DOI:

10.37988/1811-153X_2026_1_170

Intraductal laser sialolithotripsy: History of development and current state. Systematic review

Authors

  • A.S. Pankratov 1, 2, Doctor of Science in Medicine, professor of the Maxillofacial surgery Department; professor of the General and surgical dentistry Department
    ORCID: 0000-0001-9620-3547
  • D.V. Ermolin 1, PhD in Medical Sciences, associate professor of the Maxillofacial surgery Department
    ORCID: 0000-0002-8391-2042
  • T.A. Gevorkyan 1, postgraduate of the Maxillofacial surgery Department
    ORCID: 0009-0007-4484-7771
  • A.I. Shaikhaliev 1, Doctor of Science in Medicine, professor of the Maxillofacial surgery Department
    ORCID: 0000-0002-4920-7171
  • 1 Sechenov University, 119048, Moscow, Russia
  • 2 Russian Medical Academy of Continuous Professional Education, 125993, Moscow, Russia

Abstract

Sialolithiasis is a common pathology of the salivary glands, for which traditional surgical treatment often results in irreversible functional impairment, negatively affecting the digestive tract as a whole. In this context, the development of minimally invasive, gland-preserving technologies is considered a promising alternative, one of which is intraductal laser sialolithotripsy. However, its widespread adoption is limited by the relatively high cost of the equipment, necessitating the creation of an evidence base that objectively confirms the clinical effectiveness of the method. Objective: To conduct a systematic review of the literature evaluating the efficacy and safety of intraductal laser sialolithotripsy in patients with sialolithiasis.
Materials and methods.
Publications from the RSCI, Medline (PubMed), and Google Scholar databases published between 1990 and 2025 were analyzed. Keywords related to sialolithiasis, sialendoscopy, and laser lithotripsy were used. Studies describing the intervention technique, clinical outcomes, and complications were included. A qualitative descriptive synthesis was performed.
Results.
Thirty-seven publications were included. The data indicate that laser sialolithotripsy enables stone fragmentation and alleviation of clinical symptoms. Holmium and thulium lasers are the most extensively studied. The method has advantages over mechanical lithotripsy; however, limitations remain, including the risk of duct perforation and stenosis, residual stone fragments, the need for repeated interventions, as well as the influence of stone location and procedure duration on outcomes. The evidence base is limited, and comparative prospective studies with other minimally invasive techniques are lacking. Conclusion: Intraductal laser sialolithotripsy is a promising gland-preserving treatment for sialolithiasis; however, it has certain limitations, underscoring the need for comparative randomized clinical trials to assess functional outcomes and long-term safety.

Key words:

salivary stone disease, intraductal lithotripsy, lasers, sialoendoscopy

For Citation

[1]
Pankratov A.S., Ermolin D.V., Gevorkyan T.A., Shaikhaliev A.I. Intraductal laser sialolithotripsy: History of development and current state. Systematic review. Clinical Dentistry (Russia).  2026; 29 (1): 170—177. DOI: 10.37988/1811-153X_2026_1_170

