Materiały źródłowe

• #1 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Sialolithiasis is the most frequent cause of salivary gland swelling, affecting the major salivary glands: parotid, submandibular, and sublingual glands. […] In the case of larger salivary stones involving the distal submandibular duct (Wharton duct), diagnosis is often possible based on physical examination. […] Modern diagnostic techniques involve point-of-care ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and direct visualization with sialoendoscopy. […] Clinical diagnosis of sialolithiasis can be challenging as patients may not be symptomatic unless the stone obstructs the salivary ducts, termed sialadenitis. […] Conventional radiographs using occlusal views were the initial diagnostic choice in the past. […] While conventional radiography can still be useful in the initial workup of salivary stones, modern imaging techniques using ultrasound or CT scans can accurately diagnose the sialoliths and provide their exact location.

• #2 Salivary Stones – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/oral-and-pharyngeal-disorders/salivary-stones

  Stones composed of calcium salts often obstruct salivary glands, causing pain, swelling, and sometimes infection. Diagnosis is made clinically or with CT, ultrasonography, or sialography. […] Clinical diagnosis is usually adequate but sometimes CT or ultrasonography is needed. […] If a salivary stone is not apparent on examination, the patient can be given a sialagogue (eg, lemon juice, hard candy, or some other substance that triggers saliva flow). Reproduction of symptoms is almost always diagnostic of a stone. […] CT and ultrasonography are highly sensitive and are used if clinical diagnosis is equivocal. Contrast sialography is also highly sensitive but is no longer commonly done. […] The role of MRI is evolving; reported sensitivities and specificities are 90%, and in limited studies, MRI appears to be more sensitive in detecting small stones and distal duct stones than ultrasonography or contrast sialography.

• #3 Salivary gland stones

  https://www.nhs.uk/conditions/salivary-gland-stones/

  Salivary gland stones are small stones that form in salivary glands in your mouth and can block the flow of saliva (spit). They’re not usually serious and you may be able to remove them yourself. […] Most salivary gland stones form below your tongue in one of the glands supplying saliva to your mouth. You cannot always see them. […] Salivary gland stones may cause: dull pain in your mouth that comes and goes, swelling in your mouth that flares up from time to time, an infection around the stone signs of infection include pain, redness and a high temperature. […] If you feel intense pain during mealtimes, this could mean the stone is completely blocking a saliva gland. The pain usually lasts 1 to 2 hours. […] You can try to remove a salivary gland stone by doing things to increase the amount of saliva in your mouth.

• #4 Salivary Gland Disorders – Ear, Nose, and Throat Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/ear-nose-and-throat-disorders/mouth-and-throat-disorders/salivary-gland-disorders

  Salivary gland stones are most common among adults. Many people with salivary gland stones have more than one. […] Salivary stones create problems when they block the tube (duct) that carries saliva from the gland to the mouth. Blockage makes saliva back up inside the duct, causing the salivary gland to swell painfully. […] A typical symptom of a blocked salivary duct is swelling and pain over the gland that is affected. The pain and swelling worsen after eating, particularly when people eat something that stimulates saliva flow (such as a pickle or lemon juice) because when the duct is blocked, the saliva has no place to go and the gland swells. […] Swelling due to blockage of a salivary duct is diagnosed because of the relationship of pain to eating or drinking something that stimulates saliva flow. […] If this technique reduces symptoms, stones are likely to be present.

• #5 Salivary Stones – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/oral-and-pharyngeal-disorders/salivary-stones

  Stones composed of calcium salts often obstruct salivary glands, causing pain, swelling, and sometimes infection. Diagnosis is made clinically or with CT, ultrasonography, or sialography. […] Clinical diagnosis is usually adequate but sometimes CT or ultrasonography is needed. […] If a salivary stone is not apparent on examination, the patient can be given a sialagogue (eg, lemon juice, hard candy, or some other substance that triggers saliva flow). Reproduction of symptoms is almost always diagnostic of a stone. […] CT and ultrasonography are highly sensitive and are used if clinical diagnosis is equivocal. Contrast sialography is also highly sensitive but is no longer commonly done. […] The role of MRI is evolving; reported sensitivities and specificities are 90%, and in limited studies, MRI appears to be more sensitive in detecting small stones and distal duct stones than ultrasonography or contrast sialography.

