Intracorporeal lithotripsy of salivary stones: in vitro comparison of different methods.

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2025-06-01 Epub Date: 2025-03-07 DOI:10.1007/s00405-025-09268-1

Cathrin Schulze, Kruthika Thangavelu, Francesca Gehrt, Robert Schatton, Christian Keil, Hendrik Heers, Nermin H Abozenah, Boris A Stuck, Urban Geisthoff

{"title":"Intracorporeal lithotripsy of salivary stones: in vitro comparison of different methods.","authors":"Cathrin Schulze, Kruthika Thangavelu, Francesca Gehrt, Robert Schatton, Christian Keil, Hendrik Heers, Nermin H Abozenah, Boris A Stuck, Urban Geisthoff","doi":"10.1007/s00405-025-09268-1","DOIUrl":null,"url":null,"abstract":"Purpose: Intracorporeal lithotripsy is a gland-preserving treatment option for sialolithiasis. Laser lithotripsy (LL) and pneumatic lithotripsy (PL) are the only two methods currently approved, the latter being no longer available. Electrokinetic lithotripsy (EKL) is a promising alternative used for the treatment of ureteral stones. The aim of this study is to compare efficacy and therapeutical safety of EKL with LL and PL.Methods: StoneBreaker® (PL), Lithotron EL 27 Compact (EKL) and Ho:YAG laser Auriga (LL) were assessed using in vitro setups with human salivary stones, casted and tumbled stones. Efficacy was measured by the number of impulses and time taken until fragmentation. Parameters for therapeutical safety were number of impulses until perforation, propulsion, duct widening, number of tears and tear length.Results: Efficacy of EKL was higher than LL but lower than PL. The fragmentation of casted stones took 01:50 ± 00:28 min with PL, 02:49 ± 00:37 min with EKL and 05:12 ± 00:58 min with LL (Mann-Whitney-U test p < 0.01). LL caused the lowest propulsion (0.0 ± 0 cm, n = 20); the highest propulsion was observed for PL (3.5 ± 0.7 cm, n = 20). In the gelatin setup, LL induced the most extensive damage (damage index: 5.9 ± 2.9, n = 15). LL was the fastest to cause perforation in the parotid duct (1 ± 0 impulses until perforation, n = 10).Conclusion: Efficacy and safety of EKL are between those of LL and PL. Therefore, clinical testing of EKL seems to be justified.","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3233-3244"},"PeriodicalIF":1.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122608/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Archives of Oto-Rhino-Laryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00405-025-09268-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Intracorporeal lithotripsy is a gland-preserving treatment option for sialolithiasis. Laser lithotripsy (LL) and pneumatic lithotripsy (PL) are the only two methods currently approved, the latter being no longer available. Electrokinetic lithotripsy (EKL) is a promising alternative used for the treatment of ureteral stones. The aim of this study is to compare efficacy and therapeutical safety of EKL with LL and PL.

Methods: StoneBreaker^® (PL), Lithotron EL 27 Compact (EKL) and Ho:YAG laser Auriga (LL) were assessed using in vitro setups with human salivary stones, casted and tumbled stones. Efficacy was measured by the number of impulses and time taken until fragmentation. Parameters for therapeutical safety were number of impulses until perforation, propulsion, duct widening, number of tears and tear length.

Results: Efficacy of EKL was higher than LL but lower than PL. The fragmentation of casted stones took 01:50 ± 00:28 min with PL, 02:49 ± 00:37 min with EKL and 05:12 ± 00:58 min with LL (Mann-Whitney-U test p < 0.01). LL caused the lowest propulsion (0.0 ± 0 cm, n = 20); the highest propulsion was observed for PL (3.5 ± 0.7 cm, n = 20). In the gelatin setup, LL induced the most extensive damage (damage index: 5.9 ± 2.9, n = 15). LL was the fastest to cause perforation in the parotid duct (1 ± 0 impulses until perforation, n = 10).

Conclusion: Efficacy and safety of EKL are between those of LL and PL. Therefore, clinical testing of EKL seems to be justified.

查看原文本刊更多论文

唾液结石体内碎石术：不同方法的体外比较。

目的：体内碎石术是一种保留腺体的治疗选择。激光碎石（LL）和气动碎石（PL）是目前仅有的两种方法，后者已不再可用。电动碎石术（EKL）是治疗输尿管结石的一种很有前途的方法。方法：对StoneBreaker®（PL）、Lithotron EL 27 Compact （EKL）和Ho:YAG激光Auriga （LL）在人唾液结石、铸造结石和滚落结石的体外实验中进行评价。效能是通过脉冲的次数和直到碎片的时间来衡量的。治疗安全性的参数是脉冲次数，直到穿孔，推进，导管拓宽，撕裂数和撕裂长度。结果：EKL的疗效高于LL，但低于PL， PL组的结石碎裂时间为01:50±00:28 min， EKL组为02:49±00:37 min， LL组为05:12±00:58 min （Mann-Whitney-U检验）。结论：EKL的疗效和安全性介于LL和PL之间，因此临床试验EKL是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.