Endoscopic Salivary Stone Fragmentation with Pneumatic Lithotripsy in a Simulation Model.
Otolaryngol Head Neck Surg
; 154(3): 454-9, 2016 Mar.
Article
in En
| MEDLINE
| ID: mdl-26786265
ABSTRACT
OBJECTIVE:
To evaluate the endoscopic fragmentation and removal of human salivary stones by employing intracorporeal pneumatic lithotripsy in a clinical simulation model of the submandibular gland. STUDYDESIGN:
Simulation model evaluating endoscopic management of human salivary stones.SETTING:
Laboratory. SUBJECTS ANDMETHODS:
A flexible nitinol contact probe adapted to a CO2-driven handheld salivary pneumatic lithotripter was deployed through a sialendoscope to disrupt parotid (n = 1) and submandibular (n = 8) stones embedded in separate 3-dimensionally printed plastic models of the mouth and submandibular glands. Simulation included endoscopic removal of small stone fragments by standard basket retrieval supplement by irrigation and suction through a salivary duct introducer system. Correlations were made between stone volume and density with the duration of the procedures and number of pneumatic pulses required to disrupt and remove stone fragments.RESULTS:
Among the 8 stones fragmented sufficiently to permit either full endoscopic removal (n = 7) or removal of the central portion leaving an adherent rind to the duct (n = 1), the average procedure time (32 minutes) and the average number of pneumatic pulses (98) correlated with stone density (range, 0.4-1.5 g/mL) and stone volume (range, 0.05-0.4 mL). One stone was sufficiently resistant to fragmentation as to prevent successful removal.CONCLUSIONS:
Modification to the evolving technology of intracorporeal pneumatic management of nephrolithiasis was successfully applied in an ex vivo model to simulate management of sialolithiasis.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Lithotripsy
/
Salivary Calculi
/
Endoscopy
Limits:
Humans
Language:
En
Journal:
Otolaryngol Head Neck Surg
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2016
Document type:
Article
Affiliation country:
United States