• #6 Salivary Stones: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24344-sialolithiasis

  Sialolithiasis is the medical term for salivary gland stones (calculi). […] Sialolithiasis treatment depends on the size and location of the stone. Treatments may include home remedies, antibiotics, in-office stone removal or, in some cases, surgery. […] A healthcare provider can diagnose sialolithiasis during a physical examination. Theyll feel around your face and neck and look inside of your mouth for lumps or other abnormalities. Theyll also review your medical history and ask about your symptoms. […] In some cases, your healthcare provider may request imaging tests to confirm your diagnosis or to see the location of any salivary gland stones. These tests may include: X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging). […] If home remedies arent successful, your healthcare provider may try to remove the stone by gently probing the area with a blunt instrument. […] Larger salivary gland stones may require surgery. During this procedure, a surgeon inserts an endoscope into your salivary duct to locate the stone. […] If your symptoms continue after trying these home remedies, you should call a healthcare provider.

• #7 Salivary Duct Stones: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/salivary-duct-stones

  Because salivary duct stones cause mouth pain, both doctors and dentists can diagnose this condition and provide medical treatment if necessary. […] Your doctor or dentist will examine your head and neck to check for swollen salivary glands and salivary duct stones. […] Imaging tests can provide a more accurate diagnosis because your doctor will be able to see the stones. An X-ray, ultrasound, or a computed tomography (CT) scan of your face are the some of the imaging tests that may be ordered.

• #8 Salivary stones: symptoms, aetiology, biochemical composition and treatment | British Dental Journal

  https://www.nature.com/articles/sj.bdj.2014.1054

  Salivary stones, also known as sialoliths, are calcified concrements in the salivary glands. Sialoliths are more frequently located in the submandibular gland (84%), than in the parotid gland (13%). The management of salivary stones depends on the size and location of the stone. […] The primary objective in the treatment of sialolithiasis should be preservation of gland function in combination with a low level of complications and discomfort for the patient. Non-invasive conservative management of sialolithiasis consists of gland massage, in combination with use of sialogogues and irrigation. This treatment has the highest success rate when stones are small and located in the duct. […] Most patients suspected of sialolithiasis will present in the clinic during an acute phase of the disease. A careful anamnesis and physical examination of the patient are important. The physical examination should include bimanual palpation of the floor of the mouth in a posterior to anterior direction for submandibular glands or an intraoral palpation around Stensen’s duct for parotid glands. The affected gland may feel firm and tender. In case of a submandibular gland, the affected side of the floor of the mouth may be elevated and inflamed.

• #9 Salivary stones: symptoms, aetiology, biochemical composition and treatment | British Dental Journal

  https://www.nature.com/articles/sj.bdj.2014.1054

  Salivary stones, also known as sialoliths, are calcified concrements in the salivary glands. Sialoliths are more frequently located in the submandibular gland (84%), than in the parotid gland (13%). The management of salivary stones depends on the size and location of the stone. […] The primary objective in the treatment of sialolithiasis should be preservation of gland function in combination with a low level of complications and discomfort for the patient. Non-invasive conservative management of sialolithiasis consists of gland massage, in combination with use of sialogogues and irrigation. This treatment has the highest success rate when stones are small and located in the duct. […] Most patients suspected of sialolithiasis will present in the clinic during an acute phase of the disease. A careful anamnesis and physical examination of the patient are important. The physical examination should include bimanual palpation of the floor of the mouth in a posterior to anterior direction for submandibular glands or an intraoral palpation around Stensen’s duct for parotid glands. The affected gland may feel firm and tender. In case of a submandibular gland, the affected side of the floor of the mouth may be elevated and inflamed.

• #10 Salivary stones: symptoms, aetiology, biochemical composition and treatment | British Dental Journal

  https://www.nature.com/articles/sj.bdj.2014.1054

  Salivary stones, also known as sialoliths, are calcified concrements in the salivary glands. Sialoliths are more frequently located in the submandibular gland (84%), than in the parotid gland (13%). The management of salivary stones depends on the size and location of the stone. […] The primary objective in the treatment of sialolithiasis should be preservation of gland function in combination with a low level of complications and discomfort for the patient. Non-invasive conservative management of sialolithiasis consists of gland massage, in combination with use of sialogogues and irrigation. This treatment has the highest success rate when stones are small and located in the duct. […] Most patients suspected of sialolithiasis will present in the clinic during an acute phase of the disease. A careful anamnesis and physical examination of the patient are important. The physical examination should include bimanual palpation of the floor of the mouth in a posterior to anterior direction for submandibular glands or an intraoral palpation around Stensen’s duct for parotid glands. The affected gland may feel firm and tender. In case of a submandibular gland, the affected side of the floor of the mouth may be elevated and inflamed.

