Treatment of Parotid Gland Sialolithiasis with Stone Located in the Papilla or Distal Excretory Duct

This protocol applies to sialolithiasis of the parotid gland where the salivary duct calculus is located specifically in the papilla or the distal segment of the excretory duct. The precise stone position at this accessible distal site determines the procedural strategy.

Calculi situated at the papilla or in the distal excretory duct represent a distinct clinical subgroup. Their anatomical accessibility allows for transoral and combined retrieval techniques that are not applicable to more proximally located stones.

For this stone location, the evidence-based approach involves a combined transoral technique as a primary strategy, with the option of adding endoscopic or image-guided adjuncts depending on local anatomy. Which modality is selected — and how it is combined — is defined in the full protocol.