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{{Sialolithiasis}}
'''For patient information, click [[Sialolithiasis (patient information)|here]]'''
 
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{{SK}} Salivary calculus
{{SK}} Salivary calculus; salivary duct stone; salivary duct calculus
==Overview==
==[[Sialolithiasis overview|Overview]]==
'''Sialolithiasis''' refers to the formation of stones in the [[salivary glands]]. Stones are most commonly found in the [[submandibular gland]] and [[parotid gland]], where stones can obstruct [[Submandibular duct|Wharton's duct]] and [[Stenson's duct]] respectively.
 
==Causes==
==[[Sialolithiasis historical perspective|Historical Perspective]]==
It is frequently associated with chronic infection (''[[Staphylococcus aureus]], [[Streptococcus viridans]]'') of the glands, dehydration ([[phenothiazine]]s), [[Sjögren's syndrome]] and/or increased local levels of calcium, but in many cases can arise [[idiopathic]]ally.
 
==[[Sialolithiasis classification|Classification]]==
 
==[[Sialolithiasis pathophysiology|Pathophysiology]]==
 
==[[Sialolithiasis causes|Causes]]==
 
==[[Sialolithiasis differential diagnosis|Differentiating Sialolithiasis from other Diseases]]==
 
==[[Sialolithiasis epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Sialolithiasis risk factors|Risk Factors]]==
 
==[[Sialolithiasis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Natural History, Complications and Prognosis==
Complications include persistent obstruction of the duct, leading to bacterial invasion, overgrowth and infection ([[sialoadenitis]]). This can require IV antibiotics such as [[nafcillin]], and sometimes surgical drainage.
==Diagnosis==
==Diagnosis==
===History and Symptoms===
[[Sialolithiasis history and symptoms|History and Symptoms]] | [[Sialolithiasis physical examination|Physical Examination]] | [[Sialolithiasis laboratory findings|Laboratory Findings]] | [[Sialolithiasis x ray|X Ray]] | [[Sialolithiasis CT|CT]] | [[Sialolithiasis other imaging findings|Other Imaging Findings]] | [[Sialolithiasis other diagnostic studies|Other Diagnostic Studies]]
Pain, when present, usually originates from the floor of the mouth, although in many cases the stones cause only intermittent swelling.
 
===Physical Examination===
==Treatment==
Since [[mastication|chewing]] promotes release of saliva, symptoms tend to increase during meals. A palpable lump or visible swelling in the area of the gland is often noted.
[[Sialolithiasis medical therapy|Medical Therapy]] | [[Sialolithiasis surgery|Surgery]] | [[Sialolithiasis primary prevention|Primary Prevention]] | [[Sialolithiasis secondary prevention|Secondary Prevention]] | [[Sialolithiasis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Sialolithiasis future or investigational therapies|Future or Investigational Therapies]]
===X Ray===
 
Diagnosis is usually made by characteristic history and physical examination. Diagnosis can be confirmed by [[x-ray]] (80% of salivary gland calculi are visible on x-ray), or by [[sialogram]] or ultrasound.
== Case Studies ==
== Treatment ==
[[Sialolithiasis case study one|Case #1]]
===Medical Therapy===
Some current treatment options are:
* For small stones, hydration, moist heat, [[NSAID]]s occasionally, and having the patient take any food or beverage that is bitter and/or sour. Sucking on citrus fruits, such as a lemon or orange, may increase [[salivation]] and promote spontaneous expulsion of the stone.
* [[Sialendoscopy]]
* To prevent infection while the stone is lodged in the duct, sometimes antibiotics are used. In some cases when stones continually reoccur the offending salivary duct is removed.
===Surgery===
* Some stones may be massaged out by a specialist.
* An [[Otolaryngology|ENT]] or [[Oral and maxillofacial surgeon|maxillofacial surgeon]] may [[canula]]te the duct to remove the stone (sialotomy).
* A surgeon may make a small incision near the stone to remove it.[[File:Salivary gland stone removed.jpeg|thumb|Salivary gland stone and the hole left behind from the operation]]
{{Oral pathology}}


==References==
{{reflist|2}}
[[Category:Medical emergencies]]
[[Category:Medical emergencies]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
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Latest revision as of 15:14, 19 February 2013

Sialolithiasis Microchapters

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Overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Salivary calculus; salivary duct stone; salivary duct calculus

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sialolithiasis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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