• #11

  https://journals.lww.com/em-news/fulltext/2008/04000/diagnosis__salivary_gland_stone_sialolith.10.aspx

  Sialoliths are most the common cause of acute and chronic infections of salivary glands. […] Some sialoliths may be asymptomatic and identified incidentally during jaw imaging. […] To identify the degree of obstruction, the emergency physician can try to squeeze saliva from the gland to see if it is blocked. […] The differential diagnosis of salivary calculi includes infections (bacterial and viral), inflammatory conditions (Sjgren’s, sarcoidosis, radiotherapy reaction), and masses (neoplastic and nonneoplastic). […] Diagnostic imaging to identify presumed salivary calculi include conventional radiography, sialography, and ultrasonography. […] Currently, high-resolution noncontrast computerized tomography scanning is the imaging modality of choice for the evaluation of salivary stones.

• #12 Sialolithiasis. Salivary gland stones. Clínica Universidad de Navarra

  https://www.cun.es/en/diseases-treatments/diseases/sialolithiasis

  Sialolithiasis or salivary gland lithiasis is the formation of calculi in the drainage ducts of the major salivary glands (parotid, submaxillary and sublingual). […] The diagnosis of sialolithiasis is usually made by the clinical history that the patient takes and the physical examination and salivary gland ultrasound. It is common for the specialist to notice the stone when palpating the salivary gland, especially if the stone is located in the distal part of the Wharton’s or Stenon’s duct. […] Sometimes, it may be necessary to perform complementary tests such as simple x-ray, CT scan, MRI or sialography (injection of intraglandular contrast).

• #13 Salivary Stones – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/oral-and-pharyngeal-disorders/salivary-stones

  Stones composed of calcium salts often obstruct salivary glands, causing pain, swelling, and sometimes infection. Diagnosis is made clinically or with CT, ultrasonography, or sialography. […] Clinical diagnosis is usually adequate but sometimes CT or ultrasonography is needed. […] If a salivary stone is not apparent on examination, the patient can be given a sialagogue (eg, lemon juice, hard candy, or some other substance that triggers saliva flow). Reproduction of symptoms is almost always diagnostic of a stone. […] CT and ultrasonography are highly sensitive and are used if clinical diagnosis is equivocal. Contrast sialography is also highly sensitive but is no longer commonly done. […] The role of MRI is evolving; reported sensitivities and specificities are 90%, and in limited studies, MRI appears to be more sensitive in detecting small stones and distal duct stones than ultrasonography or contrast sialography.

• #14 Salivary Gland Stones: Symptoms, Causes, Treatment, and Prevention

  https://resources.healthgrades.com/right-care/oral-health/salivary-gland-stones

  Salivary gland stones, also called sialolithiasis, are calcifications that obstruct the salivary glands. […] A dentist or doctor can typically diagnose salivary gland stones by performing an oral exam. They may: […] If salivary gland stones are not apparent from an exam, a dentist or doctor may give you lemon juice or hard candy to trigger saliva flow. […] If producing saliva flow causes symptoms, it may indicate a salivary gland stone is present. […] If your doctor feels it’s necessary to order imaging tests, possible ones include: […] A doctor may be able to locate the stone by feeling and looking under the tongue. […] Salivary gland stones are usually not serious and can typically be taken care of at home. But in cases where the stone is large, there are multiple stones, or the stones keep recurring, you may need treatment from your doctor. […] If the salivary gland stone involves an infection, your doctor or dentist will prescribe an antibiotic. […] In cases where salivary gland stones cannot be removed at home, doctors can surgically remove them.

• #15 Salivary Stones: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24344-sialolithiasis

  Sialolithiasis is the medical term for salivary gland stones (calculi). […] Sialolithiasis treatment depends on the size and location of the stone. Treatments may include home remedies, antibiotics, in-office stone removal or, in some cases, surgery. […] A healthcare provider can diagnose sialolithiasis during a physical examination. Theyll feel around your face and neck and look inside of your mouth for lumps or other abnormalities. Theyll also review your medical history and ask about your symptoms. […] In some cases, your healthcare provider may request imaging tests to confirm your diagnosis or to see the location of any salivary gland stones. These tests may include: X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging). […] If home remedies arent successful, your healthcare provider may try to remove the stone by gently probing the area with a blunt instrument. […] Larger salivary gland stones may require surgery. During this procedure, a surgeon inserts an endoscope into your salivary duct to locate the stone. […] If your symptoms continue after trying these home remedies, you should call a healthcare provider.

