Sialolithiasis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2] [3]
Overview
Historical Perspective
Sialolithiasis was first discovered by Küttner in 1986. Sialadenoscope were used for the first time in 1991.
Classification
There is no established system for the classification of sialolithisis, but it may be classified according to location of the stone, radiopaque or radiolucent, symptomatic or asymptomatic.
Pathophysiology
Sialolithiasis is the presence of stones within the salivary glands or the salivary gland ducts.The exact pathogenesis of sialolithiasis not fully understood but the 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 inflammation 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 usually present.
Causes
The exact etiology of sialolithiasis is not well understood, but relative stagnation of salivary flow and calcium concentration may be important.
Differentiating Hereditary pancreatitis from Other Diseases
Sialolithiasis must be differentiated from other diseases that cause swelling in salivary glands, such as acute bacterial sialadenitis, chronic bacterial sialadenitis, viral sialadenitis, human immunodeficiency virus, radiation, and systemic diseases such as, sarcoidosis, and sjögren's syndrome.
Epidemiology and Demographics
The incidence of sialolithiasis is approximately 100 per 100,000 individuals in autopsy studies worldwide. The prevalence of sialolithiasis is approximately 450 per 100,000 individuals worldwide. Sialolithiasis commonly affects individuals between the ages of 30 and 60 years. There is no racial predilection to sialolithiasis. Men are more commonly affected by sialolithiasis than women.
Risk Factors
Common risk factors in the development of sialolithiasis include dehydration, duiretics, local trauma, sjögrens.
Screening
There is insufficient evidence to recommend routine screening for sialolithiasis.
Natural History, Complications, and Prognosis
If left untreated, patients with sialolithiasis may progress to develop secondary infection and chronic sialadenitis. Common complications of sialolithiasis include infection and recurrence. Prognosis is generally good.