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When the diameter of the stone is 5mm or less, it can be removed purely by an endoscopic technique, particularly when the stone is located above the muscles that comprise the floor of the mouth. The four common techniques used to remove the salivary gland stones are: The grasping technique; Using a small wire basket retrieval system
Less commonly the parotid gland or rarely the sublingual gland or a minor salivary gland may develop salivary stones. The usual symptoms are pain and swelling of the affected salivary gland, both of which get worse when salivary flow is stimulated, e.g. with the sight, thought, smell or taste of food, or with hunger or chewing.
A parotidectomy is the surgical excision (removal) of the parotid gland, the major and largest of the salivary glands. The procedure is most typically performed due to neoplasms [1] (tumors), which are growths of rapidly and abnormally dividing cells. Neoplasms can be benign (non-cancerous) or malignant (cancerous).
Many stone types can be detected by ultrasound; Factors contributing to stone formation (as in #Etiology) are often tested: Laboratory testing can give levels of relevant substances in blood or urine; Some stones can be directly recovered (at surgery, or when they leave the body spontaneously) and sent to a laboratory for analysis of content
Stones may be removed by manipulation in the doctor's office, or, in the worst cases, by surgery. Lithotripsy, also known as "shock wave" treatment, is best known for its use breaking up kidney stones. Lithotripsy can now be used on salivary stones as well. Ultrasound waves break up the stones, and the fragments flush out of the salivary duct. [7]
The lingual nerve can also be damaged (temporary or permanent) during surgical procedures in the mandible, in particular lower wisdom tooth removal. This would present as temporary or permanent numbness/altered sensation/altered taste to the side of tongue (side corresponding to side of surgery).
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Besides, when interventional proecudre is planned such as stone removal from salivary ducts or dilatation of the strictures in the salivary gland, this procedure is also indicated. [4] However, for those who are pregnant, with allergy to iodinated contrast, and ongoing infection or inflammation of the face, the procedure is contraindicated. [4]