Objective: Recently, different minimally invasive techniques have been developed for the management of the submandibular calculi. This retrospective study concluded our experience about transoral management of large submandibular calculi with sialendoscopy.

Methods: During a period of 10 years from 2002, patients with swelling symptom in submandibular gland were diagnosed and confirmed large calculi (>or = 10 mm) by routine methods. All cases were evaluated the degree of symptom by VAS, and some long history cases (more than 1 year) were further assessed uptake and excretion function by Tc-99m pertechnetate scintigraph. Large calculi were removed by transoral approach (gland preserving) combined with sialendoscopic management. Failure cases could be removal of the glands. Evaluation of the results included VAS assessment after big calculi removed successfully.

Results: 106 cases were found large calculi in submandibular duct (anterior 33, posterior 73). 19 cases were evaluated function by scintigraphic examination, and only 6 cases (31.6%) had the almost total function loss, and 9 cases were partial loss, 4 cases had the same function curve as other side. The success rate of transoral sialolithectomy was 101 cases (101/106, 95.3%). Residual calculi were detected in distal duct in 29 anterior cases under sialendoscopy, and 23 cases were removed successfully by forceps or basket simultaneously. 5 failure cases had undergone the gland resection ultimately. Most cases after management had relieved symptom by VAS evaluation.

Conclusion: Large submandibular calculi can be removed by gland-preserving procedures and most cases were asymptom after joint management with sialendoscopy.