Thirty years of experience and current trends in the management of sialolithiasis: a narrative review.

Abstract

Current trends in the management of sialolithiasis include a proper diagnosis with the help of a differential diagnosis. Cone beam computed tomography may be a good choice for detecting sialoliths because it is more sensitive than sonography. A practitioner should collect precise information about the stone in question, which includes the exact location of the calculus, its size and volume, and the number of calculi in a given case. For submandibular calculi, the orientation of the stone's location against the gonion and the inferior edge of the mandible creates the system of coordinates almost in a geographical fashion. The next step is management planning, and a proper surgical approach may be selected from a comprehensive list of available techniques. If the sialoendoscopic removal of calculi via ducts is impossible, endoscopy-assisted, ultrasound (US)-guided, or unassisted intraoral surgery, extracorporeal shock-wave lithotripsy (ESWL), a combination of the ESWL with the sialoendoscopy, and endoscopy-assisted ductal stretching procedure are our options. Measures must be taken to avoid or minimise postsurgical complications. The development of our knowledge, skills, diagnostic arsenal, and surgical approaches to sialolithiasis cases over the last hundred years is impressive. However, there is still room for further improvement. Some problems in diagnostics, calculus assessment, and surgical approaches require additional research.