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Sialolithiasis

Synonym: Ptyalolithiasis, salivary caliculi, salivary stones
German: Sialolithiasis

1 Definition

The definition sialolithiasis refers to the formation of calculus bodies (stones) in any of the salivary glands. They are also called sialoliths. In approximately 70-90% of cases the submandibular gland is affected (Glandula submandibularis); in 10-20% of cases a parotid gland (Glandula parotis). The sublingual salivary gland (Glandula sublingualis) is involved in about 1-5% of cases. Very rarely, stones occur in the small salivary glands of the mouth and throat.

2 Symptoms

3 Complications

Salivary stones can lead to acute sialadenitis or even abscess of the affected salivary gland. A longstanding case of sialolithiasis can lead to chronic sclerosing sialadenitis, which is then referred to as Kuttner tumour.

4 Diagnosis

Note: Due to having higher proportion of inorganic substances, sialoliths of the submandibular gland are to be confirmed using X-ray imaging with higher accuracy.

5 Differential diagnoses

6 Treatment

Typically, conservative treatment is initially indicated, or measures which may facilitate spontaneous passing of stone. Where this had not been successful, in the past surgical removal of the salivary gland was the only curative measure used. Meanwhile, the salivary duct endoscopy technique (sialendoscopy) has become established in the clinic. This often permits preservation of organ function whenever a minimally invasive removal procedure is employed.

6.1 Conservative therapy

In the instance of acute sialadenitis being present antibiotics are additionally administered.

6.2 Surgical treatment

6.3 Lithotripsy

Surgical procedures on the salivary glands demands great care, since the risk of damaging cranial nerves (facial nerve, lingual nerve, hypoglossal nerve) is quite real.

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