Sialolithiasis medical therapy: Difference between revisions
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==Medical Therapy== | ==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 salivar 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 opoid 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. | |||
=== Minimally invasive management === | |||
==== Sialoendoscopy ==== | |||
==== Extracorporeal lithotripsy ==== | |||
==== Laser lithotripsy ==== | |||
==== Wire basket retrieva ==== | |||
=== Surgical intervention === | |||
==References== | ==References== | ||
Revision as of 21:21, 5 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 salivar 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 opoid 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.