Sialolithiasis Research Articles

Comparison of the Inadequacies of Ultrasonography and Computed Tomography in the Diagnosis of Sialolithiasis.

This study aimed to determine the value of either ultrasonography and computed tomography (CT) alone or both for diagnosing salivary gland stones. Based on their clinical findings and physical examination, 188 patients with salivary stones were included. Initially, an ultrasound was performed, and then a non-contrast-enhanced thin-sliced CT scan was done. The study included 161 patients with suspected submandibular gland (SMG) sialolithiasis and 27 with parotid gland (PG) sialolithiasis. Among the SMG cases, stones were confirmed in 130 patients through interventional sialoendoscopy. Sixteen of the stones were detected by CT scan only and were not seen in the previous ultrasound examination. After the second follow-up ultrasound, which was conducted after reviewing the CT scans, 9 of them were identified. Five patients with distal stones and ductal dilation on ultrasound were confirmed to have sialolithiasis. In 5 patients with stones detected on ultrasound but not on CT, dental filling artifacts were identified as the cause. For PG cases, stones were observed in 18 out of 19 patients with suspected sialolithiasis based on ultrasound and CT findings. Three patients with positive CT findings but negative ultrasound showed stones during sialendoscopy. During an ultrasound examination, palpating the floor of the mouth with the other hand's index finger can help identify stones obscured by the shadow of the mandible, thereby enhancing the test's accuracy. Patients with dental fillings, implants, and permanent dentures should not be referred for a CT scan to avoid unnecessary exposure to ionizing radiation. They also cause significant metallic artifacts in the field of interest. In these cases, ultrasound should be considered. To minimize the effects of ionizing radiation, it is recommended to create limited field requests for the target, focusing solely on the submandibular and PGs.

SIALOLITHIASIS: REVIEW

Objectives. Sialolithiasis is the most common obstructive salivary gland disease, responsible for approximately 50% of salivary glands pathology cases. The aim of this study is to provide the literature review to present the incident rate, etiology, diagnostic and treatment trends of sialolithiasis Materials and methods: Data from the Medline database, PubMed.gov and supplementary sources were used to conduct a systematic literature search. Results: The 116 studies were analyzed. The relevant data were exported, summarized and presented. Conclusion: The most of available studies regarding the incidence rate of sialolithiasis have been based on selected hospital data and there are a few multicenter analyses. The etiology of salivary stones formation remains not completely clear and various hypotheses have been put forward, thus research into etiologic factors is still continues. Despite the introduction of new technologies in the diagnostics of salivary gland, the routine methods like radiographs and ultrasound examination are still relevant and widely used. Gland preserving techniques in the treatment of sialolithiasis have continuously replaced radical surgery

Sialolithiasis of the Submandibular Gland- A Case Report

Sialolithiasis refers to the presence of calcified structures within the ducts of salivary glands and is the most common disorder affecting these glands. Approximately 80-95% of sialoliths occur in the submandibular salivary gland. The occurrence rate of sialoliths is about 12 per 1000 individuals, with men being affected approximately twice as often as women. Sialoliths can be diagnosed through clinical examination, conventional radiography, computed tomography, and ultrasonography. Typical clinical indicators of sialoliths include painless swelling, sometimes extensive, often accompanied by difficulty opening the mouth (trismus) during eating, and symptoms that vary from mild discomfort to severe pain. This case report illustrates the clinical, radiological signs, and surgical treatment of a salivary stone in the submandibular gland.

Ultrasound-Guided Sialendoscopy Surgery for Parotid Sialolithiasis Using Yttrium Aluminum Garnet (YAG)-Holmium Laser: A Prospective Case Series.

