Sialolithiasis medical therapy: Difference between revisions
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=== Conservative treatment === | === Conservative treatment === | ||
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are: | Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are: | ||
* Hydration | * [[Hydration]] | ||
* Apply moist heat | * Apply moist heat | ||
* Massage the gland | * Massage the gland | ||
* Duct milking | * Duct milking | ||
* Using agents that increase the | * 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. | * Discontinue of the medication that decrease the saliva flow, such as the [[Tricyclic anti-depressant|TCAs]] because of their [[anticholinergic]] effects. | ||
* Pain control with NSAIDs, or | * 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 : | * Antibiotics usage in the case of superimposed infection : | ||
** Preferred regimen(1): | ** Preferred regimen(1): [[Dicloxacillin]] 500 mg q 6h PO for 7 to 10 days. | ||
** Preferred regimen(2): | ** Preferred regimen(2): [[Cephalexin]] 500 mg q 6h PO for 7 to 10 days. | ||
* If the patients clinics did not change in five days of using above antibiotics, change to: | * If the patients 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(1): [[Amoxicillin-Clavulanate|Amoxicillin/clavulanate]] 625 mg q 8h PO for 7 to 10 days. | ||
** Preferred regimen(2): | ** Preferred regimen(2): [[Clindamycin]] 300 mg q 8h PO for 7 to 10 days. | ||
* Duct discharge should be used for culture. | * Duct discharge should be used for culture. | ||
Many cases of sialolithiasis may not be cured by using medical therapy alone. There are several minimally invasive and surgery methods that can be used for salivary gland stones. | |||
==References== | ==References== | ||
Revision as of 14:27, 6 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
Conservative treatment
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are:
- 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 patients 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. There are several minimally invasive and surgery methods that can be used for salivary gland stones.