Treatment Strategies and Outcome in Minimally Invasive, Gland‐Preserving Treatment for Multiple Sialolithiasis

OBJECTIVE(S): Minimally invasive procedures are well established for patients with sialolithiasis involving single stones. For patients with multiple sialolithiasis, few data are available regarding the treatment approaches and outcomes with gland-preserving therapies. The aim of this study was to review current treatment concepts and postinterventional outcomes in these patients and to propose a treatment algorithm. STUDY DESIGN: Retrospective study. SETTING: University hospital and tertiary referral center. METHODS: The study was conducted to evaluate therapeutic effectiveness and outcome in patients who presented with multiple sialolithiasis in the major salivary glands between January 2016 and October 2022. All patients received minimally invasive treatment following established treatment algorithms. RESULTS: In 177 patients with multiple sialolithiasis, 556 stones were treated using a minimally invasive treatment regimen, with a mean of 2.55 interventions per patient. Monomodal therapy was carried out in 54.8% of the patients and multimodal therapy in 45.2%. Stone-free and/or symptom-free status was achieved for all patients with stones in the submandibular glands and for 97.6% of those with stones in the parotid glands. Gland preservation was possible in 97.2% of the patients, with no significant differences between the submandibular glands (97.8%) and parotid glands (95.2%; P = .371). CONCLUSION: Multiple sialolithiasis can be treated with high success rates. In nearly half of the patients, a multimodal minimally invasive treatment regimen is needed in order to achieve stone-free and/or symptom-free status and preservation of the gland-both possible in over 97% of cases.