Experience in using a minimally invasive method for removing salivary gland duct calculus under sonography control

Background. Removal of calculi in salivary stone disease is one of the urgent problems of maxillofacial surgery and surgical dentistry due to the complexity of the manipulation, the trauma of the technique and the frequent development of complications.

Aim. Improvement of the treatment results of patients with salivary stone disease by using our developed method of minimally invasive removal of calculi located in any part of the excretory duct of the submandibular and/or parotid salivary glands, under constant ultrasound visualization of the intervention.

Material and methods. The study included patients diagnosed with salivary stone disease (10 people: 9 male and 1 female aged 18–50 years, mean age 44.2±1.25 years). The methodology was as follows. An ultrasonic sensor was brought in from the side of the skin, and the location of the calculus in the gland duct was determined. Next, a needle with a diameter of 0.3 cm with a mandrin was inserted percutaneously through a puncture into the duct of the salivary gland to the distal surface of the calculus, and it was advanced with the help of a needle as far as possible towards the mouth of the excretory duct. Then the needle was removed, leaving a mandrel in the duct, with which the calculus was fixed in a new position. After bougienage of the excretory duct, Dormia’s basket was introduced into it, and the calculus was captured and removed. The manipulations were performed under constant ultrasound imaging.

Results. The use of the technique developed by us for minimally invasive removal of a calculus with a diameter of up to 5 mm, located in any part of the excretory duct of the submandibular and/or parotid salivary glands, under constant ultrasound visualization of the intervention course, made it possible to achieve a positive result in all 10 patients included in clinical observations.

Conclusion. The minimally invasive technique for removing calculi from the excretory ducts of the salivary glands under constant ultrasound imaging developed by us makes it possible to facilitate manipulation, its visibility and accuracy, as well as atraumaticity and prevention of complications.