Table 3. Minimally invasive treatment options for sialolithiasis.

ESWL: Extracorporeal Shockwave Lithotripsy; FDA: Food and Drug Administration

	Sialendoscopy	Sialendoscopy with laser lithotripsy	Extracorporeal shockwave lithotripsy (ESWL)
Best uses	<5mm stones Stones that are free-floating within duct	5-7mm stones	Any sized stone, although most effective for <7mm stones
Advantages	Minimally invasive Direct, high-definition intra-ductal visualization Variety of extraction instruments available Stones can be extracted intact	Direct, high-definition intra-ductal visualization Ability to remove larger sized stones while avoiding more invasive surgical operations	Easy to perform, in-office procedure Repeatable Very well-tolerated Stone fragments may pass spontaneously, thereby avoiding operating room and anesthesia
Disadvantages		Injuries to surrounding soft tissues	Possibility of incomplete stone clearance leading to recurrence Injuries to surrounding soft tissues
Success rate	>80%	81-100%	26-81%
Complication rate	3%	13%	N/A
Possible complications	Ductal strictures Perforations Ranula formation Lingual, facial nerve injuries Infection Bleeding	Ductal strictures Perforations Thermal injury to nerves and vessels (may be avoided with continuous cold saline rinsing)
Comments		Thermal injuries may be minimized with continuous saline rinsing and avoiding the duct wall with the laser Ductal stenosis can be prevented with stent placement	Sialendoscopy often performed following ESWL for complete stone fragment removal Not FDA approved in United States