Transoral submandibulotomy for deep hilar submandibular gland sialolithiasis.

OBJECTIVES/HYPOTHESIS: To assess the long-term results after transoral submandibulotomy for stones located in the deep hilar and intraparenchymal submandibular region.

STUDY DESIGN: Retrospective cohort analysis.

METHODS: Retrospective evaluation including all patients treated with transoral submandibulotomy for sialolithiasis at a tertiary referral center.

RESULTS: Complete stone removal at the first transoral surgical treatment was achieved in 185 of 234 patients (79.1%). One hundred seventy-five of the 234 patients were followed up for a mean of 31.2 ( ± 20.5) months. During the follow-up period, 140 of the 175 patients (80.0%) became symptom free after one operation. In patients with residual symptoms, no further treatment was needed in 12 patients (6.9%) due to the mildness of the symptoms; 23 patients (13.1%) received further therapy, which was successful in 15 cases. Submandibulectomy only had to be performed in 3.4% of the patients with follow-up (6/175). In a questionnaire survey, 91.4% of the patients stated that they would be prepared to have the same operation again.

CONCLUSIONS: These findings show that transoral removal of submandibular sialoliths located in the deep hilum or adjacent intraglandular parenchyma is an effective treatment that can be assisted by additional measures. The techniques described show high success rates, good long-term results, low complication rates, and they avoided the need for submandibulectomy in >95% of cases.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2038-2044, 2017.