References

  1. Afanasev V.V., Mirzakulova U.R. Salivary glands. Diseases and injuries. Moscow: GEOTAR-Media, 2019. Pp. 212—243 (In Russian).
  2. Williams M.F. Sialolithiasis. Otolaryngol Clin North Am. 1999; 32 (5): 819—34. PMID: 10477789
  3. Escudier M.P., Brown J.E., Drage N.A., McGurk M. Extracorporeal shockwave lithotripsy in the management of salivary calculi. Br J Surg. 2003; 90 (4): 482—5. PMID: 12673752
  4. Abdusalamov M.R., Afanasiev V.V., Gamataev I.I. Comparative assessment of the treatment of patients with cholelithiasis minilitotripterov and surgical removal of calculus. Russian Journal of Dentistry. 2016; 1: 9—11 (In Russian). eLIBRARY ID: 26001554
  5. Aïdan P., De Kerviler E., LeDuc A., Monteil J.P. Treatment of salivary stones by extracorporeal lithotripsy. Am J Otolaryngol. 1996; 17 (4): 246—50. PMID: 8827289
  6. Capaccio P., Torretta S., Pignataro L., Koch M. Salivary lithotripsy in the era of sialendoscopy. Acta Otorhinolaryngol Ital. 2017; 37 (2): 113—121. PMID: 28516973
  7. Zenk J., Bozzato A., Winter M., Gottwald F., Iro H. Extracorporeal shock wave lithotripsy of submandibular stones: evaluation after 10 years. Ann Otol Rhinol Laryngol. 2004; 113 (5): 378—83. PMID: 15174765
  8. Siedek V., Betz C.S., Hecht V., Blagova R., Vogeser M., Zengel P., Berghaus A., Leunig A., Sroka R. Laser induced fragmentation of salivary stones: an in vitro comparison of two different, clinically approved laser systems. Lasers Surg Med. 2008; 40 (4): 257—64. PMID: 18412223
  9. Nahlieli O., Baruchin A.M. Endoscopic technique for the diagnosis and treatment of obstructive salivary gland diseases. J Oral Maxillofac Surg. 1999; 57 (12): 1394—402. PMID: 10596658
  10. Sysolyatin S.P., Bannikova K., Sysolyatin P.G., Palkina M.O., Ivanov S.Yu. Less invasive endoscopic surgery of sialolithiasis. Head and Neck. 2018; 1: 52—56 (In Russian). DOI: 10.25792/HN.2018.6.1.52-56
  11. Koch M., Zenk J., Iro H. [Diagnostic and interventional sialoscopy in obstructive diseases of the salivary glands]. HNO. 2008; 56 (2): 139—44 (In German). PMID: 17676291
  12. Mulvaney W.P., Beck C.W. The laser beam in urology. J Urol. 1968; 99 (1): 112—5. PMID: 5637225
  13. Arzoz E., Santiago A., Esnal F., Palomero R. Endoscopic intracorporeal lithotripsy for sialolithiasis. J Oral Maxillofac Surg. 1996; 54 (7): 847—52. PMID: 8676229
  14. Sionis S., Caria R.A., Trucas M., Brennan P.A., Puxeddu R. Sialoendoscopy with and without holmium:YAG laser-assisted lithotripsy in the management of obstructive sialadenitis of major salivary glands. Br J Oral Maxillofac Surg. 2014; 52 (1): 58—62. PMID: 24280118
  15. Gundlach P., Scherer H., Hopf J., Leege N., Müller G., Hirst L., Scholz C. [Endoscopic-controlled laser lithotripsy of salivary calculi. In vitro studies and initial clinical use]. HNO. 1990; 38 (7): 247—50 (In German). PMID: 2394601
  16. Königsberger R., Feyh J., Goetz A., Schilling V., Kastenbauer E. [Endoscopic controlled laser lithotripsy in the treatment of sialolithiasis]. Laryngorhinootologie. 1990; 69 (6): 322—3 (In German). PMID: 2378659
  17. Ito H., Baba S. Pulsed dye laser lithotripsy of submandibular gland salivary calculus. J Laryngol Otol. 1996; 110 (10): 942—6. PMID: 8977858
  18. Marchal F., Becker M., Dulguerov P., Lehmann W. Interventional sialendoscopy. Laryngoscope. 2000; 110 (2 Pt 1): 318—20. PMID: 10680937
  19. Raif J., Vardi M., Nahlieli O., Gannot I. An Er:YAG laser endoscopic fiber delivery system for lithotripsy of salivary stones. Lasers Surg Med. 2006; 38 (6): 580—7. PMID: 16705704
  20. Teichman J.M., Vassar G.J., Bishoff J.T., Bellman G.C. Holmium:YAG lithotripsy yields smaller fragments than lithoclast, pulsed dye laser or electrohydraulic lithotripsy. J Urol. 1998; 159 (1): 17—23. PMID: 9400428
