Data and Picture Interpretation Stations: Cases 1–45
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar in ENT OSCEs, 2023
Sialolithiasis is defined as the formation of stones in the major salivary glands (submandibular, parotid, sublingual glands). It is a common cause of salivary gland swelling. Obstructed salivary glands can become inflamed and infected and occasionally abscesses can form, the first line investigation for patients presenting with suspected salivary gland stone is an ultrasound of the gland and neck which can also exclude salivary gland tumours. Plain films were the initial choice in the past and are still used in some settings. If available, sialography may also be used as this can be both diagnostic and therapeutic (in the case of small stones). If medical treatment (massage/silaogogues/NSAIDs and antibiotics as required) is not successful, then sialoendoscopy can be used for stones up to 4mm. Surgical excision of the gland is considered the treatment of last resort but is definitive.
Non-Neoplastic Salivary Gland Diseases
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Sialolithiasis is a common disorder characterized by the formation of a calculus (sialolith) usually within the ductal system of a gland. Sialoliths can arise in both the major and minor salivary glands—indeed, necropsy studies revealed that 1% of submandibular glands can have sialoliths while sialomicroliths (microscopic stones/concretions) are present in almost all submandibular, and some parotid glands. Sialoliths are more common in the submandibular glands (e.g. 83% of one sample) than the parotid (10%) or sublingual (7%) glands,36 and are more common in females than males, and are much more likely in adults than in children. The minor salivary glands, particularly of the upper lip, can be affected.91
Endocrine Surgery
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
A 55-year-old patient presents with a swelling in the submandibular triangle, associated with meals. What is the most likely diagnosis?Sialolithiasis: Stone in distal/middle/proximal duct or impacted in the submandibular salivary glandPrimary or secondaryMay be palpable in the floor of the mouthFifty times more common than parotid stones (due to more mucinous composition of secretion)Neoplasm – rare but must be excluded: Pleomorphic adenoma (most common)Warthins (smoking risk factor, 10% bilateral)Cystic adenoid carcinoma (neurotropic spread a problem)Mucoepidermoid carcinomaMetastases (from head and neck/oropharyngeal SCC)I would take a careful history and perform a full examination, including the oral cavity.
A stone in the lacrimal gland: a case report and literature review
Published in Orbit, 2020
Othmaliza Binti Othman, Yasuhiro Takahashi, Ma. Regina Paula Valencia, Hirohiko Kakizaki
Sialolithiasis has some clinical similarities to lacrimal gland dacryolithiasis. Sialolithiasis is most common in patients in the fourth and fifth decade of life.16,17 The male-to-female ratio ranges from 2.5:1 to 1.2:1, although recent studies showed equal distribution of salivary stones between men and women.16,17 Stasis or a decreased salivary flow is a proposed mechanism of development of sialolith, while microorganisms do not seem to play a significant role in the initiation of salivary stones.16
Ultrastructural analysis of the submandibular sialoliths: Raman spectroscopy and electron back-scatter studies
Published in Ultrastructural Pathology, 2020
Dmitry Tretiakow, Andrzej Skorek, Jacek Ryl, Joanna Wysocka, Kazimierz Darowicki
Sialolithiasis is one of the causes of salivary gland inflammation that is characterized by the formation of single or multiple deposits (sialoliths) in the salivary ducts or salivary glands. The resulting salivary duct obstruction inhibits the saliva flow, which in turn leads to inflammation of the salivary gland. The most common symptoms of sialolithiasis are of salivary gland swelling and pain (intensified during a meal) and fever.1–4
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