Sialolithiasis medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Sialolithiasis}} | {{Sialolithiasis}} | ||
{{CMG}} | {{CMG}} ; {{AE}}{{MJ}} | ||
==Overview== | |||
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are [[hydration]], moist heat, gland massage, and pain control. [[Antibiotic|Antibiotics]] can be used in the case of superimposed [[infection]]. Many cases of sialolithiasis may not be cured by using medical therapy alone; invasive, or open [[surgery]] methods can be used for the salivary gland stones. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are:<ref name="pmid24862601">{{cite journal |vauthors=Delli K, Spijkervet FK, Vissink A |title=Salivary gland diseases: infections, sialolithiasis and mucoceles |journal=Monogr Oral Sci |volume=24 |issue= |pages=135–48 |year=2014 |pmid=24862601 |doi=10.1159/000358794 |url=}}</ref> | |||
* [[Hydration]] | |||
* [[ | * Apply moist heat | ||
* | * Massage the gland | ||
* [[ | * Duct milking | ||
* Using agents that increase the saliva flow, such as lemon drops. | |||
* Discontinue of the medication that decrease the saliva flow, such as the [[Tricyclic anti-depressant|TCAs]] because of their [[anticholinergic]] effects. | |||
* Pain control with [[Non-steroidal anti-inflammatory drug|NSAIDs]], or [[Opioid|opioid analgesic]]<nowiki/>s, if needed. | |||
* Antibiotics usage in the case of superimposed infection: | |||
** Preferred regimen(1): [[Dicloxacillin]] 500 mg q 6h PO for 7 to 10 days. | |||
** Preferred regimen(2): [[Cephalexin]] 500 mg q 6h PO for 7 to 10 days. | |||
* If the patient's clinics did not change in five days of using above antibiotics, change to: | |||
** Preferred regimen(1): [[Amoxicillin-Clavulanate|Amoxicillin/clavulanate]] 625 mg q 8h PO for 7 to 10 days. | |||
** Preferred regimen(2): [[Clindamycin]] 300 mg q 8h PO for 7 to 10 days. | |||
* Duct discharge should be used for culture. | |||
Many cases of sialolithiasis may not be cured by using medical therapy alone; invasive, or open [[surgery]] methods can be used for [[salivary gland]] stones. The interventional methods are discussed in the sialolithiasis [[Sialolithiasis surgery|surgery]] page. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Medical emergencies]] | [[Category:Medical emergencies]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category: | [[Category:Gastroenterology]] | ||
[[Category:Oral pathology]] | [[Category:Oral pathology]] | ||
Latest revision as of 14:38, 26 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]
Overview
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are hydration, moist heat, gland massage, and pain control. Antibiotics can be used in the case of superimposed infection. Many cases of sialolithiasis may not be cured by using medical therapy alone; invasive, or open surgery methods can be used for the salivary gland stones.
Medical Therapy
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are:[1]
- Hydration
- Apply moist heat
- Massage the gland
- Duct milking
- Using agents that increase the saliva flow, such as lemon drops.
- Discontinue of the medication that decrease the saliva flow, such as the TCAs because of their anticholinergic effects.
- Pain control with NSAIDs, or opioid analgesics, if needed.
- Antibiotics usage in the case of superimposed infection:
- Preferred regimen(1): Dicloxacillin 500 mg q 6h PO for 7 to 10 days.
- Preferred regimen(2): Cephalexin 500 mg q 6h PO for 7 to 10 days.
- If the patient's clinics did not change in five days of using above antibiotics, change to:
- Preferred regimen(1): Amoxicillin/clavulanate 625 mg q 8h PO for 7 to 10 days.
- Preferred regimen(2): Clindamycin 300 mg q 8h PO for 7 to 10 days.
- Duct discharge should be used for culture.
Many cases of sialolithiasis may not be cured by using medical therapy alone; invasive, or open surgery methods can be used for salivary gland stones. The interventional methods are discussed in the sialolithiasis surgery page.
References
- ↑ Delli K, Spijkervet FK, Vissink A (2014). "Salivary gland diseases: infections, sialolithiasis and mucoceles". Monogr Oral Sci. 24: 135–48. doi:10.1159/000358794. PMID 24862601.