Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-29T07:55:07.424Z Has data issue: false hasContentIssue false
  • English
  • Français

Intracorporeal electrokinetic lithotripsy: an advancement in minimally invasive management of parotid duct calculus

Published online by Cambridge University Press:  08 March 2017

P C Modayil ,
V Jacob ,
G Manjaly  and
G Watson
P C Modayil
Affiliation:
Department of Otorhinolaryngology, Eastbourne District General Hospital, East Grinstead, UK
V Jacob
Affiliation:
Department of Plastic Surgery, The Queen Victoria Hospital, East Grinstead, UK
G Manjaly*
Affiliation:
Department of Otorhinolaryngology, Eastbourne District General Hospital, East Grinstead, UK
G Watson
Affiliation:
Department of Urology, Eastbourne District General Hospital, East Grinstead, UK
*
Address for correspondence: Mr George Manjaly, ENT Consultant, Department of Otorhinolaryngology, Eastbourne District General Hospital, East Sussex BN21 2UD, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Symptomatic salivary stones in the middle or proximal parotid duct have previously been treated by gland excision, which is associated with a 3–7 per cent risk to the facial nerve. Minimally invasive approaches to the management of salivary duct calculi have been devised over the past decade. Fluoroscopically guided basket retrieval, lithotripsy and intra-oral stone removal under general anaesthesia have found favour with most surgeons. Endoscopically controlled intracorporeal shock wave lithotripsy using the pneumoblastic lithotripter has been replaced by electrohydraulic lithotripsy (used in sialolith treatment).

Method:

The electrokinetic lithotripter is normally used for the treatment of lower ureteric stones, and has the benefit of minimal concomitant tissue damage. We have extended its use to the treatment of parotid duct calculi. We present initial results for its use in the treatment of a proximal parotid duct stone.

Result:

Application of the shock wave to the stone under direct vision avoided injury to the duct or to any local structure. The patient made an uneventful recovery and was asymptomatic after 18 months' follow up.

Conclusion:

Continuous, endoscopically monitored electrokinetic lithotripsy with good irrigation gives a well illuminated field and absolute delivery of energy to the target. It avoids the side effects caused by impact of the shock wave on the parotid duct and adjacent anatomical structures, thereby making it a safer procedure.

Keywords

Salivary CalculiParotid GlandLithotripsy
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 4 , April 2008 , pp. 428 - 431
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Epker, BN. Obstructive and inflammatory diseases of the major salivary glands. Oral Surg Oral Med Oral Path 1972;33:2–27CrossRefGoogle ScholarPubMed
2 Escudier, MP, McGurk, M. Symptomatic sialadenitis and sialolithiasis in the English population: an estimate of the cost of hospital treatment. Br Dent J 1999;186:463–6CrossRefGoogle ScholarPubMed
3 Bodner, L. Salivary gland calculi: diagnostic imaging and surgical management. Compendium 1993;14:572–86Google ScholarPubMed
4 Gallo, O, Berloco, P, Bruschini, L. Sialadenectomy. In: McGurk, M, ed. Controversies in the Management of Salivary Gland Disease. Oxford: Oxford University Press, 2001;297–303Google Scholar
5 Katz, PH. Endoscopy of the salivary glands [in French]. Ann Radiol (Paris) 1991;34:110–13Google ScholarPubMed
6 Iro, H, Nitsche, N, Schneider, HT, Ell, C. Extracorporeal shockwave lithotripsy of salivary gland stones. Lancet 1989;2:115CrossRefGoogle ScholarPubMed
7 Konigsberger, R, Feyh, J, Goetz, A, Schilling, V, Kastenbauer, E. Endoscopic controlled laser lithotripsy in the treatment of sialolithiasis [in German]. Laryngorhinootologie 1990;69:322–3Google ScholarPubMed
8 Nahlieli, O, Baruchin, AM. Endoscopic technique for the diagnosis and treatment of obstructive salivary gland diseases. J Oral Maxillofac Surg 1999;57:1394–401CrossRefGoogle ScholarPubMed
9 McGurk, M, Escudier, MP, Thomas, BL, Brown, JE. A revolution in the management of obstructive salivary gland disease. Dent Update 2006;33:28–36CrossRefGoogle ScholarPubMed
10 Marchai, F, Dulguerov, P, Becker, M, Barki, G, Disant, F, Lehmann, W. Specificity of parotid sialendoscopy. Laryngoscope 2001;111:264–71CrossRefGoogle Scholar
11 Zenk, J, Hosenmann, WG, Iro, H. Diameters of the main excretory ducts of adult human submandibular and parotid gland: a histologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:576–80CrossRefGoogle ScholarPubMed
12 Iro, H, Schneider, HT, Fodra, C, Waitz, G, Nitsche, N, Heinritz, HH et al. Shockwave lithotripsy of salivary duct stones. Lancet 1992;339:1333–6CrossRefGoogle ScholarPubMed
13 Ito, H, Baba, S. Pulsed dye laser lithotripsy of submandibular gland salivary calculus. J Laryngol Otol 1996;110:942–6CrossRefGoogle ScholarPubMed
14 Konigsberger, R, Feyh, J, Goetz, A, Kasenbauer, E. Endoscopically controlled electro-hydraulic intracorporeal shock wave lithotripsy of salivary stones. J Otolaryngol 1993;33:12–13Google Scholar
15 Iro, H, Zenk, J. Pneumatic intracorporeal lithotripsy of salivary calculi. In vitro and animal experiment studies [in German]. HNO 1995;43:172–6Google ScholarPubMed
16 Keeley, FX Jr, Pillai, M, Smith, G, Chrisofos, M, Tolley, DA. Electrokinetic Lithotripsy: safety, efficacy and limitations of a new form of ballistic lithotripsy. BJU International 1999;84:261–3CrossRefGoogle ScholarPubMed