[4] Sialolithiasis

Question 1

What is sialolithiasis more commonly known as?

Answer 1

Salivary stones

Question 2

What is sialolithiasis?

Answer 2

A condition where calcified mass forms within the salivary gland

Question 3

How can salivary stones be classified?

Answer 3

By which gland the salivary stone has formed in

Question 4

Which salivary gland is most commonly affected by salivary stones?

Answer 4

Submandibular gland

Question 5

What percentage of salivary stones form in the submandibular gland?

Answer 5

85%

Question 6

What percentage of salivary stones form in the parotid gland?

Answer 6

5-10%

Question 7

What percentage of salivary stones form in the sublingual or minor salivary glands?

Answer 7

0-5%

Question 8

What is thought to cause salivary stone formation?

Answer 8

A series of stages that lead to the calculus formation

Question 9

What is the first stage of salivary stone formation?

Answer 9

Presence of predisposing factors

Question 10

What are the predisposing factors for salivary stones?

Answer 10

• Abnormalities in calcium metabolism
• Dehydration
• Reduced salivary flow rate
• Altered acidity of saliva due to oropharyngeal infection
• Altered solubility of crystalloids

Question 11

What is the second stage of salivary stone formation?

Answer 11

Formation of a nidus as a result of predisposing factors

Question 12

What is the 3rd stage of salivary stone formation?

Answer 12

Successive layering of nidus with organic and inorganic material to form a calcified mass

Question 13

What is the most common cause of salivary stones?

Answer 13

Idiopathic

Question 14

What are some less common causes of salivary stones?

Answer 14

• Existing chronic infection of the glands
• Dehydration
• Sjögren’s Syndrome
• Increased local levels of calcium

Question 15

How can salivary stones present?

Answer 15

• Pain
• Swelling of gland
• Tenderness of involved glands
• Palpable hard lump
• Lack of saliva

Question 16

When does lack of saliva occur in salivary stones?

Answer 16

In total obstruction

Question 17

How does salivary stone pain present?

Answer 17

Intermittent and often suddenly worse before meal times and then get better

Question 18

How does swelling of the gland appear in salivary stones?

Answer 18

Intermittent, often worse before meal times and the goes down again

Question 19

What symptoms may develop due to secondary infection due to salivary stones?

Answer 19

• Erythema of floor of mouth
• Pus discharging
• Cervical lymphadenitis
• Hallitosis

Question 20

How are salivary stones diagnosed?

Answer 20

Clinically

Question 21

What percentage of salivary stones can be seen on x-ray?

Answer 21

80%

Question 22

How can salivary stones be confirmed?

Answer 22

• X-ray
• Sialogram
• USS

Question 23

What are the differentials for salivary stones?

Answer 23

• Obstructive sialadentis
• Mumps
• Salivary gland tumours

Question 24

How can treatment options for salivary stones be divided?

Answer 24

• Non-invasive
• Minimally invasive
• Surgical
• Supportive

Question 25

What are the non-invasive treatment options for small salivary stones?

Answer 25

• Hydration
• Moist heat therapy
• NSAIDs
• Take bitter/sour food/drink e.g. suck on lemon

Question 26

What non-invasive treatment methods can be used for larger salivary stones?

Answer 26

• Massaged out by specialist

- Shock-wave therapy

Question 27

Give one minimally invasive treatment option for salivary stones?

Answer 27

• Sialendoscopy

Question 28

How can salivary stones be treated surgically?

Answer 28

• Cannulate the duct to remove stone
• Small incision near the stone to remove it
• Removal of salivary duct in recurrent cases

Question 29

What supportive therapy is sometimes used in salivary stones?

Answer 29

Antibiotics to prevent infection due to lodged stone

Question 30

What are the potential complications of salivary stones?

Answer 30

• Recurrent stones

- Infection