Standardization of Basket Use in Sialendoscopy: A Ten-Year Retrospective Study

Sialolithiasis is a common cause of obstructive salivary gland disease, occurring in both submandibular and parotid glands. The treatment has evolved with the introduction of Sialendoscopy and micro-instruments (baskets, wires, and balloons), which allow intraductal manipulations, including stone removal and strictures, to be dilated. Nowadays, it is the main option for effectively treating these obstructive conditions, leading to improvements in overall quality of life. The objective of the present 10-year retrospective review is to standardize the basic steps involved in successfully removing intraductal sialolithiasis with a Basket instrument. A consecutive ten-year series (January/2014 to June/2024) of patients with obstructive submandibular and parotid glands due to sialolithiasis who underwent sialendoscopy using a basket successfully removed were analyzed. The procedure was conducted following the standards; all interventions were video-recorded and performed by the same surgical team using a semi-rigid modular sialendoscope (1.3 mm/1.7 mm diameter) with working channel, salivary probes, dilatators, different baskets (0.4 mm diameter and 3, 4 and 6 wires) for stones and dilatations, using some steps previously reported. In 10 years, we have performed 224 sialendoscopy due to salivary gland obstructive disease, 84.4% from sialolithiasis. The successful sialolith removal with the basket was performed using pure sialendoscopy (PS-study group) in 132 (69.8%) patients: 79.5% female patients, mean age 44.8 years; 68.9% in the submandibular gland, 65.9% single stones, with 0% major complications. The basic steps were a) how to localize; b) to evaluate (mobile/hard/single stone); c) to estimate sialolith size; d) to choose basket type; e) to choose approach technique (A: Frontal:9.1%, B: Side-to-Side: 35.6%, C: Back-to-Forward: 55.3%). All sialoliths were completely removed, and the patients recovered uneventfully. This article details the standardization of the use of basket in removing ductal stones during sialendoscopy, which is necessary to achieve a high success rate in its removal.