Sialolithiasis
Background
- Development of a calcium carbonate and calcium phosphate stone in a stagnant salivary duct
- >80% occur in the submandibular gland
Clinical Features
- Pain, swelling, and tenderness may resemble parotitis
- Sialolithiasis is exacerbated by meals and may develop over course of minutes when eating
- Typically unilateral
- A stone may be palpated within the duct and the gland is firm
Differential Diagnosis
Facial Swelling
- Buccal space infections
- Dental problems
- Canine space infection
- Facial cellulitis
- Herpes zoster
- Masticator space infections
- Maxillofacial trauma
- Neoplasm
- Parapharyngeal space infection
- Salivary gland diagnoses
- Parotitis
- Ranula
- Sialoadenitis
- Sialolithiasis
- Superior vena cava syndrome
Treatment
- Abx only indicated if concurrent infection
- Palpable stones in the distal duct may be 'milked' out
- Give lemon drops or other sialogogues
See Also
Source
Tintinalli