinations showed microliths that were observed as hyperechoic spots. Some of the microliths were accompanied with comet sign, however most of them showed no particular posterior echoes. None of them showed acoustic shadows, which are normally observed in cases with sialolithiasis. We were able to prove that some of the hyperechoic spots observed sonographically in patients with severe sjogren's syndrome were microliths. Although these multiple microliths are rarely detected, they may exist potentially in higher frequency in patients with severe Sjogren's syndrome. ( info) |
14/52. Ultrasound-guided basket retrieval of salivary stones: a new technique. We describe the successful use of ultrasound-guided retrieval of a submandibular stone with a basket in two patients. ( info) |
15/52. Parotid duct sialolithiasis in a patient with down syndrome--case report. Sialolithiasis is the phenomenon of blockage of the salivary glands. It frequently is associated with swelling, pain, and infection of the affected gland. Clinically, sialolithiasis manifests as an increase in the size of the affected gland and increased salivary secretion that results in pain during eating. It occurs mainly in the submandibular gland and less frequently in the parotid gland. This article presents a case involving a 23-year-old woman with down syndrome who demonstrated sialolithiasis in the parotid duct gland. The sialolith was radiographed and removed surgically. ( info) |
16/52. Parotid sialolithiasis in Stensen's duct. Salivary duct lithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions or sialoliths resulting in salivary ectasia and even provoking the subsequent dilation of the salivary gland. Sialolithiasis accounts for 30% of salivary diseases and most commonly involves the submaxillary gland (83 to 94%) and less frequently the parotid (4 to 10%) and sublingual glands (1 to 7%). The present study reports the case of a 45-year-old male patient complaining of bad breath and foul-tasting mouth at meal times and presenting with a salivary calculus in left Stensen's duct. Once the patient was diagnosed, the sialolith was surgically removed using local anesthesia. In this paper we have also updated a series of concepts related to the etiology, diagnosis and treatment of sialolithiasis. ( info) |
17/52. Ultrasound-guided basket retrieval of a submandibular duct stone in a child. We describe the successful use of ultrasound-guided retrieval of a submandibular stone with a basket, in a 13-year-old child. ( info) |
18/52. An uncommon case of parotid sialolithiasis. A vivid example of parotid sialolithiasis diagnosed with an anterior-posterior radiograph and subsequently followed with a superficial parotidectomy is presented. The case presentation is preceded and followed by a discussion of the pathogenesis and treatment of such an abnormality. ( info) |
19/52. Extraoral parotid sialolithotomy. The extraoral approach to duct surgery for the removal of parotid stones can be a simple procedure once the stone is accurately located in relation to the skin surface. The combination of sialography and sonography can provide this information. A case report demonstrates the step-by-step approach to diagnosis, localization, and surgery for the management of such extraglandular sialoliths. ( info) |
20/52. Diagnosing salivary stones. Sialolithiasis, or the formation of sialoliths or salivary stones, typically occurs in the ducts of the submandibular and parotid glands of middle-aged adults. pain and swelling are often among the first signs and symptoms. Obstructive sialadentitis, epidemic parotitis (mumps) and salivary gland tumors, should all be included in the differential diagnosis for sialolithiasis. ( info) |