Treatment of Sialolithiasis of Sublingual Gland in Sialolithiasis of the Submandibular Gland with Stones in the Proximal to Hilar Duct System
Clinical Scenario
This protocol applies when sialolithiasis of the sublingual gland is associated with sialolithiasis of the submandibular gland, specifically with the stone located in the proximal to hilar duct system. This anatomic position places the calculus in a region where accessibility is reduced, making it a more complex situation than distally located stones.
Treatment Approach (Partial Overview)
The structured protocol covers shock-wave based interventional options — selected according to anatomic factors and case complexity — aimed at fragmenting or mobilising stones that are difficult or impossible to reach by standard means, so that further retrieval becomes feasible. The complete clinical decision algorithm, selection criteria, and sequencing are available in the full protocol.
References
DOI: 10.3390/jcm11010231
- Stones in the Proximal to Hilar Duct System
- ISWL may be indicated in difficult cases when the patient has unfavorable anatomic conditions, in order to avoid general anesthesia (see above).
- When the stones are accessible, ESWL may be offered only in selected cases—e.g., if the patient declines all other treatment modalities or in difficult sialolithiasis.
- ESWL may then be performed with the main intention of fragmenting and mobilizing less good accessible or inaccessible stones so that they become amenable again for intSE or ISWL, to retrieve the fragments.
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