EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY OF PAROTID STONES - RESULTS OF A PROSPECTIVE CLINICAL-TRIAL

The extracorporeal shock wave treatment of parotid stones is a rather new therapy. Its usefulness was determined in a prospective study. Sev enty-six patients (36 female, 40 male, 2 to 80 years of age) with symp tomatic, sonographically detectable solitary sialoliths of the parotid gland were treated with an extracorporeal pieaoelectric shock wave th erapy after unsuccessful conservative therapy (sialagogues, gland mass age, bougienage of the secretory duct). At most, 3 treatments per pati ent were performed. Altogether, 38 of the 76 patients (50%) were free of stones and no longer suffered from complaints after completion of s hock wave treatment and a mean follow-up period of 48 months (range 6 to 71 months). During the follow-up period, in no case could renewed s tone formation be observed. Residual stone fragments were detectable i n 20 patients (26%), but did not cause further symptoms. Thirteen pati ents (17%) with residual stone fragments stated a significant improvem ent of their complaints after therapy. Five patients (7%) did not obse rve any changes of their pretherapeutic complaints and underwent parot idectomy. The therapeutic success was not influenced by stone size or by stone localization within the gland. During the follow-up period, n o side effects of the therapy were identified. With stones of the paro tid gland, extracorporeal shock wave lithotripsy is - after one has us ed conservative therapies (sialagogues, gland massage) - the treatment of choice, avoiding in the majority of cases a parotidectomy with its operative risks (paresis of the facial nerve, Frey's syndrome).