• #16 Sialolithiasis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/sialolithiasis?lang=us

  Sialolithiasis refers to the formation of calculi (sialoliths) inside the ducts or parenchyma of salivary glands and most commonly occurs in the submandibular glands and their ducts. […] Multimodal imaging can be used to evaluate these stones. […] Not all stones are radiopaque. Plain radiography is able to visualize only 80-90% of submandibular stones (which are usually located in the duct) and ~60% of parotid duct stones (more frequently found within the gland itself) presumably due to differences in the composition of the secretion of the parent glands. […] Sialography excels at delineating the exact size and location of stones within the salivary gland ducts. The stone will be visualized as a filling defect within the duct. […] Ultrasonography is well-established in cases of clinical suspicion of sialolithiasis, able not only to visualize the stone in many instances but also the gland.

• #17 Salivary stones: symptoms, aetiology, biochemical composition and treatment | British Dental Journal

  https://www.nature.com/articles/sj.bdj.2014.1054

  In addition to an oral examination, several imaging techniques can be applied. Despite the relatively high percentage of inorganic material in salivary stones, between 80-95% of the submandibular stones and 43-60% of the parotid stones are radiopaque. Demonstration of sialoliths by radiographic examination is effective in approximately 80% of the cases. […] Sialendoscopy is a minimally invasive technique to visualise the salivary duct system, usually performed under general anaesthesia. An endoscope with a very small diameter (0.6 mm) is introduced into the duct after the orificium has been dilated with special instruments with increasing diameters from 0.8-1.6 mm.

• #18 How to Diagnose and Remove Salivary Stones (Sialoliths)

  https://ostrowonline.usc.edu/salivary-stones/

  Salivary stones occur most commonly in the submandibular glands (80%90%), followed by the parotid (5%15%) and sublingual (2%5%) glands, and only very rarely occur in the minor salivary glands. […] Clinical Steps to Diagnose Salivary Stones […] The first step is bimanual palpation directed in a posterior to anterior fashion along the course of the involved duct, and it may be possible to detect a stone. […] Plain film radiographs are helpful to visualize stones. But the question is they are inexpensive, readily available, and result in minimal radiation exposure. […] It is essential to understand that 50% of parotid gland stones and 20% of submandibular gland stones are poorly calcified. This is clinically significant as these poorly calcified stones will not be detected radiographically.

• #19

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2639864/

  The introduction, 15 years ago, of extracorporeal shock wave lithotripsy in the treatment of salivary gland calculi, has changed the therapeutic approach in these patients. […] The role of ultrasonography, radiography and, in particular, of sialo-magnetic resonance imaging in diagnosis of salivary lithiasis has been evaluated. […] Ultrasonograpy should be considered first choice examination in diagnosis of salivary calculi. […] Sialo-MRI is a diagnostic, non-invasive, method recently introduced, with promising results, in the evaluation of salivary gland disease. […] The aim of this investigation was to evaluate the efficiency of ESWL, with long-term follow-up study (10 years), in patients submitted to ESWL treatment for sialo-lithiasis and also to determine the role of ultrasonography, radiography and, in particular, of sialo-magnetic resonance imaging (MRI) in the diagnosis of salivary stones.

• #20 Salivary Gland Disorders (Causes,Types, and Treatment)

  https://patient.info/doctor/salivary-gland-disorders

  Salivary gland problems may be due to infection, inflammation, obstruction or tumours. […] Usually a careful history and examination give initial clues as to the cause and ultrasound is generally the first line of investigation. All salivary gland swellings need urgent referral and investigation. […] Sialolithiasis refers to stone-related disease within the ductal systems of a gland. […] The cause of salivary gland stones is unknown. Stones are composed of mucus, cellular debris, calcium and magnesium phosphates. […] Salivary stones account for half of salivary gland disorders in the UK, with 5.9 cases per 100,000 people each year. […] Ultrasound is now the first-line investigation and excludes other causes of swelling such as malignancy or lymphadenopathy. […] Many stones will pass spontaneously so conservative treatment may consist of oral analgesics and antibiotics where there is infection. Good hydration, warm compresses and gland massage may assist the stone’s passage. […] Proximal submandibular stones may be removed by dilating/incising Wharton’s duct and a transoral approach. […] Sialendoscopy assisted by CT navigation or lithotripsy are now more usually used where possible with the aim of better preserving gland function.

