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Case Reports
. 2025 Jul 6;17(7):e87393.
doi: 10.7759/cureus.87393. eCollection 2025 Jul.

Minimally Invasive Surgical Approach for Parotid Sialolith Removal

Subhasish Burman  1 , Asish K Das  1 , Diptangshu Mallick  1 , Sandhya Tamilmani  1 , Samrat Hembram  1
Affiliations
Case Reports

Minimally Invasive Surgical Approach for Parotid Sialolith Removal

Subhasish Burman et al. Cureus. .

Abstract

Sialolithiasis is one of the most common diseases that affects the salivary glands and develops stones inside the salivary glands. We describe the case of a 36-year-old man who had been experiencing pain and swelling in the left cheek area for a month, along with discharge in the left posterior buccal vestibular region. A 3.5 mm calculus in the major parotid duct was discovered during the ultrasound scan. Under general anesthesia, the patient had a superficial parotidectomy, and the calculus was successfully removed. This case study illustrates the value of early detection and treatment of parotid sialolithiasis and shows how well superficial parotidectomy works to treat the problem.

Keywords: minimally invasive surgery; parotid duct calculus; parotid sialolithiasis; salivary gland stones; sialolithiasis treatment.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preoperative extraoral frontal view
Image showing asymmetry of the face. Swelling on the left side of the face
Figure 2
Figure 2. Preoperative extraoral photograph showing swelling on the left side of the face
Swelling extended anteroposteriorly from the zygomatic buttress to the mastoid region and superoinferiorly from the tragus to the inferior border of the mandible
Figure 3
Figure 3. Intraoral photograph showing no anomaly
The intraoral picture showing nothing significant. Normal anatomy of the mouth
Figure 4
Figure 4. USG showing calculi
USG: ultrasonography There are six boxes in the image. Each box is labeled as A, B, C, D, E, and F. A shows the calculi. The USG shows the main parotid duct calculi
Figure 5
Figure 5. Incision marked and a modified Blair incision was made
The modified Blair incision was made over the preauricular skin crease, beginning from the anterior and superior to the tragus and carried down to the left earlobe. It was extended posteriorly to the postauricular area and then again extended inferiorly to the naturally occurring horizontal skin crease on the neck
Figure 6
Figure 6. Exposure of the parotidomasseteric fascia
Figure 7
Figure 7. Superficial lobe of the parotid gland
Three Babcock forceps have been used to hold the superficial lobe of the parotid
Figure 8
Figure 8. Main trunk of the facial nerve
Artery forceps showing the main trunk ofthe  facial nerve
Figure 9
Figure 9. Removal of the superficial lobe
The superficial parotid gland has been removed. Hemostasis has been achieved
Figure 10
Figure 10. Suturing done and drain has been placed
Extraoral suturing done with 3-0 Prolene. A 14 G drain has been placed
Figure 11
Figure 11. Postoperative picture after one-month follow-up
Postoperative follow-up after one month showing that swelling had reduced in size, and wound healed uneventfully No discharging sinus tract is present
Figure 12
Figure 12. Histopathological evaluation
There is degeneration of the acini with effacement of the lobular architecture and the presence of epimyoepithelial islands and adipose tissue along with diffuse inflammatory cell infiltrates
See this image and copyright information in PMC

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