Combined external lithotripsy and endoscopic techniques for advanced sialolithiasis cases.

PURPOSE: To assess a combined external lithotripsy-sialoendoscopy method developed for advanced salivary gland sialolithiasis. MATERIALS AND METHODS: A total of 94 patients (43 males and 51 females) underwent these treatment methods. Of these 94 patients, 60 had pathologic features in the submandibular gland and 34 in the parotid gland. A miniature external lithotripter was used, combined with multifunctional sialoendoscopes and endoscopic-assisted techniques, to achieve effective removal/elimination of the stones in these difficult cases. RESULTS: Total elimination of the stone using lithotripsy alone was achieved in 32% of the cases; in 29%, intraductal endoscopic assistance was needed. In the remaining 39%, the removal of a stone was achieved with the help of an endoscopy-assisted extraductal approach (37 cases). At 6 months of follow-up, all patients who had undergone lithotripsy or lithotripsy plus intraductal endoscopy had an absence of symptoms. Of the 37 patients who had undergone an endoscopy-assisted extraductal approach, 35 (95%) remained asymptomatic. CONCLUSIONS: Lithotripsy plus intraductal or extraductal endoscopic treatment of sialolithiasis is a highly effective surgical method of eliminating/removing salivary stones, especially those attached to the surrounding tissue and in the secondary ducts. This method helps to avoid resection of the salivary glands and represents an additional development of minimal invasive surgical techniques.

Salivary gland injury subsequent to implant surgery.

Implant-based prosthetic restoration and oral rehabilitation is a very popular modality of treatment, with excellent success rates. Although a relatively safe procedure, implant insertion has its risks, which have been described in the literature. This article describes an as-yet unreported complication following implant insertion-salivary gland injury. The characteristics of salivary gland injury are examined, and 4 cases in which the salivary apparatus was injured or obstructed during 1 of the phases of implant therapy are presented.

Tongue piercing and its adverse effects.

Piercing has become so popular during the last 20 to 30 years that many physicians are now treating patients with piercings and dealing with its side effects. We present 3 cases that illustrate the complications of tongue piercing (ie, infection, bleeding, and embedded ornaments). We describe the methods for inserting the ornaments to illustrate the possible adverse effects. Treatment recommendations and their application to those 3 patients are described.