Sialolithiasis pathophysiology: Difference between revisions

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{{Sialolithiasis}}
{{Sialolithiasis}}


{{CMG}}; {{MA}}  
{{CMG}}; {{AE}} {{MA}}  
==Overview==
==Overview==
The exact pathogenesis of [disease name] is not fully understood.
Sialolithiasis is the presence of stones within the [[Salivary gland|salivary glands]] or the salivary gland ducts.The exact pathogenesis of sialolithiasis not fully understood but the relative stagnation of salivary flow and calcium concentration may be important. 75 percent of sialolithiasis cases are single. 3 percent of stones are bilateral and most of them are located in [[Parotid gland|parotid glands]]. Stone formation is 80 to 90 percent in the [[submandibular gland]], 6 to 20 percent in the [[Parotid gland|parotid glands]] and 1 to 2 percent in the [[Sublingual gland|sublingual]] or minor salivary glands. Sialoadenitis is inflammation of a salivary gland. Acute sialoadenitis may be caused by [[Virus|viral]] or [[bacterial]] infection. Chronic sialoadenitis is caused by repeated episodes of inflammation. On [[gross pathology]], hard yellow -white spherical depositions usually less than 1 cm are seen. On microscopic pathology, dilated ducts with squamous metaplasia or calculi are usually present.
 
OR
 
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
 
OR
 
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
 
OR
 
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
 
OR
 
 
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
 
OR
 
The progression to [disease name] usually involves the [molecular pathway].
 
OR
 
The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Pathophysiology==
==Pathophysiology==
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===Pathogenesis===
===Pathogenesis===


==== Sialolithiasis : ====
==== Sialolithiasis ====
* Presence of stones within the salivary glands or the salivary gland ducts.
{| align="right"
|[[image:123.jpg|thumb|700px|The major salivary glands.1. Parotid gland, 2. Submandibular gland, 3. Sublingual gland.Source: Wikimedia Commons<ref name="urlFile:Illu quiz hn 02.jpg - Wikimedia Commons">{{cite web |url=https://commons.wikimedia.org/wiki/File:Illu_quiz_hn_02.jpg#/media/File:Illu_quiz_hn_02.jpg |title=File:Illu quiz hn 02.jpg - Wikimedia Commons |format= |work= |accessdate=}}</ref>]]
|}
* Presence of stones within the [[Salivary gland|salivary glands]] or the salivary gland ducts.


* The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important.
* The exact pathogenesis of sialolithiasis not fully understood but the relative stagnation of salivary flow and [[calcium]] concentration may be important.


* Component of salivary stones include: <ref name="pmid104777892">{{cite journal |vauthors=Williams MF |title=Sialolithiasis |journal=Otolaryngol. Clin. North Am. |volume=32 |issue=5 |pages=819–34 |year=1999 |pmid=10477789 |doi= |url=}}</ref>
* Component of salivary stones include: <ref name="pmid104777892">{{cite journal |vauthors=Williams MF |title=Sialolithiasis |journal=Otolaryngol. Clin. North Am. |volume=32 |issue=5 |pages=819–34 |year=1999 |pmid=10477789 |doi= |url=}}</ref>
** Calcium phosphate
** [[Calcium phosphate]]
** Hydroxyapatite
** [[Hydroxyapatite]]
** Magnesium
** [[Magnesium]]
** Ammonium
** [[Ammonium]]
** Potassium
** [[Potassium]]


* Parotid, submandibular, sublingual glands and minor salivary glands are prone to the development of stones.<ref name="pmid25443682">{{cite journal |vauthors=Mandel L |title=Salivary gland disorders |journal=Med. Clin. North Am. |volume=98 |issue=6 |pages=1407–49 |year=2014 |pmid=25443682 |doi=10.1016/j.mcna.2014.08.008 |url=}}</ref><ref name="pmid3318353">{{cite journal |vauthors=McKenna JP, Bostock DJ, McMenamin PG |title=Sialolithiasis |journal=Am Fam Physician |volume=36 |issue=5 |pages=119–25 |year=1987 |pmid=3318353 |doi= |url=}}</ref>
* [[Parotid gland|Parotid]], [[Submandibular gland|submandibular]], [[Sublingual gland|sublingual glands]] and minor [[salivary glands]] are prone to the development of stones.<ref name="pmid25443682">{{cite journal |vauthors=Mandel L |title=Salivary gland disorders |journal=Med. Clin. North Am. |volume=98 |issue=6 |pages=1407–49 |year=2014 |pmid=25443682 |doi=10.1016/j.mcna.2014.08.008 |url=}}</ref><ref name="pmid3318353">{{cite journal |vauthors=McKenna JP, Bostock DJ, McMenamin PG |title=Sialolithiasis |journal=Am Fam Physician |volume=36 |issue=5 |pages=119–25 |year=1987 |pmid=3318353 |doi= |url=}}</ref>


