Abstract
Sialolithiasis is a common cause of salivary gland obstruction, but cases with multiple stones are rare and challenging. We present a 32-year-old woman with several months of recurrent right parotid swelling and pain, especially during meals. Ultrasound revealed multiple hyperechoic foci, including an 11 mm stone near the second upper molar, and sialendoscopy enabled the successful removal of 32 stones ranging from 2 to 11 mm. A multistage extraction under general anesthesia with probe dilatation, micro-instruments, and baskets was completed without complications. At follow-up, the patient was asymptomatic with normal salivary flow, no residual stones on ultrasound, and no adverse events. This case demonstrates the feasibility and safety of sialendoscopic management of an unusually high stone burden, highlighting the value of balloon-assisted ductal access, careful imaging, and preventive care in preserving gland function.