Impact of sialoendoscopy in the diagnosis and treatment of submandibular gland sialolithiasis

Summary Introduction: Sialolithiasis is one of the most common causes of benign obstructive salivary gland dis ease, most frequently aff ecting the submandibular gland. The aim of this study was to evaluate the therapeutic benefi t of sialoendoscopy in patients with submandibular gland sialolithiasis. Materials and methods: This retrospective study (2010– 2023) focused on patients with submandibular gland sialolithiasis who underwent sialendoscopy. When sialolithiasis was identified, the characteristics of the sialoliths (location, mobility, and size) were assessed. Success rate of stone extraction and postoperative outcomes were also evaluated. Results: A total of 338 patients presenting with submandibular gland swelling and pain were analyzed. Sialolithiasis was confi rmed in 215/ 338 (63.6%) patients. A freely mobile sialolith was found in 78/ 215 (36.3%) cases and a fi xed one in 137/ 215 (63.7%) cases, of which 50/ 215 (23.2%) were located distally and 87/ 215 (40.5%) were found proximally. The stone was successfully removed sialoendoscopically in 74/ 78 (94.9%) of freely mobile sialoliths, in 47/ 50 (94.0%) that were distally fixed, and in 50/ 87 (57.5%) that were proximally fixed sialoliths. Success rate of sialendoscopic extraction differed signifi cantly according to the mobility and location of the sialolith – higher success was achieved with mobile and distally fi xed stones, while a lower success rate was seen with proximally fi xed ones (P < 0.001). Signifi cantly higher extraction success rate was observed in sialoliths with a size up to 4 mm in diameter (P = 0.002). Conclusion: Sialoendoscopically-assisted extraction of freely mobile and distally located sialoliths with a maximum diameter of 4 mm demonstrates high success rates, alleviates patient symptoms, and preserves salivary gland function. Key words sialolithiasis – benign obstructive dis ease of the salivary glands – sialoendoscopy – submandibular gland