• #21

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2639864/

  US with high frequency linear transducer (10-13 MHz) is first choice investigation for diagnosis of salivary stones. […] In this study, we propose a sialo-MRI examination in the diagnostic workup of sialolithiasis. […] Sialo-MRI allows acute, to be differentiated from chronic, inflammation, on the basis of the signal intensities, T2 weight in particular, since it is possible to perform this method even during acute inflammation. […] Sialo-MRI can indirectly identify the presence of a stone by demonstrating proximal salivary duct dilatation. […] Sialo-MRI proved to be a non-invasive diagnostic method without ionizing radiation exposure and with a higher definition of the glandular parenchyma and ductal system, compared to the other methods available.

• #22 How to Diagnose and Remove Salivary Stones (Sialoliths)

  https://ostrowonline.usc.edu/salivary-stones/

  A catheter will be inserted through the duct opening oil, or water-based iodine contrast will be instilled. Then imaging using panoramic, CBCT, CT images, or MRI will be used. Sialolith will look like a void in the sialography image. […] Ultrasound is widely used as a first-line imaging modality to assess the presence of salivary gland stone. It is safe as no radiation is involved in the modality, less costly than other imaging, and can visualize large stones. […] CT images have higher sensitivity than plain film radiography for detecting salivary stones using a slice thickness of 0.2 0.5 mm. […] CBCT can be used, and it has the advantages of reduced superimpositions and distortions of the panoramic image and reduced radiation exposure over medical CT. […] Sialendoscopy can be used as a diagnostic and therapeutic technique for salivary gland stones. Its advantages include allowing visualization of the duct canal and segments of a duct and removing stone if possible.

• #23 Understanding Sialolithiasis: Symptoms, Diagnosis, and Treatment

  https://home.hippoed.com/blog/understanding-sialolithiasis-symptoms-diagnosis-and-treatment

  Sialoliths, more commonly referred to as salivary gland stones, are calcified structures or stones within any of the major salivary glands, These stones vary in size and can be found anywhere along the salivary duct or within the gland itself. […] Diagnosing sialolithiasis can be done clinically but involves a physical exam that often isnt routine in the urgent care setting. […] An enlarged, firm and tender gland is often indicative of sialolithiasis. […] In many cases, physical exam findings and palpation can help identify sialoliths, but imaging may be needed depending on the clinical scenario: […] A non-contrast CT scan is the gold standard for salivary stone visualization. […] Management of sialolithiasis largely depends on the size and location of the stone: […] If the stone is visible or palpable, then it is large enough that an ENT referral is advisable for potential surgical intervention. […] Sialolithiasis may not be an everyday complaint in urgent care, but a thorough physical exam can help you diagnose and treat this condition.

• #24 Sialolithiasis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/sialolithiasis?lang=us

  CT is excellent at visualizing stones both within the duct and within the gland. […] MRI is able not only to visualize larger stones but able in many instances to map the ductal anatomy and to assess the gland. […] In many instances, conservative medical management suffices. Hydration and moist heat are helpful. NSAIDs may be beneficial. Sucking on something sour, such as a lemon, may increase salivation and promote spontaneous expulsion of the stone. […] If these measures are unsuccessful, surgical removal of the salivary stone from the duct may be required.

• #25 Diagnosis of Salivary Gland Stones

  https://www.ohniww.org/diagnosing-salivary-gland-stones/

  How are salivary gland stones diagnosed? […] The best way to make the diagnosis is with a CT Scan of the salivary glands. […] Salivary stones contain a lot of calcium deposits and tend to light up brightly within the salivary gland on CT imaging. […] Some stones however do not show up on CT scan because of low calcium content and are best diagnosed with sialendoscopy where they can be removed simultaneously. […] Best Screening Test for Salivary Stones– CT Scan […] Best Study/Procedure Diagnosis– Sialendoscopy […] Best Treatment Option– Sialendoscopy can be diagnostic and therapeutic.

