Sialolithiasis pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
Sialolithiasis is presence of stones within the salivary glands or the salivary gland ducts.The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important. 75 percent of | Sialolithiasis is presence of stones within the [[Salivary gland|salivary glands]] or the salivary gland ducts.The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important. 75 percent of sialolithiasis cases are single. 3 percent of stones are bilateral and most of them are located in [[Parotid gland|parotid glands]]. Stone formation is 80 to 90 percent in the [[submandibular gland]], 6 to 20 percent in the [[Parotid gland|parotid glands]] and 1 to 2 percent in the [[Sublingual gland|sublingual]] or minor salivary glands. Sialoadenitis is inflamamtion of a salivary gland. Acute sialoadenitis may be caused by [[Virus|viral]] or [[bacterial]] infection. Chronic sialoadenitis is caused by repeated episodes of inflammation. On [[gross pathology]], hard yellow -white spherical depositions usually less than 1 cm are seen. On microscopic pathology, dilated ducts with squamous metaplasia or calculi are usullay present. | ||
==Pathophysiology== | ==Pathophysiology== | ||
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==== Sialolithiasis : ==== | ==== Sialolithiasis : ==== | ||
* Presence of stones within the salivary glands or the salivary gland ducts. | * Presence of stones within the [[Salivary gland|salivary glands]] or the salivary gland ducts. | ||
* The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important. | * The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important. | ||
| Line 22: | Line 22: | ||
** Potassium | ** Potassium | ||
* Parotid, submandibular, sublingual glands and minor salivary glands are prone to the development of stones.<ref name="pmid25443682">{{cite journal |vauthors=Mandel L |title=Salivary gland disorders |journal=Med. Clin. North Am. |volume=98 |issue=6 |pages=1407–49 |year=2014 |pmid=25443682 |doi=10.1016/j.mcna.2014.08.008 |url=}}</ref><ref name="pmid3318353">{{cite journal |vauthors=McKenna JP, Bostock DJ, McMenamin PG |title=Sialolithiasis |journal=Am Fam Physician |volume=36 |issue=5 |pages=119–25 |year=1987 |pmid=3318353 |doi= |url=}}</ref> | * [[Parotid gland|Parotid]], [[Submandibular gland|submandibular]], [[Sublingual gland|sublingual glands]] and minor salivary glands are prone to the development of stones.<ref name="pmid25443682">{{cite journal |vauthors=Mandel L |title=Salivary gland disorders |journal=Med. Clin. North Am. |volume=98 |issue=6 |pages=1407–49 |year=2014 |pmid=25443682 |doi=10.1016/j.mcna.2014.08.008 |url=}}</ref><ref name="pmid3318353">{{cite journal |vauthors=McKenna JP, Bostock DJ, McMenamin PG |title=Sialolithiasis |journal=Am Fam Physician |volume=36 |issue=5 |pages=119–25 |year=1987 |pmid=3318353 |doi= |url=}}</ref> | ||
* Parotid glands and stensen ducts are located anterior to the external auditory canal. | * [[Parotid gland|Parotid glands]] and stensen ducts are located anterior to the [[external auditory canal]]. | ||
* Submandibular glands and wharton ducts are located beneath the floor of the mouth. | * [[Submandibular gland|Submandibular glands]] and wharton ducts are located beneath the floor of the mouth. | ||
* Sublingual glands are located beneath the mucous membrane of the floor of the mouth. | * [[Sublingual gland|Sublingual glands]] are located beneath the mucous membrane of the floor of the mouth. | ||
* 75 percent of sialadenosis cases are single | * 75 percent of sialadenosis cases are single | ||
* 3 percent of stones are bilateral and most of them are located in parotid glands. | * 3 percent of stones are bilateral and most of them are located in [[Parotid gland|parotid glands]]. | ||
* Submandibular stones are the largest ones and are often located in the wharton ducts. | * [[Submandibular gland|Submandibular]] stones are the largest ones and are often located in the wharton ducts. | ||
* Parotid stones are the smaller than submandibular stones, and they are more located within the glands and they are more multiple. | * [[Parotid gland|Parotid]] stones are the smaller than [[Submandibular gland|submandibular]] stones, and they are more located within the glands and they are more multiple. | ||
* Stone formation is 80 to 90 percent in the submandibular gland, 6 to 20 percent in the parotid glands, 1 to 2 percent occur in the sublingual or minor salivary glands.<ref name="pmid179578462">{{cite journal |vauthors=Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L |title=Modern management of obstructive salivary diseases |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=4 |pages=161–72 |year=2007 |pmid=17957846 |pmc=2640028 |doi= |url=}}</ref> | * Stone formation is 80 to 90 percent in the [[submandibular gland]], 6 to 20 percent in the [[Parotid gland|parotid glands]], 1 to 2 percent occur in the [[Sublingual gland|sublingual]] or minor salivary glands.<ref name="pmid179578462">{{cite journal |vauthors=Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L |title=Modern management of obstructive salivary diseases |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=4 |pages=161–72 |year=2007 |pmid=17957846 |pmc=2640028 |doi= |url=}}</ref> | ||
* Stones occur equally on the right and left sides. | * Stones occur equally on the right and left sides. | ||
'''Sialoadenitis''' | '''Sialoadenitis''' | ||
* Inflammation of a salivary gland | * [[Inflammation]] of a [[salivary gland]] | ||
* Swelling is usually present | * [[Swelling]] is usually present | ||
