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  • • Both a cause and a consequence of chronic sialadenitis

    • May produce suppurative sialadenitis

    • Stones are composed of inorganic calcium and sodium phosphate deposited on an organic nidus or cellular debris

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Epidemiology

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  • • 80-90% occur in the ducts of the submandibular glands

    • 20-40% of stones are radiolucent

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Symptoms and Signs

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  • • Painful swelling

    • Patients may complain of extrusion of gravel from the ducts

    • Symptoms worse with eating

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Imaging Findings

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  • • Soft-tissue films reveal radiodense stone

    • CT may show sialoliths

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  • • Diagnosis confirmed by palpation of stone or demonstration of decreased salivary flow

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  • • Physical exam

    • CT scan

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  • • Intraoral removal of stones by ductal dilation and massage

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Surgery

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  • • Operation to excise the gland

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Indications

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  • • For stones in the hilum of the gland that cause chronic pain and swelling

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References

Brook I: Diagnosis and management of parotitis. Arch Otolaryngol Head Neck Surg 1992;118:469.  [PubMed: 1571113]

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