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The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of various treatment modalities for parotid gland stones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted in accordance with the PRISMA guidelines. Eligible studies were identified by searching PubMed\/MEDLINE, the Cochrane Library, Scopus and Google Scholar. Eligible observational studies and clinical trials reporting on patients with parotid stones were included. The outcomes assessed included stone-free rate, symptom improvement and the presence of any complications. A single-arm random-effects meta-analysis was performed, focusing on endoscopy-only, endoscopy-assisted and extracorporeal shock wave lithotripsy (ESWL). Bias risk was assessed using the Newcastle\u2013Ottawa Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 42 studies involving 1,559 patients were analyzed. Endoscopy-assisted removal showed the highest stone-free rate (93%, 95%CI: 90\u201396) and symptom improvement (91%, 95%CI: 92\u201399) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Combined endoscopic-external approaches were effective for complex stones but had higher complication rates (24%, 95% CI: 14\u201337). ESWL had a lower stone-free rate (58%) but aided long-term symptom control (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). CT-navigation did not significantly enhance clearance (80%). Most complications were minor; no permanent facial nerve injuries were reported. The quality of the evidence was limited by heterogeneity and the lack of any randomized trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopy-assisted and combined approaches offer effective, gland-preserving options for parotid sialolithiasis. ESWL and laser techniques remain adjunctive but warrant further research. Prospective, standardized trials are needed to define any optimal management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-025-09697-y","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T17:42:58Z","timestamp":1759340578000},"page":"1337-1352","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Parotid gland sialolithiasis: a comprehensive systematic review and meta-analysis"],"prefix":"10.1007","volume":"283","author":[{"given":"Giovanni","family":"Salzano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8717-7121","authenticated-orcid":false,"given":"Veronica","family":"Scocca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Committeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Troise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Angelo","family":"Vaira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome R.","family":"Lechien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Abbate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Dell\u2019Aversana","family":"Orabona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"issue":"2","key":"9697_CR1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1259\/dmfr\/24118767","volume":"36","author":"RK Ngu","year":"2007","unstructured":"Ngu RK, Brown JE, Whaites EJ, Drage NA, Ng SY, Makdissi J (2007) Salivary duct strictures: nature and incidence in benign salivary obstruction. 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