Abstract
Problem
Minimally invasive therapies of sialolithiasis have been developed to avoid complications of sialadenectomy like nerve injury or frey's syndrome. Sialendoscopy and extracorporeal shock wave lithotripsy are used to manage stone removement and fragmentation. The size of salivary calculi often limits minimally invasive treatment. Chemical and electrolytic dissolution have been used successfully to reduce the diameter of sialoliths in vitro. The aim of this study was to compare the effect of electrolitholysis (ELL) and the combination of ELL with chemolitholysis on salivary calculi.
Methods
Eleven submandibular calculi (7-19mm diameter) were halved. These halves were randomised to the ELL group and the ELL combined with chemolitholysis group. The calculi were placed in a glass tube and two platinum electrodes (0.5mm diameter) were brought in contact with their surfaces. For the ELL group isotonic sodium chloride was used as rinsing solution whereas calculi of the ELL combined with chemolitholysis group were rinsed with diluted acetic acid (0.6%, pH 2.78). Electrical current (30mA, 14V) with periodic current reversal was applied to the electrodes for three hours. To determine the extent of dissolution, the calculi were weighed and photographed before and after the treatment.
Results
The mean weight reduction of salivary calculi was 14,7±5,8 mg (19,9±8,4%) after ELL and 16,2±8,8 mg (23,1 ±20,5%) after ELL combined with chemolitholysis respectively. The differences were not statistically significant. The corrosive effect of both methods could be shown by morphologic changes of the calculi.
Conclusion
In this study a comparable weight reduction of salivary calculi was achieved using ELL alone or ELL combined with chemolitholysis with diluted acetic acid. These methods could be helpful to diminish the size of salivary calculi within the scope of minimally invasive treatment of sialolithiasis. Further investigations should be done.
Significance
Basic research.
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