Long‐Term Outcomes of Surgical Management for Submandibular Sialolithiasis: Gland Resection Versus Preservation

ABSTRACT Objective Describe long‐term outcomes of submandibular sialolithiasis treatment, comparing gland‐preserving procedures to gland resection. Methods This retrospective cohort study with prospective patient‐reported outcome assessment study included all patients who underwent initial surgical management of submandibular sialolithiasis by a single surgeon from 2013 to 2018. Patients were contacted in 2024 and surveyed regarding treatment response. The primary outcome was xerostomia at long‐term follow‐up, measured using the Xerostomia Questionnaire (XQ). Secondary outcomes included stone recurrence, postoperative complications, and “ultimate surgical success,” defined as resolution of salivary symptoms without additional interventions during the 5‐to‐10‐year interval following the initial series of procedures. Eighty‐two patients were identified; 36 (43.9%) completed follow‐up. Results Of 36 respondents (median follow‐up 97.4 months), 11 (30.6%) underwent initial gland resection and 25 (69.4%) underwent initial gland‐preserving, sialendoscopy‐assisted procedures. Among the preservation group, 1 patient required a second gland‐preserving procedure, and 3 ultimately underwent gland removal due to persistent symptoms. Resolution of symptoms after the first procedure occurred in all resection patients (100%) and 18 of 25 (72%) in the preservation group. Among those with preserved glands at follow‐up ( n = 22), 6 (27.3%) reported xerostomia (mean XQ 8.0) compared to 4 of 14 (28.6%) in the resection group (mean XQ 3.4). Ultimate surgical success was achieved in 90.9% of the preservation group and 100% of the resection group. Conclusions Both surgical approaches offer durable outcomes, though gland preservation may carry a higher risk of persistent symptoms and potential need for additional intervention. Xerostomia rates were comparable, suggesting gland preservation does not necessarily reduce long‐term xerostomia risk. Level of Evidence OCEBM Level 4.