This protocol applies to sialolithiasis of the parotid gland where the calculus is situated from the hilum through to an intraparenchymal location — a stone position that places it beyond the distal duct and requires a specialised approach to access and removal.
The critical factor in this scenario is the presence of a parotid gland calculus at the hilar or intraparenchymal level. This specific location shapes the procedural strategy and determines which intervention is appropriate.
When the stone is endoscopically accessible, management involves a combined approach using both endoscopic and transcutaneous techniques. Imaging guidance may be incorporated. The full selection criteria, procedural algorithm, and technical details are available in the structured protocol.
DOI: 10.1007/s00405-025-09697-y
Hilar to Intraparenchymal Stones
Patients with treatment-resistant stones and those in whom ESWL is contraindicated have an indication for the combined endoscopic–transcutaneous approach.
The prerequisite for this is endoscopic accessibility of the stone.
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