This protocol covers the management of sialolithiasis of the sublingual gland in the specific clinical context of concurrent sialolithiasis of the parotid gland where the stone occupies a hilar to intraparenchymal location.
The stone in this setting is located in the hilar to intraparenchymal region of the parotid gland. Up to 20% of all salivary stones are found in an intraparenchymal location. Stones at this depth are frequently not visible and may not be directly accessible via sialendoscopy, which significantly influences the choice of intervention.
When gland preservation is the intended goal, extracorporeal shock-wave lithotripsy (ESWL) plays a central role and may represent the only viable option for stones at this location. The full intervention sequence — including how subsequent steps are determined based on the degree of mobilisation achieved — is detailed in the complete protocol.
DOI: 10.3390/jcm11010231
Hilar to Intraparenchymal Stones. Up to 20% of all stones are in an intraparenchymal location.
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.
ESWL is then conducted to achieve stone fragmentation and mobilization of stones or fragments.
After adequate mobilization, ESWL may be supplemented by intSE or combined with ISWL or even a combined approach, if a stone is accessible.
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