Parotid sialolithiasis is a common condition in middle-aged individuals, with most cases occurring in the submandibular and sublingual glands, followed by the parotid glandsand minor salivary glands. The treatment of salivary gland stones, particularly those of the parotid glands, remains challenging. Endoscopic surgery using a yttrium aluminum garnet (YAG)-holmium laser for parotid sialolithiasis is a minimally invasive approach that provides effective treatment for patients. This study aimed to evaluate the outcomes of the endoscopic laser treatment of parotid sialolithiasis a YAG-holmium laser. A prospective case series study was conducted on 21 patients diagnosed with salivary gland stones in the parotid gland based on clinical features and imaging findings (includingultrasound and computed tomography scans), from March 2022 to March 2024.These patients underwent sialendoscopy surgery using a YAG-holmium laser and were evaluated for surgical results at 2, 4, and 12 weeks. Cases with completely reduced symptoms accounted for 90.5%, whereas cases with partially reduced symptoms accounted for 9.5%. The ultrasound image of the salivary gland after surgery was significantly improved compared to that before surgery. After three months of surgery, most patients (90.5%) were satisfied. The postoperative complication rate was 14.3%, which included scarring at the opening of the salivary gland and in the salivary duct. Sialendoscopic surgery using a YAG-holmium laser for parotid sialolithiasis is a minimally invasive surgical intervention that leaves no scarring, reduces the risk of complications as seen inopen surgery, and shortens the postoperative care time for patients.

Occurrence, physicochemical properties and clinical symptoms of salivary stones (Sialoliths)

Occurrence, physicochemical properties and clinical symptoms of salivary stones (Sialoliths)

A PhD completed. More insight into the origin and composition of salivary stones

Salivary stones are hardened, stony calcifications that primarily develop in the drainage duct of a salivary gland. They can lead to obstruction of the saliva flow, resulting in swelling and pain. Since the aetiology of salivary stones remains largely unclear, this was further investigated in this PhD study. A case-control review of patient records showed that systemic diseases and lifestyle factors most likely do not play a role in their occurrence. The biochemical composition of salivary stones removed by oral-maxillofacial surgeons was examined, revealing that large salivary stones have a different inorganic composition than small salivary stones. Several salivary proteins were detected in submandibular salivary stones, including lysozyme, s-IgA, and -amylase. Clumping together of these proteins may play a role in the initial formation of salivary stones.

Prospects for Using a Pulsed Tm-Doped Fiber Laser for Lithotripsy of Salivary Stones

Prospects for Using a Pulsed Tm-Doped Fiber Laser for Lithotripsy of Salivary Stones

Microbiomic association between the saliva and salivary stone in patients with sialolithiasis

Salivary stones, known as sialoliths, form within the salivary ducts due to abnormal salivary composition and cause painful symptoms, for which surgical removal is the primary treatment. This study explored the role of the salivary microbial communities in the formation of sialoliths. We conducted a comparative analysis of microbial communities present in the saliva and salivary stones, and sequenced the 16S rRNA gene in samples obtained from patients with sialoliths and from healthy individuals. Although the diversity in the saliva was high, the essential features of the microbial environment in sialoliths were low diversity and evenness. The association of microbial abundance between stones and saliva revealed a positive correlation between Peptostreptococcus and Porphyromonas, and a negative correlation for Pseudomonas in saliva. The functional potential differences between saliva and stones Bacterial chemotaxis and the citrate cycle were negatively correlated with most genera found in salivary stone samples. However, the functions required for organic compound degradation did not differ between the saliva samples. Although some microbes were shared between the sialoliths and saliva, their compositions differed significantly. Our study presents a novel comparison between salivary stones and salivary microbiomes, suggesting potential preventive strategies against sialolithiasis.

CURRENT ISSUES IN RADIOLOGICAL DIAGNOSIS OF SALIVARY STONE DISEASE: REVIEW ARTICLE

Relevance. Salivary stones, also known as sialoliths, pose a diagnostic and therapeutic challenge due to the lack of a definitive etiology and the limitations in preventive measures. Numerous studies have presented diverse and often conflicting explanations for the formation of salivary stones, hindering the development of effective preventive strategies.
 Objective of this study is to synthesize existing literature on the etiology, prevention, diagnosis, and treatment of salivary stone disease.
 Materials and methods. A systematic review of the available literature was conducted to explore current perspectives on salivary stone disease. The review synthesized and systematized contemporary views on the etiology of the disease, its pathogenesis, preventive strategies, and treatment approaches.
 Results. Most of the authors, analyzing the main causes and accompanying factors of the occurrence of salivary stone disease, suggest to use various radiological diagnostic methods for its diagnosis.
 Radiological methods of research are key in the plan of carrying out differential diagnosis of salivary stone disease with other diseases and determining an adequate method of treatment.
 Conclusion. The review of scientific publications allows us to state that currently there are a large number of diverse and contradictory opinions about the etiology of the occurrence of salivary stone disease, and its pathogenesis is poorly studied. The methods of diagnosis of salivary stone disease proposed by the authors of scientific publications are based on the desire to find optimal and minimally invasive methods of early and accurate diagnosis of the disease.

