Treatment of Sialolithiasis of the Parotid Gland with Stone at Hilar to Intraparenchymal Location

Clinical Scenario

This protocol applies to sialolithiasis of the parotid gland where the calculus is situated from the hilum to an intraparenchymal position — a location at which the stone may not be directly visible or reachable via endoscopic access alone.

Treatment Approach (overview — partial)

When gland preservation is the goal, extracorporeal shock-wave lithotripsy (ESWL) is central to management in this stone location, serving to fragment and mobilize the calculus. Whether and how ESWL is combined with additional interventional steps depends on the degree of stone mobilization achieved.

The complete sequenced protocol — including the criteria and options for supplementary interventional procedures — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1007/s00405-025-09697-y

Hilar to Intraparenchymal Stones
As the stones are often not visible and/or accessible with the sialendoscope, ESWL is a valuable and sometimes the only treatment modality if gland preservation is intended.
After adequate mobilization, ESWL may be supplemented by intSE or combined with ISWL or even a combined approach, if a stone is accessible.

View source ↗