* Parotid glands and stensen ducts are located anterior to the external auditory canal.
* [[Parotid gland|Parotid glands]] and stensen ducts are located anterior to the [[external auditory canal]].


* Submandibular glands and wharton ducts are located beneath the floor of the mouth.
* [[Submandibular gland|Submandibular glands]] and wharton ducts are located beneath the floor of the [[mouth]].


* Sublingual glands are located beneath the mucous membrane of the floor of the mouth.
* [[Sublingual gland|Sublingual glands]] are located beneath the mucous membrane of the floor of the [[mouth]].


* 75 percent of sialadenosis cases are single  
* 75 percent of sialolithiasis cases are single  


* 3 percent of stones are bilateral and most of them are located in parotid glands.
* 3 percent of stones are bilateral and most of them are located in [[Parotid gland|parotid glands]].


* Submandibular stones are the largest ones and are often located in the wharton ducts.   
* [[Submandibular gland|Submandibular]] stones are the largest ones and are often located in the wharton ducts.   


* Parotid stones are the smaller than submandibular stones, and they are more located within the glands and they are more multiple.   
* [[Parotid gland|Parotid]] stones are the smaller than [[Submandibular gland|submandibular]] stones, and they are more located within the glands and they are more multiple.   


* Stone formation is 80 to 90 percent in the submandibular gland, 6 to 20 percent in the parotid glands, 1 to 2 percent occur in the sublingual or minor salivary glands.<ref name="pmid179578462">{{cite journal |vauthors=Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L |title=Modern management of obstructive salivary diseases |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=4 |pages=161–72 |year=2007 |pmid=17957846 |pmc=2640028 |doi= |url=}}</ref>
* Stone formation is 80 to 90 percent in the [[Submandibular gland|submandibular glands]], 6 to 20 percent in the [[Parotid gland|parotid glands]], 1 to 2 percent occur in the [[Sublingual gland|sublingual]] or minor salivary glands.<ref name="pmid179578462">{{cite journal |vauthors=Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L |title=Modern management of obstructive salivary diseases |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=4 |pages=161–72 |year=2007 |pmid=17957846 |pmc=2640028 |doi= |url=}}</ref>


* Stones occur equally on the right and left sides.
* Stones occur equally on the right and left sides.
'''Sialoadenitis'''
* Inflammation of a salivary gland
* Swelling is usually present
* Acute sialoadenitis may be caused by viral or bacterial infection<ref name="pmid3318353" />
** Parotid and submandibular glands are more involved in acute sialadenitis.
**;
**:
* Chronic sialoadenitis is caused by repeated episodes of inflammation and finally it progresses to salivary gland dysfucntion.
==Associated Conditions==
==Associated Conditions==
* [[Sjögren's syndrome|Sjögrens]]<ref name="pmid23242089">{{cite journal |vauthors=Moghe S, Pillai A, Thomas S, Nair PP |title=Parotid sialolithiasis |journal=BMJ Case Rep |volume=2012 |issue= |pages= |year=2012 |pmid=23242089 |pmc=4543829 |doi=10.1136/bcr-2012-007480 |url=}}</ref>
* Medications such as [[Anticholinergic|anticholinergics]]<ref name="pmid23242089" />


