Outcomes of Large Salivary Stone Interventions in a Tertiary Head and Neck Center

Monday, September 30, 2024

4:18 PM – 4:24 PM EDT

Location: MBCC, 208

Disclosure(s):

Rebecca J. Doctor, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

William Nicholas Doyle, BS, Jr.:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christopher J. Nickel, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: With the advent of minimally invasive salivary endoscopy, gland preservation has been a key component in the management of obstructive sialadenitis to maintain salivary flow and limit complication risk associated with gland removal. There however remains concern over the utility of this technique with large sialoliths, leading to gland excision being offered to many of these patients, particularly outside of specialized centers. We sought to evaluate the safety and efficacy of surgical management of large sialoliths.

Methods: In this retrospective chart review, all cases with the primary procedure coded as sialolithotomy were retrieved from a tertiary care center OR list from August 14, 2017 to October 4, 2023. Inclusion criteria required patients to be diagnosed with at least one salivary stone ≥ 8 mm confirmed by pathology report. Demographic data, complications, and follow-up details were manually retrieved and recorded using REDCap.

Results: A total of 48 patients met inclusion criteria with an average largest sialolith size of 14.1 mm. Most patients presented with sialolithiasis-related infections before surgery (85.4%). In this cohort, 87.5% of patients underwent a gland preserving approach, while six patients (12.5%) were treated with submandibular gland resection and none managed with parotidectomy. Complications were infrequent, with 81.3% reporting none. The main complication was postoperative infection requiring antibiotics (12.5%). Of those patients initially managed with gland preservation, only one (2.1%) required additional intervention for incomplete sialolith removal during the follow up period. None of the patients had a serious acute complications requiring hospital admission or re-operation within 30 days of surgery.

Conclusions: Operative management of large salivary stones demonstrated a low complication rate, with a rare need for further surgery.

Presenting Author(s)

Rebecca J. Doctor, BA

MS4
University of South Florida
Tampa, Florida, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
KP

Kyle Phan, BS

University of South Florida
Tampa, Florida, United States

Disclosure information not submitted.

Co-Author(s)

KP

Kyle Phan, BS

University of South Florida
Tampa, Florida, United States

Disclosure information not submitted.
William Nicholas Doyle, Jr., BS

MS4
University of South Florida Morsani College of Medicine
Allentown, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Christopher J. Nickel, MD

Assistant Professor
University of South Florida
Tampa, Florida, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Matthew J. Mifsud, MD

Associate Professor, College of Medicine Otolaryngology
University of South Florida
Tampa, FL, United States

Disclosure information not submitted.