Salivary Gland Stone
Salivary stone also known as salivary calculi or sialolithiasis. It is commonly occurred in submandibular gland or duct and less commonly developed in parotid gland or even rarer in minor salivary gland or sublingual gland.
The cause of the sialolith or salivary stone formation is usually unknown, however chronic infection of salivary gland, dehydration,chronic inflammation or sjogren’s syndrome and increased local level of calcium would contribute to sialolith formation. Tenderness would be elicited over the swollen gland and palpable hard lump on the floor of the mouth could indicates impacted stone near the submandibular duct orifice. There might be pus discharge coming out from the duct when the gland is infected.
Mode of investigations includes plain X-ray where 70-80 percents of the stone might be able to be seen in the radiograph as it is radiopaque. Sialogram could be done to visualise the duct and stone and to identify the area of stenosis and dilation. CT sialogram or ct neck are the other options of radio-imaging that could be used in this condition.
Treatment of the salivary stone includes medical treatment especially when inflammation and infection had set in. Antibiotic, anti-inflammatory and painkiller might be useful in acute setting. Medication that used to increase salivation e.g vitamin C or eating natural sour fruits such as orange or lemon may help to increase saliva formation and might be able to promote natural expulsion of the sialolith from the duct especially when the stone is small. It also could be massaged out from the duct by the expert in certain cases.
Procedure – Non Invasive
With the advances in medical bio-technology, the duct could be examined with sialoendoscopy and if stone detect, it could be removed with basket.
Procedure – Invasive
Stone impacted over the submandibular duct on the floor of mouth could be removed via marsupiliazation of the submandibular duct and removal of the stone. More proximal stone in the gland might need submandibulectomy or parotidectomy to be done when non invasive procedure of sialoendoscopy have failed.