Categories
ORGAN SYSTEMS Otolaryngeal system (ENT)

Sialolithiasis

Stones in salivary glands.

  • M/C salivary gland disorder (1.2% of unilateral major salivary gland swelling)
  • Can occur in all 3 major salivary glands:
    • Submandibular gland (Wharton duct) (M/C, 80% cases)
      • Due to more viscous secretion
    • Parotid gland (Stensen’s duct) (19% cases)
    • Sublingual gland (1% cases)
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The major salivary glands (paired on each side). 1. Parotid gland, 2. Submandibular gland, 3. Sublingual gland. | Public Domain, https://commons.wikimedia.org/w/index.php?curid=1074079

Aetiology

  • Dehydration
  • Trauma

Clinical features

  • Recurrent pre/periprandial pain
  • Swelling of affected gland

Submandibular gland:

Parotid gland:


Complication

Acute bacterial sialadenitis or glandular abscesses:

Prolonged blockage can produce a persistent ductal dilatation with a swelling that does not subside, and could lead to the complete degeneration of the parenchyma, becoming a hot spot where secondary infections may occur.


Differential diagnosis

 

  • Sialolithiasis
  • Sialadenitis (inflammatory or infectious)
  • Neoplasm

 


Management

Conservative management:

  • NSAIDs
  • Gland massage
  • Warm compress
  • Sour food/candies (promotes salivary flow)

Minimally invasive procedures:

  • Interventional sialography
  • Lithotripsy

Surgical management:

  • Sialectomy: Cannulation of duct to remove the stone
  • Surgical excision
  • Sialoendoscopy

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