Spyttstein i munngulvet – en kasuistikk

English summary Nor Tannlegeforen Tid. 2024; 134: 216-9. Sialolithiasis, or salivary gland stones, is a common condition that affects the salivary glands, often causing pain and functional issues. This article discusses a clinical case at the specialist clinic at University of Oslo, highlighting the challenges and considerations in diagnosing and treating sialolithiasis. The case involves a 45-year-old woman with a radiopaque lesion in the floor of her mouth. Based on clinical and radiological examination the diagnosis was sialolithiasis, and a sialolithotomy procedure was performed to remove the stone. The discussion covers the causes, radiological features, and treatment options for sialolithiasis.

Dystrophic calcification of the parotid salivary glands in Sjogren's disease

This article discusses a rare clinical case of differential diagnosis between salivary stone disease and calcinosis, which developed against the background of autoimmune pathology. Diagnosis of these pathologies causes difficulties for practitioners, and treatment methods have fundamental differences. In this regard, the description of this case is relevant and significant. The algorithm of the main and additional research methods to confirm the diagnosis is described.

Bilateral Submandibular Sialolithiasis: A Case Report

Introduction: Lithiasis is the most common salivary disease in adults. Most salivary stones (80% to 95%) produces in the submandibular gland, 5% to 20% in the parotid gland, while the sublingual gland and minor salivary glands account for no more than 2%. Isolated involvement of one gland is usual. Simultaneous lithiasis of both submandibular glands is less frequent. The objective of this study is to report our experience in the treatment of lithiasis of the bilateral submandibular gland. Observation: Mr. K. M, 68 years old, chronic smoking, consulted in emergency November 2023 at the Mohammed VI Oujda University Hospital, for bilateral submandibular swelling. This swelling has been developing for 10 years and increased in size during meals. The current history dates back to 1 month ago with the increase in the right submandibular mass associated with dysphagia. The clinical examination revealed a right and left submandibular swelling, presence of right inflammatory signs: warm mass, painful on palpation, fixed in the deep plane, with expression of pus from the Wharton orifice. Cervical CT scan injected with contrast product was in favor of bilateral sialadenitis on sialolithiasis complicated by submaxillary abscess on the right. Bilateral submandibulectomy with extraction the calculi is done via an external cervical. No post-operative complications were observed and the patient was discharged from the hospital after two days of hospitalization. Discussion: The family history of sialolithiasis suggests the search for a genetic or familial origin of bilateral lithiasis of the submandibular glands, if there is not an obvious or probable etiology. Conclusion: Bilateral submandibular lithiasis is a rare clinical event but one that must be researsh for even in cases of isolated submandibular lithiasis. Extraction of the calculation is made by radical submaxillectomy by cervical externally, and the results are satisfactory.

A Case Report on Giant Submandibular Sialolithiasis

Sialolithiasis is a term used to denote the formation of salivary stones / sialoliths which are calcified concretions located within the parenchyma / ductal system of salivary glands. In today’s times it is a very common salivary gland disorder leading to salivary secretion obstruction. Conservative management is the choice of treatment for small accessible stones while surgical intervention is needed for larger stones. Treatment modalities include salivary gland massage, the use of sialagogues or surgical removal of the gland.

