What Is Sialolithiasis?

Salivary stone disease refers to a series of lesions caused by calcified masses in the salivary glands and their ducts. Submandibular salivary stones are the most common, followed by parotid glands. Salivary stones often prevent saliva from being excreted and secondary infections cause acute or recurrent inflammation of the glands. Can be seen at any age, more common in young people 20 to 40 years old. There are more males than females, and those with a short course of disease may take several days, and the elderly may have years or even decades.

Basic Information

English name: sialolithiasis
Visiting department: Oral and Maxillofacial Surgery
Multiple groups: 20 to 40 year old young men

Common locations: Submandibular gland
Common symptoms: The affected glands quickly swell and pain when eating, and symptoms can be gradually reduced and subsided after eating

Causes of salivary stone disease

The formation mechanism of salivary stones has not been fully understood, and it is generally believed to be related to saliva retention caused by foreign bodies, inflammation, and various reasons, and may also be related to the metabolism disorder of the inorganic salt of the body. Most salivary stones occur in the submandibular gland and may be related to the following factors:

1. The submandibular gland is a mixed gland. The secreted saliva is rich in mucin, which is more viscous than the parotid secretion, and the calcium content is more than 2 times, and calcium salts are easy to deposit.

2. The submandibular gland duct walks from bottom to top, and the gland secretion fluid flows in the direction of gravity. The catheter is long and has a curved part at the back of the mouth bottom. The catheter is tortuous throughout, which makes the saliva easily stagnant and leads to the formation of salivary stones.

Clinical manifestations of salivary stone disease

Small salivary gland stones are not obvious, and obstructive symptoms occur when large stones block the ducts and affect saliva drainage. It is characterized by rapid swelling and pain in the affected glands each time you eat, and symptoms can be gradually reduced and subsided after eating. When using both hands for internal and external palpation, large stones at the front end can be touched.

Salivary stone test

1. Laboratory tests show that the blood calcium concentration is higher than normal. Such as concurrent infections, the total number of white blood cells increases.

2. X-ray examination with bite film to check the bottom of the mouth, a radiographic block on the film can confirm the diagnosis. Submandibular gland ducts should be selected with temporomandibular transverse occlusal films over the anterior salivary stones. Submandibular ducts and sialoliths in the glands should be taken with lateral submandibular glands. Salivary stones with low calcification are difficult to show on X-ray films, and salivary gland imaging can be performed. The salivary stones appear as round, oval, or spindle-shaped filling defects.

3. B-ultrasound can display calculus images.

4.CT is a more effective diagnostic method. In addition to the obvious stones that can be observed, it is more advantageous to observe the scope of inflammation masses and the internal structure of abscesses caused by it.

Diagnosis of salivary stone disease

According to the characteristics of swelling of the submandibular gland accompanied by pain during eating, catheter drainage, and palpation of both hands and calculi in the catheter, etc., clinical diagnosis of submandibular glaucoma and submandibular adenitis. X-ray examination and CT examination should be done to confirm the diagnosis.

Differential diagnosis of salivary stone disease

1. Benign or malignant tumors of the sublingual gland have no symptoms of obstruction of salivary secretion and salivary glanditis. There are no stones on X-ray examination or angiography, and the palpable tumor is substantial and no tenderness.

2. Submandibular gland tumors showed progressive enlargement, and there was no history of eating swelling or submandibular gland inflammation. Tumor pathology can confirm the diagnosis.

3. Patients with submandibular space infection have a history of dental disease. The swelling in the submandibular area is hard infiltration, the skin is flushed, and depression edema can occur. Submandibular gland duct secretion may be reduced without symptoms of sialolith obstruction.

Salivary Stones Treatment

Conservative treatment

Very small salivary stones and parotid duct stones can be treated conservatively. It contains cotton swabs or vitamin C tablets dipped in citric acid, and can also eat acidic fruits, which promotes the secretion of saliva and promotes the excretion of salivary stones.

2. Surgical treatment

For stones in the anterior segment of the submandibular duct, the stones can be removed from the mouth of the duct by pushing. A stone was formed in the middle of the catheter, and an incision was made in the mouth in the direction of the catheter to remove it. Chronic submandibular glanditis and glandular atrophy have been complicated by stones or salivary stones in the posterior part of the catheter and glands, and the submandibular glands are often removed at the same time. In recent years, some people have adopted a lithotripter, lithotripsy, salivary glandoscopy catheter and other treatment methods to some extent.

3. Symptomatic treatment

Patients with sialitis were treated with antibiotics.