OBJECTIVES/HYPOTHESIS: To evaluate the long-term outcome of intraoral removal of large submandibular gland calculi. STUDY DESIGN: Retrospective cohort study. METHODS: A retrospective review (1995-2008) of 118 patients with submandibular calculi > or = 10 mm treated by intraoral surgical removal with preservation of the salivary gland. RESULTS: Calculi were completely removed in 103/118 (87.3%) cases, partially removed in 14/118 (11.9%), with failure to remove any fragments in only 1/118 (0.8%). After a mean follow-up of 42 months, 101/118 (85.6%) cases remained asymptomatic, 17/118 (14.4%) cases had modest obstructive or infective symptoms, 4/118 (3.4%) cases suffered recurrent stones, and in 1/118 (0.8%) case persistent symptoms dictated salivary gland removal. CONCLUSIONS: The data suggest that the majority of large submandibular gland calculi can be removed by gland-preserving procedures retaining an asymptomatic salivary gland. This casts doubt on the commonly held premise that salivary stones normally lead to chronic sialoadenitis, which is the basis for the current policy of sialoadenectomy.
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