Distribution of Misdiagnostic Maxillofacial Nonmalignant Lesions and Conditions in Salah Alden Government

Diagnosis is the corner stone & entry to the treatment of lesions or conditions. Because misdiagnosis leads to incorrect treatment. It is very important to understand the distribution between the most common misdiagnosis nonmalignant lesions& conditions in the maxillofacial region as apart of whole misdiagnosis. Decrease patient complaining. Evaluate the most common misdiagnosis lesions& conditions in maxillofacial region. Decrease load to hospitals& clinics& decrease infections. The data collected by standardized formula for all patients& different patient clinical, radiological examination & methods used to confirm the diagnosis. Total no. are 30 patients, misdiagnosis lesions& conditions 13% (Sinusitis or dental pain), 20% (submandibular Lymphadenitis. or Sialadenitis), 20% (Otalgia). 10%(Psychopath),10%(Trigeminal neuralgia) ,7%(migraine) ,7%( maxillary sinusitis),13%(submandibular saialidinitis). the true diagnosis was 13%,( Oroantral fistula),20%(oro-Cutaneous fistula),20%(Tmj pain),10%(Tmj dislocation),10%(dental pain),7%(dental pain),7%(Maxillary sinus cyst),13%(submandibular Salivary gland stone). The more unorganized medical &or surgical branches interference within region may lead to these misdiagnosis results. Poor educated patients, doctor’s decision with inadequate examination& investigation participate in increase patients complaining

Sialolithiasis Disease: Clinical Observations of Large Salivary Stones of The Submandibular Salivary Gland

This article presents clinical observations related to large salivary stones that occur in the submandibular salivary gland in salivary stone disease. The author describes several clinical cases in which salivary concretions of unusually large sizes were discovered and studied. The article presents data on the localization of stones, sizes, as well as complications resulting from their presence. The analysis of the presented clinical observations allows us to draw conclusions about the unusual and rare nature of this type of salivary stone disease. A detailed description of clinical cases, including the results of multispiral tomography and orthopantomogram, allows us to better understand the features of the formation and development of large salivary stones in the submandibular salivary gland. This article has practical value for dentists and medical specialists involved in the diagnosis and treatment of salivary stone disease. It provides additional knowledge about possible complications associated with large salivary stones, and also emphasizes the importance of timely detection and removal of such stones to prevent possible complications and improve the quality of life of patients.

Sialolith with Sialadenitis: A Case Study and a Proposal of a Diagnostic Algorithm

AbstractSialolithiasis along with sialadenitis is one of the commonly occurring salivary gland disorders. Sialadenitis is an inflammatory disease of the salivary glands. It usually occurs insidiously causing pain to the patient and may lead to development of fibrous mass of the salivary gland. The cause of sialadenitis is most commonly due to the salivary duct caliculi which is termed as sialolith or salivary stones which causes statis of saliva in the ducts. This condition is usually accompanied by pain and tenderness of the involved site. Therefore, we report a case of a male patient aged 60 years with pain in the floor of the mouth in the submandibular region which was diagnosed as submandibular sialolithiasis along with sialadenitis and propose a diagnostic algorithm.

The submandibular sialolithiasis in an eight-year-old child: a case report

Sialolithiasis is a commonly encountered disease of the salivary glands and represents up to 30-50% of all salivary gland diseases. However, the condition is rarely encountered in the paediatric population. The formation of a salivary stone is believed to be secondary to the deposition of calcium salts around a nidus, which is commonly associated with desquamated epithelial tissue or sloughing from a recent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. The calculi were located on the right in 100.0% of paediatric patients. Moreover, 20.0% of paediatric patients exhibited sialoliths in the glands. In this paper, we present the case of an 8-year-old male child who presented with a history of swelling over the right submandibular region since four months and had not responded to the conservative treatment given for the last four months. On examination, a small, rounded salivary calculus was found at the Wharton duct orifice near the papilla. A minimally invasive surgical procedure of intraoral excision of the calculus was done, and the patient was prevented from undergoing surgical excision of the gland. A large number of relatively small and distal sialoliths in paediatric patients can be removed using intraoral retrieval under local or general anesthesia. The clinical evaluation of the entire salivary tract with a high index of suspicion helps in early diagnosis and avoids the development of an abscess and other complications that may require surgical excision of the gland.

