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Sialolithiasis Radiology

last modified on: Wed, 04/24/2024 - 10:19

Updated by Piper Wenzel, BS April 2024

See also: Sialolithiasis; Parotid Sialogram Stone; Submandibular gland stone removal sialendoscopy case example

  • Around 85% of stones occur in the submandibular gland, around 15% occur in the parotid gland (Hammett 2022)
  • Most common in the 3rd to 6th decades of life; males > females (Ashindoitiang 2023)
  • Patients with stone(s) may have no symptoms or may present with painful swelling after meals (Ashindoitiang 2023)
  • Risk factors for development include increased age, history of radiation therapy to head/neck, Sjogren's syndrome, medication affecting saliva production, decreased fluid intake (Ferneini 2021, Hammett 2022)
  • ~ 80% of submandibular and 60% of parotid stones are visible on plain radiographic imaging (Friedman 2023)
  • CT is highly sensitive for small stones not otherwise visible on plain film (Friedman 2023)
  • Ultrasound may be used first-line in children and may diagnosis stones > 2mm (Friedman 2023)
  • MR sialography may diagnose radiolucent stones - may appear as a hypointense area in a dilated duct (Friedman 2023)
  • Conservative measures may be taken initially including gland massage, NSAIDs, and sialogogues (Hammett 2022)
  • If unreponsive to conservative treatment, further measures including endoscopy, transoral ductotomy, extracorporeal shock wave lithotripsy, or duct and gland excision may occur (Hammett 2022)

References

Ashindoitiang JA, Nwagbara VIC, Ugbem T, Odoks RK, Udo Solomon A, Akpan SO, Ogamba N, Asuquo ME. Huge sialolith of the submandibular gland: a case report and review of literature. J Int Med Res. 2023 Jan;51(1):3000605221148443. doi: 10.1177/03000605221148443. PMID: 36624984; PMCID: PMC9834782.

Hammett JT, Walker C. Sialolithiasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 26, 2022.

Friedman E, Cai Y, Chen B. Imaging of Major Salivary Gland Lesions and Disease. Oral Maxillofac Surg Clin North Am. 2023;35(3):435-449. doi:10.1016/j.coms.2023.02.007

Ferneini EM. Managing Sialolithiasis. J Oral Maxillofac Surg. 2021 Jul;79(7):1581-1582. doi: 10.1016/j.joms.2021.04.021. PMID: 34215413.