Sialolithiasis
Submandibular gland stone removal sialendoscopy case example
- 80-90% of stones occur in the submandibular gland, 10-20% occur in the parotid gland
- 25% of patients with one stone with have multiple stones; bilaterlal stones are very rare, however
- 80% of submandibular and 60% of parotid stones are visible on plain radiographic imaging
- Uric acid stones may form in the setting of gout - the only systemic disease known to produce salivary stones
- Non-contrast CT is highly sensitive for small stones not otherwise visible on plain film
- Non-calcified stones and duct dilatation are best observed with sialogram
- Treatment can involve transoral ductotomy, extracorporeal shock wave lithotripsy, or duct and gland excision
- More recently sialendoscopy with sialithectomy has gained popularity as a treatment option