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Therapy of Sialolithiasis with the Calculase III ™-Holmium Laser: First Results
Background Interventional sialendoscopy is first choice in the treatment of sialolithiasis. 80-85 % of all stones have to be fragmented before extraction is possible, however. Pneumatic and laser lithotripsy currently are the most promising methods with success rates of > 80-90 %. Since 2019 a new Holmium laser (Calculase III™) is available for intraductal laser lithotripsy (iLL).
Methods Sialolithiasis in the parotid (PG, all accessible stones) und submandibular gland (SMG, posthilar/intraparenchymal stones) were treated using the Calculase III™-Holmium laser. After successful fragmentation instrumental extraction of the fragments was performed.
Results 30 Patients were treated by iLL, 19 had sialolithiasis in the PG and 11 in the SMG (14 male, 16 female). In 13.3 % of cases patients had multiple stones, in 13.3 % several stones were treated. Altogether 36 stones were treated by iLL. 100 % of all stones focused on could be completely fragmented. 1-3 iLL were performed per patient. The energy used was between 0.8 und 1.2 J/pulse, the power between 3.2 and 4.8 watt. All stones treated by iLL could be extracted completely. 2 patients with multiple stones (6.7 %) became not complete stone-free (intraparenchymal stone in each), but all became complaint-free. Stent implantation was performed in 13 cases (in 12 of these GP). In all cases the glands could be preserved.
Conclusion ILL using the Calculase III™-Holmium laser showed to be a promising method in the therapy of sialolithiasis of the major salivary glands. The treatment spectrum was extended by iLL in particular in cases with difficult sialolithiasis.
10 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York