  21. Chan K.F., Vassar G.J., Pfefer T.J., Teichman J.M., Glickman R.D., Weintraub S.T., Welch A.J. Holmium:YAG laser lithotripsy: A dominant photothermal ablative mechanism with chemical decomposition of urinary calculi. Lasers Surg Med. 1999; 25 (1): 22—37. PMID: 10421883
  22. Schrötzlmair F., Müller M., Pongratz T., Eder M., Johnson T., Vogeser M., von Holzschuher V., Zengel P., Sroka R. Laser lithotripsy of salivary stones: Correlation with physical and radiological parameters. Lasers Surg Med. 2015; 47 (4): 342—9. PMID: 25788338
  23. Wang S.J., Chen L.C., Lin Y.C., Chen Y.C., Dang L.H., Chen P.Y., Su C.H., Hung S.H. Prognostic factors for the outcome of salivary gland Holmium:YAG laser intraductal lithotripsy. Ear Nose Throat J. 2023; 102 (7): NP308-NP312. PMID: 33877921
  24. Luers J.C., Petry-Schmelzer J.N., Hein W.G., Gostian A.O., Hüttenbrink K.B., Beutner D. Fragmentation of salivary stones with a 980nm diode laser. Auris Nasus Larynx. 2014; 41 (1): 76—80. PMID: 23871189
  25. Durbec M., Dinkel E., Vigier S., Disant F., Marchal F., Faure F. Thulium-YAG laser sialendoscopy for parotid and submandibular sialolithiasis. Lasers Surg Med. 2012; 44 (10): 783—6. PMID: 23224989
  26. Bannikova K.A. Endosialoscopy in the diagnosis and treatment of patients with sialolithiasis): dissertation abstract. Moscow: RUDN University, 2021. 26 p (in Russian.
  27. Koch M., Schapher M., Mantsopoulos K., Iro H. Intraductal lithotripsy in sialolithiasis using the Calculase III™ Ho:YAG laser: First experiences. Lasers Surg Med. 2021; 53 (4): 488—498. PMID: 32997838
  28. Guenzel T., Hoch S., Heinze N., Wilhelm T., Gueldner C., Franzen A., Coordes A., Lieder A., Wiegand S. Sialendoscopy plus laser lithotripsy in sialolithiasis of the submandibular gland in 64 patients: A simple and safe procedure. Auris Nasus Larynx. 2019; 46 (5): 797—802. PMID: 30765274
  29. Kałużny J., Klimza H., Tokarski M., Piersiala K., Witkiewicz J., Katulska K., Wierzbicka M. The Holmium:YAG laser lithotripsy-a non-invasive tool for removal of midsize stones of major salivary glands. Lasers Med Sci. 2022; 37 (1): 163—169. PMID: 33219871
  30. Koch M., Hung S.H., Su C.H., Lee K.S., Iro H., Mantsopoulos K. Intraductal lithotripsy in sialolithiasis with two different Ho:YAG lasers: presetting parameters, effectiveness, success rates. Eur Rev Med Pharmacol Sci. 2019; 23 (13): 5548—5557. PMID: 31298306
  31. Martellucci S., Pagliuca G., de Vincentiis M., Greco A., Fusconi M., De Virgilio A., Gallipoli C., Gallo A. Ho:YAG laser for sialolithiasis of Wharton’s duct. Otolaryngol Head Neck Surg. 2013; 148 (5): 770—4. PMID: 23462654
  32. Rai V., Walvekar R.R., Verma J., Monga U., Rai D., Munjal M. Laser-assisted sialolithotripsy: A correlation of objective and subjective outcomes. Laryngoscope. 2022; 132 (12): 2344—2349. PMID: 35289948
  33. Achim V., Light T.J., Andersen P.E. Gland preservation in patients undergoing sialoendoscopy. Otolaryngol Head Neck Surg. 2017; 157 (1): 53—57. PMID: 28669304
  34. Su C.H., Lee K.S., Tseng T.M., Hung S.H. Endoscopic Holmium:YAG laser-assisted lithotripsy: A preliminary report. B-ENT. 2015; 11 (1): 57—61.
  35. Su C.H., Lee K.S., Hsu J.H., Lee F.P., Lin H.Y., Lin S.P., Hung S.H. Pediatric sialendoscopy in Asians: A preliminary report. J Pediatr Surg. 2016; 51 (10): 1684—7. PMID: 27325357
  36. Phillips J., Withrow K. Outcomes of Holmium Laser-Assisted Lithotripsy with Sialendoscopy in Treatment of Sialolithiasis. Otolaryngol Head Neck Surg. 2014; 150 (6): 962—7. PMID: 24598407
