'''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.
ICD10 = {{ICD10|K|11|5|k|00}} |
==Causes==
ICD9 = {{ICD9|527.5}} |
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.
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MeshID = D015494 |
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'''Sialolithiasis''' is most commonly found in the [[submandibular gland]]. Stone formation in [[salivary glands]]. It is frequently associated with chronic infection (''Staphylococcus aureus, Steptococcus viridans'') of the glands and dehydration (phenothiazines). Treatment includes having patient suck on something sour to promote stone expulsion through increased [[salivation]].
It involves the largest ducts and the presence of higher concentration of calcium.
==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==
===History and Symptoms===
Pain, when present, usually originates from the floor of the mouth, although in many cases the stones cause only intermittent swelling.
===Physical Examination===
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.
===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.
== Treatment ==
===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}}
It is identified by swelling located under the jaw in the salivatory duct, swelling increases especially be fore meals.
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
History and Symptoms
Pain, when present, usually originates from the floor of the mouth, although in many cases the stones cause only intermittent swelling.
Physical Examination
Since 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.
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.
Treatment
Medical Therapy
Some current treatment options are:
For small stones, hydration, moist heat, NSAIDs 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.
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.
A surgeon may make a small incision near the stone to remove it.File:Salivary gland stone removed.jpegSalivary gland stone and the hole left behind from the operation
