{Reference Type}: Journal Article
{Title}: The changing landscape of pediatric salivary gland stones: A half-century systematic review.
{Author}: Chen T;Szwimer R;Daniel SJ;Chen T;Szwimer R;Daniel SJ;
{Journal}: Int J Pediatr Otorhinolaryngol
{Volume}: 159
{Issue}: 0
{Year}: Aug 2022
{Factor}: 1.626
{DOI}: 10.1016/j.ijporl.2022.111216
{Abstract}: <B>OBJECTIVE: </B>To assess the evidence for pediatric sialolithiasis, including its demographic characteristics, diagnosis, and demonstrate the shift in its treatment paradigm.<BR><B>METHODS: </B>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.<BR><B>METHODS: </B>Patients under the age of 18 with sialolithiasis were included.<BR><B>METHODS: </B>Study design, cohort size, age, sex, symptoms, stone characteristics, diagnostic modality and intervention were collected data points.<BR><B>RESULTS: </B>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%.<BR><B>CONCLUSIONS: </B>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.