Erste Erfahrungen mit der intrakorporalen elektrokinetischen Lithotripsie von Speichelsteinen

Introduction

Sialolithiasis can be treated using different approaches. Intracorporal lithotripsy encompasses laser lithotripsy and pneumatic lithotripsy. The device for the latter is no longer available. A need for alternative methods exists. Intracorporeal electrokinetic lithotripsy (EKL) has been proven to be effective in the treatment of kidney stones. EKL has also been tested successfully for salivary stones in in-vitro studies demonstrating both efficacy and safety within the range of pneumatic and laser lithotripsy.

Material and methods

After extensive in-vitro investigations, we offered EKL treatment to suitable patients with salivary stones as an alternative off-label option to standard approaches. Retrospective results are presented.

Results

Since December 2022, treatment courses of 2 patients were completed with EKL. In the first patient (female, 75 years), a 5 mm stone inside the intraglandular part of right Stensen"s duct was fragmented. The session took 144 minutes and was carried out in general anesthesia. Within one week, two additional sessions of sialendoscopy (33 and 70 minutes) were necessary to remove residual fragments and fibrin-like, soft obstructions. After 18 months, neither patient history nor sonography showed hints of residual fragments or obstructions.

The second patient (61 years, male) had a 15x4x4 mm stone in the distal part of the right Stensen"s duct. Intraductal lithotripsy with EKL in general anesthesia took 78 minutes and lead to the total removal of the stone.

In both cases, no relevant side effects were observed.

Discussion

First clinical results of EKL for the treatment of sialolithiasis were successful and without relevant side effects. EKL seems to be suitable for this indication.

Urban Geisthoff received a grant from Walz EL for the preclinical testing of EKL.