Managing Sialolithiasis

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Overview: Salivary stones, also called sialolithiasis, are small deposits of calcium and other minerals that form in the salivary glands. Larger stones can block the flow of saliva and cause the affected gland to swell. This disease is more common in men. Eighty percent of salivary gland stones occur in the submandibular gland. Others can occur in the parotid and sublingual glands. (Fig 1) Causes: The cause of these stones is not known. However, many factors can contribute to their formation. These factors include:•advancing age.•having radiation therapy on the head or neck.•mouth injuries or trauma.•taking medications that affect saliva production.•Sjogren's syndrome.•having kidney problems.•not drinking enough water. Symptoms: Salivary stones do not usually cause symptoms when they are forming and they can sometimes disappear on their own. However, these stones can result in pain and swelling in the affected gland if the flow of saliva in the gland is blocked. The affected gland can get infected. This is called sialadenitis. Testing: To diagnose this problem, your oral and maxillofacial surgeon will obtain a medical history and examine you. He or she might order some imaging studies to detect stones and rule out other potential causes. Treatment: Management of these stones is usually done with conservative measures. This includes applying moist heat and gentle massage to the salivary gland. Staying well hydrated is important. Lemon drops can help stimulate salivation. Ibuprofen or other nonsteroidal anti-inflammatory drugs can reduce pain and swelling. If your surgeon notices evidence of infection, an antibiotic may be prescribed. For larger, harder-to-remove stones, the oral and maxillofacial surgeon can make a small incision in the mouth to remove the stone. Another treatment option involves a less invasive technique called sialendoscopy. This technique uses small lighted scopes inserted into the gland's opening in the mouth to visualize the salivary duct system and locate the stone. Then, using small instruments, the surgeon can remove the stone. (Fig 2) For patients with recurrent stones or irreversible damage to the salivary gland, surgical removal of the gland may be necessary. Sialendoscopic Management of Obstructive Salivary Gland Pathology: A Retrospective Analysis of 236 CasesJournal of Oral and Maxillofacial SurgeryVol. 79Issue 7PreviewTo analyze and assess the results of treating obstructive salivary gland pathology by sialendoscopy or sialendoscopic-assisted surgery and analyze the difference in submandibular and parotid gland pathology. Full-Text PDF