Extracorporeal Lithotripsy

Background and Indication

Treatment of sialolithiasis is currently achieved by a minimally invasive gland-preserving therapy regime. The observation by van den Akker and Busemann-Sokole that salivary gland function completely recovers after stone removal later was confirmed by others.

In >80% of stones, fragmentation is necessary because of the size, impaction, and location. Of all stones in the submandibular, 80–85% and 75–80% in the parotid gland can be treated by transoral duct surgery and/or interventional sialendoscopy, including intraductal lithotripsy, which are methods of choice. However, 10–15% of stones in the submandibular gland and 20–25% in the parotid gland are not accessible with sialendoscopy but can be treated by extracorporeal shock wave lithotripsy (ESWL). The first successful fragmentation of a salivary stone in the parotid gland by ESWL was reported by Iro et al. in 1989.