sialolith

Saliva: frequency

There are about 5,000 to 10,000 cases of salivary stones per year in Germany. In most cases (65 to 95 percent of cases), the stones are located in the submandibular gland (glandula submandibularis). The parotid gland (Glandula parotidea) is affected in five to 20 percent of cases, the sublingual gland (sublingual gland) in one to 15 percent.

Saliva stone: appearance

Saliva stones often consist of calcium phosphate or calcium bicarbonate. Magnesium can also be part of them. They can look very different. A salivary stone can be yellow or gray, smooth or humped, oval or round. It can grow between several millimeters and two centimeters.

Salivary stone: symptoms

Since the sialolithiasis obstructs the salivary drainage from the glands, they swell up. Especially when chewing the saliva is expressed by pain, as it stimulates the production of saliva and the drainage blockage, the gland swells even further.

Saliva: causes

A salivary stone is formed when the composition of the saliva is changed. This occurs, for example, in inflammation of the salivary gland. But even patients with metabolic diseases have salivary changes.

Narrowing of the ducts of the salivary gland can also lead to the formation of salivary stones due to secretion congestion. This narrowing can be due to a previous inflammation or even occur in cystic fibrosis due to the viscosity of the mucus. Also a mumps disease can lead to a narrowing of the excretory ducts and thus increase the risk for a salivary stone.

Salivary stone: diagnostics

See a doctor if you have persistent head and neck swelling, severe pain or other signs of illness. He will first ask you in detail about your medical history (anamnesis). Possible questions are:

• Since when are you having those complaints?
• Do the complaints during chewing increase?
• Have you had similar symptoms in the past?

Saliva stone: examinations

Then your doctor examines your salivary glands: he scans you to detect possible swelling or hardening.

For a safe diagnosis, the doctor will perform an ultrasound scan (sonography). This also serves to rule out other diseases that cause similar symptoms. These include an abscess or a tumor of the salivary gland.

In some cases, a so-called sialography is necessary. This contrast medium is injected into the duct of the gland and then made an X-ray. So the exact location of the stone can be determined. Rarely, other imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) are needed.

Saliva: Therapy

The salivary therapy mainly depends on the location and size of the stone. Small stones can usually be massaged. For stones that sit just before the end of the excretory duct, it can be slit open and the stone removed.

For larger stones, there are two different therapy methods available: shockwave therapy and endoscopy.

In shockwave therapy, ultrasound waves are sent from the outside to the gland. These mince the salivary stone. The remaining debris are usually so small that they drain over the excretory duct.

At endoscopy, a small camera is advanced into the exit duct until the stone is visible. Then this can be recovered with the help of a small pliers or a small basket. If necessary, the gear can also be rinsed or expanded.

Saliva: Prognosis

With timely treatment and treatment of the underlying disease that has led to salivary formation, the prognosis is good and the sialolithiasis heals without consequences. Without therapy, a collection of pus (abscess) can form, which urgently needs to be treated surgically, otherwise there is a risk of sepsis.

Forming repeatedly sialoliths, removal of the affected salivary gland is recommended.