Minimally Invasive Radiologically Guided Intervention for the Treatment of Salivary Calculi

Purpose: To describe the technique and examine the value of salivary stone extraction using a minimally invasive, radiologically guided approach as an alternative to salivary gland surgery for the treatment of benign salivary gland obstruction. Methods: Eighty-six cases of sialolithiasis (83 patients) were treated by stone removal using a Dormia basket under local anesthesia and fluoroscopic guidance. Postoperative assessment was made clinically at review, by sialogram and by questionnaire. Results: Of 86 cases of sialolithiasis treated, in 55 (64%) it was possible to remove all stones. In 12 cases (14%) part of a stone or some of a number of calculi were removed and in 19 cases (22%) the procedure failed. The commonest reason for failure was fixation of the stone within the duct. Symptoms at review (range 1–49 months, mean 17 months) were relieved in 55 of 67 (82%) of cases where a stone or portion of stone was removed. Conclusions: Stone removal from the salivary duct system by radiologically guided, minimally invasive approach is a simple procedure with low morbidity and high patient acceptance when appropriate selection criteria are applied. These criteria are considered and recommendations made.