* Acute sialoadenitis may be caused by viral or bacterial infection<ref name="pmid3318353" /> | * Acute sialoadenitis may be caused by viral or bacterial infection<ref name="pmid3318353" /> | ||
** Parotid and submandibular | ** [[Parotid gland|Parotid]] and [[submandibular gland]]<nowiki/>s are more involved in acute sialadenitis. | ||
* Chronic sialoadenitis is caused by repeated episodes of inflammation and finally it progresses to salivary gland dysfucntion. | * Chronic sialoadenitis is caused by repeated episodes of [[inflammation]] and finally it progresses to salivary gland dysfucntion. | ||
==Associated Conditions== | ==Associated Conditions== | ||
* | * [[Sjögren's syndrome|Sjögrens]]<ref name="pmid23242089">{{cite journal |vauthors=Moghe S, Pillai A, Thomas S, Nair PP |title=Parotid sialolithiasis |journal=BMJ Case Rep |volume=2012 |issue= |pages= |year=2012 |pmid=23242089 |pmc=4543829 |doi=10.1136/bcr-2012-007480 |url=}}</ref> | ||
* Medications such as anticholinergics<ref name="pmid23242089" /> | * Medications such as [[Anticholinergic|anticholinergics]]<ref name="pmid23242089" /> | ||
==Gross Pathology== | ==Gross Pathology== | ||
| Line 75: | Line 75: | ||
==Microscopic Pathology== | ==Microscopic Pathology== | ||
*On microscopic histopathological analysis, | *On microscopic histopathological analysis, | ||
**Dilated ducts with squamous metaplasia or calculi | **Dilated ducts with [[squamous metaplasia]] or [[calculi]] | ||
**Chronic inflammation | **Chronic [[inflammation]] | ||
**Destruction of acini | **Destruction of acini | ||
**Fibrosis in sialadenitis | **[[Fibrosis]] in [[sialadenitis]] | ||
==References== | ==References== | ||
Revision as of 15:56, 31 January 2018
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Risk calculators and risk factors for Sialolithiasis pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mahda Alihashemi M.D. [2]
Overview
Sialolithiasis is presence of stones within the salivary glands or the salivary gland ducts.The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important. 75 percent of sialolithiasis cases are single. 3 percent of stones are bilateral and most of them are located in parotid glands. Stone formation is 80 to 90 percent in the submandibular gland, 6 to 20 percent in the parotid glands and 1 to 2 percent in the sublingual or minor salivary glands. Sialoadenitis is inflamamtion of a salivary gland. Acute sialoadenitis may be caused by viral or bacterial infection. Chronic sialoadenitis is caused by repeated episodes of inflammation. On gross pathology, hard yellow -white spherical depositions usually less than 1 cm are seen. On microscopic pathology, dilated ducts with squamous metaplasia or calculi are usullay present.
Pathophysiology
Pathogenesis
Sialolithiasis :
- Presence of stones within the salivary glands or the salivary gland ducts.
- The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important.
- Component of salivary stones include: [1]
- Calcium phosphate
- Hydroxyapatite
- Magnesium
- Ammonium
- Potassium
- Parotid, submandibular, sublingual glands and minor salivary glands are prone to the development of stones.[2][3]
- Parotid glands and stensen ducts are located anterior to the external auditory canal.
- Submandibular glands and wharton ducts are located beneath the floor of the mouth.
- Sublingual glands are located beneath the mucous membrane of the floor of the mouth.
- 75 percent of sialadenosis cases are single
- 3 percent of stones are bilateral and most of them are located in parotid glands.
- Submandibular stones are the largest ones and are often located in the wharton ducts.
- Parotid stones are the smaller than submandibular stones, and they are more located within the glands and they are more multiple.
- Stone formation is 80 to 90 percent in the submandibular gland, 6 to 20 percent in the parotid glands, 1 to 2 percent occur in the sublingual or minor salivary glands.[4]
- Stones occur equally on the right and left sides.
Sialoadenitis
- Inflammation of a salivary gland
- Swelling is usually present
- Acute sialoadenitis may be caused by viral or bacterial infection[3]
- Parotid and submandibular glands are more involved in acute sialadenitis.
- Chronic sialoadenitis is caused by repeated episodes of inflammation and finally it progresses to salivary gland dysfucntion.
Associated Conditions
- Sjögrens[5]
- Medications such as anticholinergics[5]
Gross Pathology
 |
- On gross pathology, hard yellow -white spherical depositions usually less than 1 cm in diameter is characteristic finding of sialolithiasis.[5]
Microscopic Pathology
- On microscopic histopathological analysis,
- Dilated ducts with squamous metaplasia or calculi
- Chronic inflammation
- Destruction of acini
- Fibrosis in sialadenitis
References
- ↑ Williams MF (1999). "Sialolithiasis". Otolaryngol. Clin. North Am. 32 (5): 819–34. PMID 10477789.
- ↑ Mandel L (2014). "Salivary gland disorders". Med. Clin. North Am. 98 (6): 1407–49. doi:10.1016/j.mcna.2014.08.008. PMID 25443682.
- ↑ 3.0 3.1 McKenna JP, Bostock DJ, McMenamin PG (1987). "Sialolithiasis". Am Fam Physician. 36 (5): 119–25. PMID 3318353.
- ↑ Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L (2007). "Modern management of obstructive salivary diseases". Acta Otorhinolaryngol Ital. 27 (4): 161–72. PMC 2640028. PMID 17957846.
- ↑ 5.0 5.1 5.2 Moghe S, Pillai A, Thomas S, Nair PP (2012). "Parotid sialolithiasis". BMJ Case Rep. 2012. doi:10.1136/bcr-2012-007480. PMC 4543829. PMID 23242089.
- ↑ <"http://www.gnu.org/copyleft/fdl.html">GFDL, <"http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0 or <"https://creativecommons.org/licenses/by-sa/2.5-2.0-1.0">CC BY-SA 2.5-2.0-1.0], <"https://commons.wikimedia.org/wiki/File%3ASialolithiasis.jpg">
