- formation of stones within the ducts of the major salivary glands: parotid, submandibular, and sublingual glands
- In some cases, sialoliths can obstruct the salivary ducts, leading to inflammation, superimposed bacterial infection termed sialadenitis
- Risk factors:
- Hypercalcemia
- Gout
- Smoking
- decreased fluid intake
- decreased salivary production (eg: diuretic use)
- Symptoms
- Intermittent facial Swelling and pain often associated with eating
- Small hard rock palpable in gland or visible at os
- Differentials
- Cellulitis
- Poor dentition and dental abscess formation
- Infection of the buccal or masticator space
- Herpes zoster
- Neoplasm
- Diagnosis
- Usually Clinical
- Xray: usually stones are radio-opaque (80% submandibular gland, 60% parotid gland)
- Other options: USS scan, CT , Sialography
- Management
- conservative measures
- massaging the salivary gland
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- sialogogues (lemon juice)
- Discontinue anti-cholinergics
- Often comes and goes
- Sialadentitis : Acute infection
- If not improving – ENT
- Patient info
- Patients should be informed that sialolithiasis has an excellent prognosis and resolve with conservative management in most cases.
- Patients require education on common initial symptoms such as glandular swelling and pain with meals that suggest they have formed a new sialolith.
- While sialolithiasis is usually idiopathic, the formation of stones can be secondary to an obstructing process such as ductal stenosis or neoplasm.
- Patients should be educated about the need to inform their clinician of recurrent or worsening symptoms that would indicate a need for a more advanced imaging workup or referral to a head and neck specialist.
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