This protocol applies to patients with sublingual gland sialolithiasis presenting in the specific context of sialolithiasis of the parotid gland where the stone is situated in the papilla or distal excretory duct.
Management is guided primarily by stone size and consistency. Minimally invasive endoscopic techniques and extracorporeal fragmentation approaches are among the options considered — with the choice between them depending on specific stone characteristics. The complete selection criteria, sequencing, and decision algorithm are set out in the structured protocol.
Stones in the Papilla and Distal Excretory Duct
Mobile stones not exceeding 3–5 mm in size are an ideal indication for extraction with intSE using instruments such as a basket or forceps, if necessary after application of ISWL.
Endoscopic mobilization or fragmentation is indicated for stones 5–7 mm in size.
If the stones have a weak consistency, mechanical fragmentation using microdrills is a possible solution in some cases.
However, in general, in particular if the stones are of a hard consistency and/or are greater than 7 mm, ISWL represents an excellent treatment modality with high success rates.
DOI: 10.3390/jcm11010231
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