Sialolithiasis is the presence of stones in any of the salivary glands or ducts. These stones, primarily made of calcium, can obstruct the normal flow of saliva, leading to pain and swelling. Though often manageable, early diagnosis and treatment are crucial to prevent complications like infections or abscesses.
Epidemiology
- Most stones occur in the submandibular glands.
- More common in men.
- Typically affects individuals in adulthood.
Aetiology
The exact cause of sialolithiasis is unclear. It’s believed to result from the stagnation of calcium-rich saliva, which can lead to stone formation. Local inflammation or injury to the gland or duct can contribute to this process.
Clinical Presentation
- Pain and swelling in the affected gland, though it can sometimes be painless.
- Pain may worsen during eating or even the anticipation of food, as saliva production increases.
- Stones can sometimes be palpable or visible at the duct openings during a physical exam.
Investigation
- CT Scan: Gold standard for diagnosis, providing clear imaging of the stone.
- Ultrasound: A non-invasive and commonly used imaging technique.
Treatment
- Conservative management for smaller stones:
- Hydration
- Sialogogues (stimulate saliva flow)
- Gland massage
- NSAIDs for pain relief.
- Antibiotics if an infection is suspected.
- Surgical intervention for larger stones that cannot pass naturally.
Complications
- Sialadenitis: Infection and inflammation of the salivary gland.
- Salivary gland abscess: Collection of pus, potentially requiring surgical drainage.
Visual Representation
- Left Image: Shows a stone in the left submandibular duct/gland.
- Right Image: Displays a stone in the right submandibular duct with duct dilation.
Key Insight
Early detection and treatment of sialolithiasis are essential to prevent complications. If you experience persistent swelling or pain in your jaw area, consult an ENT specialist for proper evaluation and care.