The changing landscape of pediatric salivary gland stones: A half-century systematic review.

Abstract

OBJECTIVE:

To assess the evidence for pediatric sialolithiasis, including its demographic characteristics, diagnosis, and demonstrate the shift in its treatment paradigm.

DESIGN:

A systematic review of sources from the Medline and Embase databases was conducted from inception to Dec 4, 2020. Two researchers independently extracted data and assessed quality.

PATIENTS:

Patients under the age of 18 with sialolithiasis were included.

MAIN OUTCOME MEASURES:

Study design, cohort size, age, sex, symptoms, stone characteristics, diagnostic modality and intervention were collected data points.

RESULTS:

Forty-one studies with 243 patients were included in the review, of which 40 were case reports or series. Most stones were found in the submandibular gland (n = 210, 85.4%) and were single stones (n = 101, 71.1%). Average stone size was 7.7 mm. The most common diagnostic imaging modality used was ultrasound (n = 73, 47.4%), shifting from plain radiograph which was favoured in earlier years. Similarly, open gland excision was historically preferred, but since 2000, sialoendoscopy comprised 40.5% of all treatment modalities and continues to increase in prevalence, up to 52.1% by 2020. Extracorporeal shock wave lithotripsy was associated with the highest complication rate of 54.2%.

CONCLUSIONS:

The pediatric sialolithiasis diagnostic and therapeutic landscape has changed with ultrasound replacing plain radiographs, and sialoendoscopy replacing submandibular gland excision. Further high-level quality evidence research is required to refine the indications, effectiveness, and safety of sialoendoscopy in pediatric sialolithiasis.

• Authors: Tanya Chen, Rachel Szwimer, Sam J Daniel
• Journal: International journal of pediatric otorhinolaryngology (Int J Pediatr Otorhinolaryngol) Vol. 159 Pg. 111216 (Aug 2022) ISSN: 1872-8464 [Electronic] Ireland
• PMID: 35777140 (Publication Type: Journal Article, Review, Systematic Review)
• Copyright: Copyright © 2022 Elsevier B.V. All rights reserved.

Topics

• Child
• Endoscopy (methods)
• Humans
• Lithotripsy (methods)
• Salivary Gland Calculi (diagnosis, therapy)
• Salivary Glands
• Submandibular Gland (surgery)
• Submandibular Gland Diseases
• Treatment Outcome