Sialolithiasis
Sialolithiasis
It is a disorder that occurs in the major salivary glands, most often in middle-aged men. In addition to water, which is its main component, saliva contains many organic and inorganic substances. Any disturbance in the composition or drainage of the saliva produced can be the beginning of the formation of salivary glands.
The sialoliths are formed inside the glands, in their duct system. They are hard, spherical or elongated in shape and are white, yellowish or brown in colour.
Frequency of occurrence
- Submandibular gland: 80%
- Parotid gland: 19%
- Sublingual gland: 1%
The increased appearance of sialoliths in the submandibular gland is due to:
- the composition of the saliva produced by the gland (more mucous)
- the position of the gland (the flow of saliva is against gravity)
- its construction (wide and short pore)
Symptoms
- Pain (usually after a meal)
- Sudden hard swelling
- Fever
- Chronic swelling (after repeated inflammation)
Diagnosis
90% of sialoliths are radiolucent, so they can be detected with a simple X-ray. If the stone is located near the exit of the duct it can be visible and palpable. For stones located deeper, ultrasound and CT scans are useful.
Treatment
In case of sudden swelling of the gland due to duct obstruction and if the stone is close to the duct outlet and is palpable, it can be removed diastolically. If the stone is deep in the duct or inside the gland, then acute inflammation is treated with antibiotic therapy. After the acute phase has passed, it may be decided to surgically remove the gland.