• #26 How to Diagnose and Remove Salivary Stones (Sialoliths)

  https://ostrowonline.usc.edu/salivary-stones/

  A catheter will be inserted through the duct opening oil, or water-based iodine contrast will be instilled. Then imaging using panoramic, CBCT, CT images, or MRI will be used. Sialolith will look like a void in the sialography image. […] Ultrasound is widely used as a first-line imaging modality to assess the presence of salivary gland stone. It is safe as no radiation is involved in the modality, less costly than other imaging, and can visualize large stones. […] CT images have higher sensitivity than plain film radiography for detecting salivary stones using a slice thickness of 0.2 0.5 mm. […] CBCT can be used, and it has the advantages of reduced superimpositions and distortions of the panoramic image and reduced radiation exposure over medical CT. […] Sialendoscopy can be used as a diagnostic and therapeutic technique for salivary gland stones. Its advantages include allowing visualization of the duct canal and segments of a duct and removing stone if possible.

• #27 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Sialography is traditionally regarded as the gold standard for diagnosing sialolithiasis as it allows excellent visualization of the salivary ducts and underlying ductal pathology. […] Non-contrast computed tomography (NCCT) is a widely used modality for the evaluation of sialolithiasis. […] MR sialography demonstrates similar sensitivity and specificity to NCCT for the evaluation of sialolithiasis. […] Sialendoscopy allows for direct visualization of salivary stones and the salivary ducts, thus providing excellent sensitivity and specificity. […] Ultrasonography provides a non-invasive method of imaging sialolithiasis. […] Management of sialolithiasis should begin with conservative measures, including massaging the salivary gland, nonsteroidal anti-inflammatory drugs, and sialogogues.

• #28 Salivary Stones – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/oral-and-pharyngeal-disorders/salivary-stones

  Stones composed of calcium salts often obstruct salivary glands, causing pain, swelling, and sometimes infection. Diagnosis is made clinically or with CT, ultrasonography, or sialography. […] Clinical diagnosis is usually adequate but sometimes CT or ultrasonography is needed. […] If a salivary stone is not apparent on examination, the patient can be given a sialagogue (eg, lemon juice, hard candy, or some other substance that triggers saliva flow). Reproduction of symptoms is almost always diagnostic of a stone. […] CT and ultrasonography are highly sensitive and are used if clinical diagnosis is equivocal. Contrast sialography is also highly sensitive but is no longer commonly done. […] The role of MRI is evolving; reported sensitivities and specificities are 90%, and in limited studies, MRI appears to be more sensitive in detecting small stones and distal duct stones than ultrasonography or contrast sialography.

• #29

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2639864/

  US with high frequency linear transducer (10-13 MHz) is first choice investigation for diagnosis of salivary stones. […] In this study, we propose a sialo-MRI examination in the diagnostic workup of sialolithiasis. […] Sialo-MRI allows acute, to be differentiated from chronic, inflammation, on the basis of the signal intensities, T2 weight in particular, since it is possible to perform this method even during acute inflammation. […] Sialo-MRI can indirectly identify the presence of a stone by demonstrating proximal salivary duct dilatation. […] Sialo-MRI proved to be a non-invasive diagnostic method without ionizing radiation exposure and with a higher definition of the glandular parenchyma and ductal system, compared to the other methods available.

• #30 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Sialography is traditionally regarded as the gold standard for diagnosing sialolithiasis as it allows excellent visualization of the salivary ducts and underlying ductal pathology. […] Non-contrast computed tomography (NCCT) is a widely used modality for the evaluation of sialolithiasis. […] MR sialography demonstrates similar sensitivity and specificity to NCCT for the evaluation of sialolithiasis. […] Sialendoscopy allows for direct visualization of salivary stones and the salivary ducts, thus providing excellent sensitivity and specificity. […] Ultrasonography provides a non-invasive method of imaging sialolithiasis. […] Management of sialolithiasis should begin with conservative measures, including massaging the salivary gland, nonsteroidal anti-inflammatory drugs, and sialogogues.

