Sialolithiasis (Stone in Salivary Gland)

Introduction:

Sialolithiasis refers to the formation of calcified stones, or sialoliths, within the ducts of the salivary glands. These stones can obstruct the flow of saliva, leading to symptoms such as pain, swelling, and infection. Treatment typically involves stone removal to restore normal salivary gland function.

Understanding Sialolithiasis:

Sialolithiasis occurs when minerals in the saliva crystallize and form stones within the ducts of the salivary glands. These stones can vary in size and may obstruct the ducts, impairing the flow of saliva. Sialoliths most commonly affect the submandibular glands but can also occur in the parotid and sublingual glands.

Characteristics of Sialolithiasis:

• Location: Sialoliths typically form in the ducts of the salivary glands, particularly the submandibular duct (Wharton’s duct) and, less commonly, the parotid duct (Stensen’s duct) or sublingual ducts.
• Composition: The composition of sialoliths varies but often includes calcium salts, such as calcium phosphate or calcium carbonate, along with other minerals found in saliva.
• Size: Sialoliths can range in size from a few millimeters to several centimeters in diameter and may be single or multiple.
• Symptoms: Obstruction of the salivary ducts by sialoliths can lead to symptoms such as pain, swelling, tenderness, and difficulty opening the mouth or swallowing.

Causes and Risk Factors:

• Salivary Stasis: Reduced salivary flow or stasis can predispose to the formation of sialoliths. Factors contributing to salivary stasis include dehydration, medications that reduce saliva production, and conditions such as Sjögren’s syndrome.
• Composition of Saliva: Changes in the composition of saliva, such as alterations in pH or mineral content, can promote the formation of sialoliths.
• Anatomical Factors: Anatomic variations or strictures in the salivary ducts can increase the risk of sialolithiasis by providing sites for stone formation and impaction.

Signs and Symptoms:

• Pain: Patients with sialolithiasis may experience intermittent or constant pain in the affected salivary gland region, particularly during meals when saliva production is stimulated.
• Swelling: Swelling and tenderness may occur in the affected gland, leading to a palpable lump or mass in the cheek or floor of the mouth.
• Difficulty with Salivation: Obstruction of the salivary ducts by sialoliths can result in decreased saliva production and difficulty with salivation, leading to dry mouth and difficulty swallowing.
• Infection: In some cases, sialolithiasis may be complicated by salivary gland infection (sialadenitis), characterized by symptoms such as fever, redness, and purulent discharge from the duct opening.