Over the past fifteen years, increasing public demand for minimally invasive surgery and recent technological advances have led to the development of a number of conservative therapeutic treatments for obstructive salivary gland diseases such as stones and duct stenosis. These include extracorporeal shock wave lithotripsy, sialendoscopy, laser intracorporeal lithotripsy, interventional radiology, video-assisted conservative surgical removal of parotid and submandibular stones, and botulinum toxin therapy. Each of these methods can be used as a stand-alone therapeutic method or in combination with one or more of the above options, usually on a day or overnight basis under local or general anesthesia. The multimodal approach is completely successful in approximately 80% of patients and reduces the need for gland removal by 3%, justifying the combination, albeit labor-intensive and relatively expensive, as part of a modern and functional treatment of salivary gland stones. Regarding the treatment of salivary duct anomalies such as strictures and kinks, interventional radiology with fluoroscopically guided balloon ductoplasty appears to be the most appropriate method despite the use of radiation. Operative sialendoscopy alone is the best therapeutic option for all mobile intraluminal causes of obstruction such as microliths, mucus plugs or foreign bodies, or for the local treatment of inflammatory conditions such as recurrent chronic mumps or autoimmune diseases of the salivary glands. Finally, if one of the above methods fails and regardless of the cause of obstruction, botulinum toxin injection into the salivary gland parenchyma using color Doppler ultrasound monitoring should be considered before deciding on surgical removal of the gland.

Salivary glands, salivary stones, salivary duct stenosis, surgical treatment, extracorporeal lithotripsy, sialendoscopy, botulinum toxin therapy

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