Sialolithiasis diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2] [3]

Overview

Sialolithiasis is mainly diagnosed by history and physical examination. Diagnosis can be confirmed by computed tomography, ultrasound, magnetic resonance sialography, conventional sialography. High resolution computed tomography (HRCT) scanning is the study of choice for the diagnosis of sialolithisis.

Diagnostic Study of Choice

Sialolithiasis is mainly diagnosed by history and physical examination. Diagnosis can be confirmed by computed tomography, ultrasound, magnetic resonance sialography, conventional sialography.

Study of choice:

Computed tomography

High resolution computed tomography (HRCT) scanning is the study of choice for the diagnosis of sialolithiasis.^[1]
- Most stones contain enough calcium, so they can be visible with non-contrast CT scan.

The following results are seen in acute obstructive due to sialolithiasis after administration of contrast:
- The gland may appear enlarged
- Hyperdensity of gland with stranding

In chronic sialolithiasis, fatty atrophy and reduction in salivary gland parenchymal volume may be seen.

The comparison table for diagnostic studies of choice for sialolithiasis

The sensitivity and specificity of CT scan and ultrasonography in a patient with sialolitiasis is given below:^[2]

Method	Sensitivity	Specificity
CT scan	98%	88%
Ultrasound	65%	80%

References

↑ Ellies, Maik; Laskawi, Rainer; Arglebe, Christian; Schott, Anngrit (1996). "Surgical management of nonneoplastic diseases of the submandibular gland". International Journal of Oral and Maxillofacial Surgery. 25 (4): 285–289. doi:10.1016/S0901-5027(06)80058-5. ISSN 0901-5027.
↑ Thomas WW, Douglas JE, Rassekh CH (2017). "Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis". Otolaryngol Head Neck Surg. 156 (5): 834–839. doi:10.1177/0194599817696308. PMID 28457224.

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[ElliesLaskawi1996-1] Ellies, Maik; Laskawi, Rainer; Arglebe, Christian; Schott, Anngrit (1996). "Surgical management of nonneoplastic diseases of the submandibular gland". International Journal of Oral and Maxillofacial Surgery. 25 (4): 285–289. doi:10.1016/S0901-5027(06)80058-5. ISSN 0901-5027.

[pmid28457224-2] Thomas WW, Douglas JE, Rassekh CH (2017). "Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis". Otolaryngol Head Neck Surg. 156 (5): 834–839. doi:10.1177/0194599817696308. PMID 28457224.

[1]

[2]