When a parotid calculus is located in the middle or proximal duct, or in the hilar region, the clinical approach differs from distal-duct stones. Stone position directly determines which interventional strategy is appropriate and feasible.
Clinical scenario: Sialolithiasis of the parotid gland with the calculus located in the middle or proximal duct, or in the hilar region.
Management in this setting may involve extracorporeal shock-wave lithotripsy (ESWL), where available, as part of the therapeutic strategy. The complete protocol specifies how and when additional minimally invasive techniques are incorporated, and under what conditions each step applies.
DOI: 10.1007/s00405-025-09697-y
Stones in the Middle or Proximal Duct and Hilar Region
If intSE or ISWL are not feasible (mainly because the stone is not accessible or visible), ESWL is indicated if available, and it can then again be supplemented with intSE or ISWL.
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