Ablation of TRPC3 disrupts Ca2+ signaling in salivary ductal cells and promotes sialolithiasis

Clinical studies and structural analyses of salivary stones strongly suggest a linkage between higher saliva calcium (Ca2+) and salivary stone formation, sialolithiasis; however, the process and the mechanism leading to Ca2+ overload during sialolithiasis is not well understood. Here, we show that TRPC3 null (−/−) mice presented with a reduction in Ca2+ entry and current in ductal cells with higher saliva [Ca2+] suggesting diminished transepithelial Ca2+ flux across the salivary ductal cells, leaving more Ca2+ in ductal fluid. Significantly, we found that TRPC3 was expressed in mice and human salivary ductal cells, while intraductal stones were detected in both mice (TRPC3−/−) and patient (sialolithiasis) salivary glands. To identify the mechanism, we found that TRPC3 was crucial in preventing the expression of calcification genes (BMP2/6, Runx2) in ductal cells which may be due to higher extracellular Ca2+ in SMG tissues. Similarly, inflammatory (IL6, NLRP3), fibrotic (FN1, TGFβ1) and apoptotic (Bax1/Bcl2) markers were also elevated, suggesting that the loss of TRPC3 induces genetic changes that leads to salivary gland cell death and induction of inflammatory response. Overall, ablation of TRPC3−/− leads to higher saliva [Ca2+], along with elevated detrimental gene expressions, altogether contributing to salivary gland stone formation.

Proteomic analysis of sialoliths from calcified, lipid and mixed groups as a source of potential biomarkers of deposit formation in the salivary glands

Salivary stones, also known as sialoliths, are formed in a pathological situation in the salivary glands. So far, neither the mechanism of their formation nor the factors predisposing to their formation are known despite several hypotheses. While they do not directly threaten human life, they significantly deteriorate the patient’s quality of life. Although this is not a typical research material, attempts are made to apply various analytical tools to characterise sialoliths and search for the biomarkers in their proteomes. In this work, we used mass spectrometry and SWATH-MS qualitative and quantitative analysis to investigate the composition and select proteins that may contribute to solid deposits in the salivary glands. Twenty sialoliths, previously characterized spectroscopically and divided into the following groups: calcified (CAL), lipid (LIP) and mixed (MIX), were used for the study. Proteins unique for each of the groups were found, including: for the CAL group among them, e.g. proteins from the S100 group (S100 A8/A12 and P), mucin 7 (MUC7), keratins (KRT1/2/4/5/13), elastase (ELANE) or stomatin (STOM); proteins for the LIP group—transthyretin (TTR), lactotransferrin (LTF), matrix Gla protein (MPG), submandibular gland androgen-regulated protein 3 (SMR3A); mixed stones had the fewest unique proteins. Bacterial proteins present in sialoliths have also been identified. The analysis of the results indicates the possible role of bacterial infections, disturbances in calcium metabolism and neutrophil extracellular traps (NETs) in the formation of sialoliths.

Woman with facial swelling.

A 68-year-old woman presented to the emergency department (ED) with rapidly progressing left submandibular swelling and inability to tolerate secretions. Her physical examination showed the left submandibular gland was markedly enlarged, firm, and exquisitely tender to palpation. Laboratory tests were remarkable for a white blood cell count of 16.22 k/μL with a neutrophil predominance (81.3%). Computed tomography of the neck was performed and showed markedly dilated, enhancing left submandibular duct that mimicked an abscess, measuring over 1.0 cm in diameter (normal 1–3 mm)1 without visualized obstructing calculus (Figures 1 and 2). Numerous sialoliths were noted within both submandibular glands (Figure 3). In the ED, the patient had rapid worsening of the oral cavity and submandibular edema, and her airway was secured via nasotracheal intubation. She was admitted to the intensive care unit and received intravenous antibiotics and steroids, with resolution of her symptoms within 3 days. She was extubated and discharged home. Sialolithiasis, or salivary stones, may form in any of the salivary glands, but the submandibular gland is the most common site (80%) and forms the largest stones.2 Submandibular stones can be diagnosed on physical examination by palpating the floor of the mouth and pushing the tongue upward and backward to put tension on the papilla.3 Imaging may be necessary if stones are unable to be seen or palpated. Management is usually conservative and includes applying heat packs, massaging the gland, and use of sialagogues to promote saliva production. Anti-staphylococcal antibiotics are administered if there are signs of infection.