Sialolithiasis

• • 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

Epidemiology

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

  • 20-40% of stones are radiolucent

Symptoms and Signs

• • Painful swelling

  • Patients may complain of extrusion of gravel from the ducts

  • Symptoms worse with eating

Imaging Findings

• • Soft-tissue films reveal radiodense stone

  • CT may show sialoliths

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

• • Physical exam

  • CT scan

• • Intraoral removal of stones by ductal dilation and massage

Surgery

• • Operation to excise the gland

Indications

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

References