==Gross Pathology==
==Gross Pathology==
*On gross pathology, hard yellow -white spherical depositions usually less than 2 cm in diameter, [feature2], and [feature3] are characteristic findings of [disease name].
{| align="right"
|[[image:Sialolithiasis.jpg|thumb|300px|Salivary gland stones- By PGA (Own work), via Wikimedia Commons<ref><"http://www.gnu.org/copyleft/fdl.html">GFDL, <"http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0 or <"https://creativecommons.org/licenses/by-sa/2.5-2.0-1.0">CC BY-SA 2.5-2.0-1.0], <"https://commons.wikimedia.org/wiki/File%3ASialolithiasis.jpg"></ref>]]
|}
*On gross pathology, hard yellow -white spherical depositions usually less than 1 cm in diameter is  characteristic finding of sialolithiasis.<ref name="pmid23242089" />
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==Microscopic Pathology==
==Microscopic Pathology==
*On microscopic histopathological analysis,
*On microscopic histopathological analysis,
**Dilated ducts with squamous metaplasia or calculi
**Dilated ducts with [[squamous metaplasia]] or [[calculi]]
**Chronic inflammation
**Chronic [[inflammation]]
**Destruction of acini
**Destruction of acini
**Fibrosis in sialadenitis  
**[[Fibrosis]] in [[sialadenitis]]


==References==
==References==
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[[Category:Gastroenterology]]
[[Category:Medicine]]
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Latest revision as of 00:10, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

Sialolithiasis is the presence of stones within the salivary glands or the salivary gland ducts.The exact pathogenesis of sialolithiasis not fully understood but the relative stagnation of salivary flow and calcium concentration may be important. 75 percent of sialolithiasis cases are single. 3 percent of stones are bilateral and most of them are located in parotid glands. Stone formation is 80 to 90 percent in the submandibular gland, 6 to 20 percent in the parotid glands and 1 to 2 percent in the sublingual or minor salivary glands. Sialoadenitis is inflammation of a salivary gland. Acute sialoadenitis may be caused by viral or bacterial infection. Chronic sialoadenitis is caused by repeated episodes of inflammation. On gross pathology, hard yellow -white spherical depositions usually less than 1 cm are seen. On microscopic pathology, dilated ducts with squamous metaplasia or calculi are usually present.

Pathophysiology

Pathogenesis

Sialolithiasis

The major salivary glands.1. Parotid gland, 2. Submandibular gland, 3. Sublingual gland.Source: Wikimedia Commons[1]
  • The exact pathogenesis of sialolithiasis not fully understood but the relative stagnation of salivary flow and calcium concentration may be important.
  • 75 percent of sialolithiasis cases are single
  • 3 percent of stones are bilateral and most of them are located in parotid glands.
  • Submandibular stones are the largest ones and are often located in the wharton ducts.
  • Parotid stones are the smaller than submandibular stones, and they are more located within the glands and they are more multiple.
  • Stones occur equally on the right and left sides.

Associated Conditions

Gross Pathology

Salivary gland stones- By PGA (Own work), via Wikimedia Commons[7]
  • On gross pathology, hard yellow -white spherical depositions usually less than 1 cm in diameter is characteristic finding of sialolithiasis.[6]















Microscopic Pathology

References

  1. ↑ "File:Illu quiz hn 02.jpg - Wikimedia Commons".
  2. ↑ Williams MF (1999). "Sialolithiasis". Otolaryngol. Clin. North Am. 32 (5): 819–34. PMID 10477789.
  3. ↑ Mandel L (2014). "Salivary gland disorders". Med. Clin. North Am. 98 (6): 1407–49. doi:10.1016/j.mcna.2014.08.008. PMID 25443682.
  4. ↑ McKenna JP, Bostock DJ, McMenamin PG (1987). "Sialolithiasis". Am Fam Physician. 36 (5): 119–25. PMID 3318353.
  5. ↑ Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L (2007). "Modern management of obstructive salivary diseases". Acta Otorhinolaryngol Ital. 27 (4): 161–72. PMC 2640028. PMID 17957846.
  6. ↑ 6.0 6.1 6.2 Moghe S, Pillai A, Thomas S, Nair PP (2012). "Parotid sialolithiasis". BMJ Case Rep. 2012. doi:10.1136/bcr-2012-007480. PMC 4543829. PMID 23242089.
  7. ↑ <"http://www.gnu.org/copyleft/fdl.html">GFDL, <"http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0 or <"https://creativecommons.org/licenses/by-sa/2.5-2.0-1.0">CC BY-SA 2.5-2.0-1.0], <"https://commons.wikimedia.org/wiki/File%3ASialolithiasis.jpg">

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