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Sialolithiasis (also termed salivary calculi, [1] or salivary stones) [1] is a crystallopathy where a calcified mass or sialolith forms within a salivary gland, usually in the duct of the submandibular gland (also termed "Wharton's duct"). Less commonly the parotid gland or rarely the sublingual gland or a minor salivary gland may develop ...
Blockage, whether caused by salivary duct stones or external compression, may cause pain and swelling of the parotid gland . Koplik's spots which are pathognomonic of measles are found near the opening of the parotid duct. The parotid duct may be cannulated by inserting a tube through the internal orifice in the mouth. [2]
Strictures are the second most common cause of chronic obstructive sialadenitis, after salivary stones. [1] In line with this, strictures may give rise to the "meal time syndrome", [1] where there is pain and swelling of the involved salivary gland upon salivary stimulation with the sight, smell and taste of food.
Thus, sialoendoscopy is an efficient yet simple mode of treatment for major salivary gland obstructions, strictures and sialoliths (salivary stones). Depending on the obstruction, sialoendoscopy can be conducted under local anesthesia in an outpatient office or in the operating room under general anesthesia .
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]
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Salivary gland fistulae are almost always related to the parotid gland or duct, although the submandibular gland is rarely the origin. [ 1 ] The fistula can communicate with the mouth (usually causing no symptoms), the paranasal sinuses (giving rhinorrhea ) [ 1 ] or the facial skin (causing saliva to drain onto the skin).
Formation of stones in glandular ducts can result in the development of obstructive sialadenitis. There may be a history of abrupt episodic swelling of the parotid or submandibular gland which is usually painful. These episodes typically occur around meal times, lasting 2–3 hours, and gradually subside.