Lithotripsy for refractory pediatric sialolithiasis

Symptomatic salivary stones in the middle or proximal parotid duct have traditionally been treated by gland excision, which is associated with a 3% to 27% risk to the facial nerve in the pediatric population. Minimally invasive approaches to the management of salivary duct calculi have been introduced over the last several years. Fluoroscopically guided basket retrieval, lithotripsy, and intraoral stone removal under general anesthesia have found favor with many surgeons. Our patient had extracorporeal lithotripsy to his parotid gland with complete disintegration of the stone. He has had no evidence of stone recurrence or further bouts of parotitis. Extracorporeal shock wave lithotripsy with or without duct dilation is an efficient technique for the therapy of sialolithiasis in selected patients, especially patients who are at higher risk from a surgical standpoint.