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{{SI}}
{{Sialolithiasis}}
'''For patient information, click [[Sialolithiasis (patient information)|here]]'''
 
{{CMG}}
{{CMG}}


{{SK}} Salivary calculus
{{SK}} Salivary calculus; salivary duct stone; salivary duct calculus
==Overview==
==[[Sialolithiasis overview|Overview]]==
'''Sialolithiasis''' refers to the formation of stones in the [[salivary glands]]. Stones are most commonly found in the [[submandibular gland]] and [[parotid gland]], where stones can obstruct [[Submandibular duct|Wharton's duct]] and Stenson's duct respectively. This calculus ([[sialolith]] - pronounced SIGH-al-low-lith) is a [[salivary gland]] stone consisting of layers of calcified organic matter - calcium phosphate and carbon, with traces of magnesium, chloride and ammonium. Sialoliths are not related to kidney stones.
 
==[[Sialolithiasis historical perspective|Historical Perspective]]==
 
==[[Sialolithiasis classification|Classification]]==


==Causes==
==[[Sialolithiasis pathophysiology|Pathophysiology]]==
It is frequently associated with chronic infection (''[[Staphylococcus aureus]], [[Streptococcus viridans]]'') of the glands, dehydration ([[phenothiazine]]s), [[Sjögren's syndrome]] and/or increased local levels of calcium, but in many cases can arise [[idiopathic]]ally.
 
==[[Sialolithiasis causes|Causes]]==
 
==[[Sialolithiasis differential diagnosis|Differentiating Sialolithiasis from other Diseases]]==
 
==[[Sialolithiasis epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Sialolithiasis risk factors|Risk Factors]]==
 
==[[Sialolithiasis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Natural History, Complications and Prognosis==
Complications include persistent obstruction of the duct, leading to bacterial invasion, overgrowth and infection ([[sialoadenitis]]). This can require IV antibiotics such as [[nafcillin]], and sometimes surgical drainage.
==Diagnosis==
==Diagnosis==
===History and Symptoms===
[[Sialolithiasis history and symptoms|History and Symptoms]] | [[Sialolithiasis physical examination|Physical Examination]] | [[Sialolithiasis laboratory findings|Laboratory Findings]] | [[Sialolithiasis x ray|X Ray]] | [[Sialolithiasis CT|CT]] | [[Sialolithiasis other imaging findings|Other Imaging Findings]] | [[Sialolithiasis other diagnostic studies|Other Diagnostic Studies]]
Pain, when present, usually originates from the floor of the mouth, although in many cases the stones cause only intermittent swelling.
 
===Physical Examination===
==Treatment==
Since [[mastication|chewing]] promotes release of saliva, symptoms tend to increase during meals. A palpable lump or visible swelling in the area of the gland is often noted.
[[Sialolithiasis medical therapy|Medical Therapy]] | [[Sialolithiasis surgery|Surgery]] | [[Sialolithiasis primary prevention|Primary Prevention]] | [[Sialolithiasis secondary prevention|Secondary Prevention]] | [[Sialolithiasis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Sialolithiasis future or investigational therapies|Future or Investigational Therapies]]
===X Ray===
 
Diagnosis is usually made by characteristic history and physical examination. Diagnosis can be confirmed by [[x-ray]] (80% of salivary gland calculi are visible on x-ray), or by [[sialogram]] or ultrasound.
== Case Studies ==
== Treatment ==
[[Sialolithiasis case study one|Case #1]]
===Medical Therapy===
Some current treatment options are:
* For small stones, hydration, moist heat, [[NSAID]]s occasionally, and having the patient take any food or beverage that is bitter and/or sour. Sucking on citrus fruits, such as a lemon or orange, may increase [[salivation]] and promote spontaneous expulsion of the stone.
* [[Sialendoscopy]]
* To prevent infection while the stone is lodged in the duct, sometimes antibiotics are used. In some cases when stones continually reoccur the offending salivary duct is removed.
===Surgery===
* Some stones may be massaged out by a specialist.
* An [[Otolaryngology|ENT]] or [[Oral and maxillofacial surgeon|maxillofacial surgeon]] may [[canula]]te the duct to remove the stone (sialotomy).
* A surgeon may make a small incision near the stone to remove it.[[File:Salivary gland stone removed.jpeg|thumb|Salivary gland stone and the hole left behind from the operation]]
{{Oral pathology}}


==References==
{{reflist|2}}
[[Category:Medical emergencies]]
[[Category:Medical emergencies]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
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{{Oral pathology}}


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Latest revision as of 15:14, 19 February 2013

Sialolithiasis Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sialolithiasis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography or Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Case #1

Sialolithiasis On the Web

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Directions to Hospitals Treating Sialolithiasis

Risk calculators and risk factors for Sialolithiasis

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Salivary calculus; salivary duct stone; salivary duct calculus

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sialolithiasis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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