Factors influencing the outcome of extracorporeal shock wave lithotripsy in the management of salivary calculi.

Abstract

OBJECTIVES/HYPOTHESIS:

To identify the factors that affect outcome (stone clearance, partial clearance without symptoms, and residual stone with symptoms unchanged) of extracorporeal shock wave lithotripsy (ESWL). To develop and validate a predictive model for outcome of treatment.

STUDY DESIGN:

Prospective controlled trial.

METHODS:

There were 142 salivary calculi (78 submandibular, 64 parotid) entered into a prospective clinical trial of ESWL. The results were analyzed and a predictive model generated, which was validated using a second group of patients treated by the same technique.

RESULTS:

ESWL achieved complete success (stone and symptom free) in 67 (47.15%) of cases (submandibular 28/78, 35.9%; parotid 39/64, 60.9%). Partial success (residual stone and symptom free) was obtained in a further 49 (34.5%) (submandibular 29/78, 37.2%; parotid 20/64, 31.3%). Failure occurred in 26 (18.3%) of cases (submandibular 21/78, 26.9%; parotid 5/64, 7.8%).

CONCLUSIONS:

ESWL can eradicate salivary calculi but its effectiveness is dependant mainly on size of the stone. Using a regression analysis model stone clearance can be reliably predicted based on stone size. A less important factor is the radiodensity of the stone, whereas a greater proportion of parotid calculi are eliminated by ESWL than submandibular calculi.

• Authors: Michael P Escudier, Jackie E Brown, Venkata Putcha, Pasquale Capaccio, Mark McGurk
• Journal: The Laryngoscope (Laryngoscope) Vol. 120 Issue 8 Pg. 1545-9 (Aug 2010) ISSN: 1531-4995 [Electronic] United States
• PMID: 20641082 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Child
• Humans
• Lithotripsy
• Middle Aged
• Prospective Studies
• Regression Analysis
• Salivary Gland Calculi (therapy)
• Treatment Outcome
• Young Adult