Sialolithiasis: Salivary Gland Calculi
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Questions and Answers

What is the primary component of sialoliths?

  • Salivary solutes
  • Salivary proteins
  • Calcium (correct)
  • Organic debris
  • At what rate do sialoliths grow?

  • 1 mm/year (correct)
  • 10 mm/year
  • 1 cm/year
  • 5 mm/year
  • Which of the following factors can contribute to the formation of sialoliths?

  • Diabetes
  • Hypertension
  • Dehydration
  • Inflammation (correct)
  • What is the most common location for sialolith formation?

    <p>Submandibular gland</p> Signup and view all the answers

    What is a common symptom of sialolithiasis?

    <p>Pain with psychic stimulation of salivary flow</p> Signup and view all the answers

    What is the primary cause of pain and swelling in patients with salivary calculi?

    <p>Obstruction of the duct by the sialolith</p> Signup and view all the answers

    What is the purpose of sialography in the diagnosis of salivary calculi?

    <p>To locate the site of the stone in the duct</p> Signup and view all the answers

    What is the recommended procedure for removing smaller sialoliths located peripherally near the ductal opening?

    <p>Manipulation (milking the gland)</p> Signup and view all the answers

    What is a possible complication of long-term obstruction of the salivary duct?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of using sialogogues in patients with salivary calculi?

    <p>To stimulate and enhance salivary flow</p> Signup and view all the answers

    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.

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    Description

    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.

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