10 Questions
What is the primary component of sialoliths?
Calcium
At what rate do sialoliths grow?
1 mm/year
Which of the following factors can contribute to the formation of sialoliths?
Inflammation
What is the most common location for sialolith formation?
Submandibular gland
What is a common symptom of sialolithiasis?
Pain with psychic stimulation of salivary flow
What is the primary cause of pain and swelling in patients with salivary calculi?
Obstruction of the duct by the sialolith
What is the purpose of sialography in the diagnosis of salivary calculi?
To locate the site of the stone in the duct
What is the recommended procedure for removing smaller sialoliths located peripherally near the ductal opening?
Manipulation (milking the gland)
What is a possible complication of long-term obstruction of the salivary duct?
All of the above
What is the purpose of using sialogogues in patients with salivary calculi?
To stimulate and enhance salivary flow
Study Notes
Sialolithiasis
- Sialolithiasis is the formation of sialolith (salivary calculi, salivary stone) in the salivary duct or gland, resulting in obstruction of salivary flow.
- Sialolith is a calcareous substance that forms in the parenchyma or duct of major or minor salivary glands due to crystallization of salivary solutes.
- Sialoliths are yellowish white, single or multiple, and may be round, ovoid, or elongated, with a size of 2 cm or more in diameter.
- Sialoliths grow at a rate of 1 mm/year.
Factors Contributing to Sialolith Formation
- Inflammation
- Local irritation
- Drugs
- Stagnation of saliva
- Increased calcium content and thick consistency of submandibular gland secretion
- Long, curved Wharton's duct increasing chance of entrapment of organic debris
- Position of the gland increasing chances of saliva stagnation
Clinical Features
- Sialolithiasis can occur at any age, but is more common in middle-aged persons.
- Pain occurs with psychic stimulation of salivary flow when a duct of the major gland is involved.
- Patients complain of pain and swelling during and after eating.
- Obstruction of the duct by the sialolith causes prevention of salivary flow and increased pressure, producing pain.
- The stone can be palpated, especially if present at the peripheral aspect of the duct.
Investigations
- Radiographs (AP view, lateral, lateral oblique, or occlusal view)
- Sialography to locate the salivary calculi
Complications
- Bacterial infection of the gland resulting in obstruction of long duration
- Retention of saliva resulting in formation of mucoceles
- Rarely, complete obstruction of the duct resulting in atrophy of the gland
Management
- Removal of the sialolith through various techniques depending on the number, size, site, and age of the patient
- Manipulation (milking the gland) for smaller sialoliths located peripherally near the ductal opening
- Surgical removal for larger sialoliths
- Intubation of the duct with a fine soft plastic catheter and application of suction for stones that are not impacted
- Removal of the gland for multiple stones or stones in the gland
- Piezoelectric shockwave lithotripsy to fragment salivary stones, which then pass through the duct as salivary flow is stimulated and enhanced by sialogogues.
Test your knowledge about Sialolithiasis, a condition where salivary stones or calculi form in the salivary duct or gland, obstructing salivary flow. Learn about the characteristics of sialoliths and their formation in the salivary glands.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
