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A Serious Complication of Laser Lithotripsy

      We have read with great interest the recent article by Sun et al,
      • Sun Y.T.
      • Lee K.S.
      • Hung S.H.
      • Su C.H.
      Sialendoscopy with holmium:YAG laser treatment for multiple large sialolithiases of the Wharton duct: A case report and literature review.
      which describes a patient with multiple large stones in his submandibular gland that were successfully treated under sialendoscopy with laser lithotripsy. We have been performing this procedure at our clinic since 2010, and we have been using laser lithotripsy for the past 2 years. We would like to make a contribution to their article and report a serious complication of this procedure that we have just recently experienced.
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      References

        • Sun Y.T.
        • Lee K.S.
        • Hung S.H.
        • Su C.H.
        Sialendoscopy with holmium:YAG laser treatment for multiple large sialolithiases of the Wharton duct: A case report and literature review.
        J Oral Maxillofac Surg. 2014; 72: 2491
        • Phillips J.
        • Withrow K.
        Outcomes of holmium laser-assisted lithotripsy with sialendoscopy in treatment of sialolithiasis.
        Otolaryngol Head Neck Surg. 2014; 150: 962
        • Sionis S.
        • Caria R.A.
        • Trucas M.
        • et al.
        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: 58
        • Marchal F.
        • Chossegros C.
        • Faure F.
        • et al.
        A comprehensive classification.
        Rev Stomatol Chir Maxillofac. 2008; 109: 233

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        Journal of Oral and Maxillofacial SurgeryVol. 73Issue 5
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          Thank you for your interest in our article.1 We totally agree that the risk of serious trauma to the duct throughout the procedure should never be underestimated. As you mentioned, this is a time-consuming procedure, and we believe that the 1.6-mm sialendoscope might have been slightly large. It would be possible to further decrease the risk of ductal damage by using the 1.3-mm sialendoscope. Moreover, the sialostent has been recommended to be placed over the site at which sialendoscopic procedures have been applied (Fig 1A).
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