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Relevance. The current limits of endoscopic removal of sialolithes are limited to 3-5mm, larger sialolithes require crushing, but an effective and safe technology has not yet been found. The solution to this problem is primarily related to the technologies of shock wave lithotripsy. Currently, various methods of lithotripsy using extracorporeal and intracorporeal sources are described in the literature. The positive experience of urological laser lithotripsy served as the basis for our study of the possibilities of using the thule laser device FiberLase U2 for the fragmentation of sialolithes. Materials and Methods. The study included 16 clinical observations of patients diagnosed with sialolithiasis who underwent sialoendoscopy with additional application of the technique of intra-c urrent crushing of the concretion with a thule laser device FiberLase U2 with subsequent extraction of fragments. Results and Discussion. Sialolithes were fragmented in all 16 clinical cases, regardless of shape and structure. Large fragments were removed using basket traps and endoscopic forceps. In 9 out of 16 observations, the operation ended with the complete removal of the stone and all its visible fragments (until the duct was completely cleaned). In 7 patients, fragments remained in the duct, which could not be removed. During the crushing process, we observed an undesirable effect of retrograde migration of the stone with a pulse impact, as well as the resulting suspension of small fragments and air bubbles complicated the visibility and the operation process. Also, in 3 cases, when the stone was destroyed, the laser beam hit the duct wall, which was accompanied by weak bleeding and for a while hindered endoscopic visibility and required active irrigation. Conclusion. At the first time, the technology of thule laser lithotripsy was used that made possible the destruction of sialolithes and remove stones larger than 5 mm. This approach expands the limits of endoscopic surgery of sialolithiasis. At the same time, there is a number of important problems that require further study and improvement of the method.

Background. The pathologies of the salivary glands are very diverse. Salivary stone disease occupies a special place among diseases of the salivary glands of a non-neoplastic nature. The incidence of salivary stone disease is extremely extensive and accounts for up to 85% of all pathologies of the salivary glands.Objective. Improvement of minimally invasive methods of treatment of salivary stone disease, which does not lead to excision of the gland.Material and methods. On the basis of the Clinics of the Samara State Medical University of the Ministry of Health of Russia, in the period from 2010 to 2020, a clinical group was formed, consisting of 193 patients with salivary stone disease of various localization. The age of the patients ranged from 16 to 84 years. All patients were therapeutically examined at the preoperative stage, voluntary informed consent was signed. Shockwave sialotripsy was performed in 95 patients of the main group (in 64 patients the calculus was located in the submandibular salivary gland, in 31 patients – in the parotid salivary gland). For lithotripsy, we used a lithotripter apparatus "Edap" (France) and "Wolf" (Germany).Results. The analysis of the results obtained as a result of the study made it possible to draw a conclusion about reasonably better results of removal of calculi in the ducts of the salivary glands using the lithotripter "Swiss LithoClast® Master" (Switzerland). At the first visit and the therapeutic effect of the lithotripter, all patients suffering from bouts of salivary colic showed complete cessation.Conclusion. Thus our study, which was devoted to the study of the results of various methods of treating patients with salivary stone disease showed that sialolithotripsy using special narrowly targeted devices for crushing and subsequent excretion of salivary calculi allows to achieve the best results at present.

Background: The pathologies of the salivary glands are very diverse. Salivary stone disease occupies a special place among diseases of the salivary glands of a non-neoplastic nature. The incidence of salivary stone disease is extremely extensive and accounts for up to 85% of all pathologies of the salivary glands., Objective: Improvement of minimally invasive methods of treatment of salivary stone disease, which does not lead to excision of the gland., Material and Methods: On the basis of the Clinics of the Samara State Medical University of the Ministry of Health of Russia, in the period from 2010 to 2020, a clinical group was formed, consisting of 193 patients with salivary stone disease of various localization. The age of the patients ranged from 16 to 84 years. All patients were therapeutically examined at the preoperative stage, voluntary informed consent was signed. Shockwave sialotripsy was performed in 95 patients of the main group (in 64 patients the calculus was located in the submandibular salivary gland, in 31 patients - in the parotid salivary gland). For lithotripsy, we used a lithotripter apparatus «Edap» (France) and «Wolf» (Germany)., Results: The analysis of the results obtained as a result of the study made it possible to draw a conclusion about reasonably better results of removal of calculi in the ducts of the salivary glands using the lithotripter «Swiss LithoClast® Master» (Switzerland). At the first visit and the therapeutic effect of the lithotripter, all patients suffering from bouts of salivary colic showed complete cessation., Conclusion: Thus, our study, which was devoted to the study of the results of various methods of treating patients with salivary stone disease, showed that sialolithotripsy using special narrowly targeted devices for crushing and subsequent excretion of salivary calculi allows to achieve the best results at present.

The authors with the goal of postoperative dynamic control over the results of surgical treatment of patients previously operated for salivary stone disease and various ducts deformations of the parotid salivary glands examined 16 patients with an observation period up to 8 years. It was found that recurrent acute parotitis or recurrence of stone formation was observed in 100% of cases. The authors developed methods of surgical treatment leads to long-term clinical success with no recurrence of the disease.

The authors conducted an analysis of the efficiency of the method of suandokmai for diagnosis and treatment of diseases of the salivary glands. The use of calendarscope allows to establish the absence of stone in the case of salivary colic. In rare cases it is possible to remove the stone without surgical intervention at small dimensions of the calculus. 'Price of equipment - the efficiency of diagnosis and treatment' does not allow to recommend the method in clinical practice.