  37. Epifanov S.A., Zolotukhin S.Yu. Usage of contact laser-based lithotripsy in treatment of sialolithiasis. Bulletin of Pirogov National Medical and Surgical Center. 2019; 1: 49—52 (In Russian). DOI: 10.25881/BPNMSC.2019.92.20.010
  38. Chu D.W., Chow T.L., Lim B.H., Kwok S.P. Endoscopic management of submandibular sialolithiasis. Surg Endosc. 2003; 17 (6): 876—9. PMID: 12618947
  39. Yang S.W., Chen T.A. Transoral carbon dioxide laser sialolithectomy with topical anaesthesia. A simple, effective, and minimally invasive method. Int J Oral Maxillofac Surg. 2011; 40 (2): 169—72. PMID: 21050722
  40. Angiero F., Benedicenti S., Romanos G.E., Crippa R. Sialolithiasis of the submandibular salivary gland treated with the 810- to 830-nm diode laser. Photomed Laser Surg. 2008; 26 (6): 517—21. PMID: 19099383
  41. Hardy L.A., Wilson C.R., Irby P.B., Fried N.M. Thulium fiber laser lithotripsy in an in vitro ureter model. J Biomed Opt. 2014; 19 (12): 128001. PMID: 25518001
  42. Blackmon R.L., Case J.R., Trammell S.R., Irby P.B., Fried N.M. Fiber-optic manipulation of urinary stone phantoms using holmium:YAG and thulium fiber lasers. J Biomed Opt. 2013; 18 (2): 28001. PMID: 23377013
  43. Kamal W., Kallidonis P., Koukiou G., Amanatides L., Panagopoulos V., Ntasiotis P., Liatsikos E. Stone retropulsion with Ho:YAG and Tm:YAG lasers: A clinical practice-oriented experimental study. J Endourol. 2016; 30 (11): 1145—1149. PMID: 27527803
  44. Zhuchkova D.V., Sysolyatin S.P. Experimental investigation of the effect of retropulsion in sialolithotripsy with a thulium laser. Clinical Dentistry (Russia). 2023; 1: 121—125 (In Russian). DOI: 10.37988/1811-153X_2023_1_121
  45. Zhuchkova D.V., Bannikova K.A. Investigation of the process of laser crushing of sialolites in an experiment. In: proceedings of “Current issues in maxillofacial surgery and dentistry” conference. Saint-Petersburg: Military Medical Academy, 2022. Pp.103—105 (In Russian). eLIBRARY ID: 49875755
  46. Zhuchkova D.V., Sysolyatin S.P. Thulium laser safe mode selection for in vitro sialolithotripsy. Clinical Dentistry (Russia). 2024; 1: 84—89 (In Russian). DOI: 10.37988/1811-53X_2024_1_84
  47. Zhuchkova D.V. Endoscopic laser sialolithotripsy (experimental clinical study): dissertation abstract. Moscow: RUDN University, 2024. 23 p. (in Russian).
  48. Scales C.D. Jr, Lai J.C., Dick A.W., Hanley J.M., van Meijgaard J., Setodji C.M., Saigal C.S., Urologic Diseases in America Project Comparative effectiveness of shock wave lithotripsy and ureteroscopy for treating patients with kidney stones. JAMA Surg. 2014; 149 (7): 648—53. PMID: 24839228
  49. Fried N.M., Irby P.B. Advances in laser technology and fibre-optic delivery systems in lithotripsy. Nat Rev Urol. 2018; 15 (9): 563—573. PMID: 29884804
  50. Faklaris I., Bouropoulos N., Vainos N.A. Sialolithiasis: Application parameters for an optimal laser therapy. J Biophotonics. 2020; 13 (7): e202000044. PMID: 32277604
  51. Schulze C., Thangavelu K., Gehrt F., Schatton R., Keil C., Heers H., Abozenah N.H., Stuck B.A., Geisthoff U. Intracorporeal lithotripsy of salivary stones: in vitro comparison of different methods. Eur Arch Otorhinolaryngol. 2025; 282 (6): 3233—3244. PMID: 40053089
  52. Nahlieli O., Shacham R., Bar T., Eliav E. Endoscopic mechanical retrieval of sialoliths. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95 (4): 396—402. PMID: 12686923
  53. Nahlieli O., Shacham R., Zaguri A. Combined external lithotripsy and endoscopic techniques for advanced sialolithiasis cases. J Oral Maxillofac Surg. 2010; 68 (2): 347—53. PMID: 20116707

Received

December 25, 2025

Accepted

February 25, 2026

Published on

March 31, 2026