• #31 Sialolithiasis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/sialolithiasis?lang=us

  Sialolithiasis refers to the formation of calculi (sialoliths) inside the ducts or parenchyma of salivary glands and most commonly occurs in the submandibular glands and their ducts. […] Multimodal imaging can be used to evaluate these stones. […] Not all stones are radiopaque. Plain radiography is able to visualize only 80-90% of submandibular stones (which are usually located in the duct) and ~60% of parotid duct stones (more frequently found within the gland itself) presumably due to differences in the composition of the secretion of the parent glands. […] Sialography excels at delineating the exact size and location of stones within the salivary gland ducts. The stone will be visualized as a filling defect within the duct. […] Ultrasonography is well-established in cases of clinical suspicion of sialolithiasis, able not only to visualize the stone in many instances but also the gland.

• #32 How to Diagnose Salivary Gland Stones – Prof. Dr. Teoman Dal, ENT Specialist

  https://www.teomandal.com/en/how-to-diagnose-salivary-gland-stones

  The first stage in the diagnosis of salivary gland stones is the assessment of the story given by the patient. […] If the stones are found to be eligible for being removed with sialendoscopy, based on the result of ultrasonography, it is useful to make a detailed evaluation of the locations, sizes and number of the stones through computed tomography, before any endoscopic procedures. […] The sialography procedure considered to be the most important procedure in the diagnosis of such stones, which is performed by giving contrast agents visible in X-rays to the salivary gland ducts, began to be performed less commonly because of its implementation challenges, allergy risks and unavailability in cases of infection, especially after computed tomography and sialendoscopic evaluations became popular.

• #33 How to Treat Salivary Gland Stones – Prof. Dr. Teoman Dal, ENT Specialist

  https://www.teomandal.com/en/how-to-treat-salivary-gland-stones

  The first stage in the diagnosis of salivary gland stones is the assessment of the story given by the patient. […] For patients, in whom a definitive diagnosis could not be made with standard X-rays or computerized tomography, the most important diagnostic method for the evaluation of the condition of the salivary glands and ducts as well as for the verification of a diagnosis was considered to be sialography. […] After the beginning of the use of sialendoscopy, a technique that provides important diagnostic and therapeutic benefits, minimally invasive approaches and protection of the salivary glands have come to the fore. […] Therefore, nowadays ultrasonography, computed tomography, and MRI (magnetic resonance imaging) tests in specific cases are preferred, which enable more detailed evaluation of the sizes, number and locations of the stones, as well as the conditions of the salivary glands and ducts are performed when planning an intervention. […] On the other hand, besides its therapeutic use sialendoscopy provides important benefits for the diagnosis and treatment of certain problems such as narrowness in the salivary ducts and blockage in them due to stone, thickened secretions and residues that cannot be detected through other methods.

• #34 Salivary stones: symptoms, aetiology, biochemical composition and treatment | British Dental Journal

  https://www.nature.com/articles/sj.bdj.2014.1054

  In addition to an oral examination, several imaging techniques can be applied. Despite the relatively high percentage of inorganic material in salivary stones, between 80-95% of the submandibular stones and 43-60% of the parotid stones are radiopaque. Demonstration of sialoliths by radiographic examination is effective in approximately 80% of the cases. […] Sialendoscopy is a minimally invasive technique to visualise the salivary duct system, usually performed under general anaesthesia. An endoscope with a very small diameter (0.6 mm) is introduced into the duct after the orificium has been dilated with special instruments with increasing diameters from 0.8-1.6 mm.

• #35 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Sialography is traditionally regarded as the gold standard for diagnosing sialolithiasis as it allows excellent visualization of the salivary ducts and underlying ductal pathology. […] Non-contrast computed tomography (NCCT) is a widely used modality for the evaluation of sialolithiasis. […] MR sialography demonstrates similar sensitivity and specificity to NCCT for the evaluation of sialolithiasis. […] Sialendoscopy allows for direct visualization of salivary stones and the salivary ducts, thus providing excellent sensitivity and specificity. […] Ultrasonography provides a non-invasive method of imaging sialolithiasis. […] Management of sialolithiasis should begin with conservative measures, including massaging the salivary gland, nonsteroidal anti-inflammatory drugs, and sialogogues.

• #36 Diagnosis of Salivary Gland Stones

  https://www.ohniww.org/diagnosing-salivary-gland-stones/

  How are salivary gland stones diagnosed? […] The best way to make the diagnosis is with a CT Scan of the salivary glands. […] Salivary stones contain a lot of calcium deposits and tend to light up brightly within the salivary gland on CT imaging. […] Some stones however do not show up on CT scan because of low calcium content and are best diagnosed with sialendoscopy where they can be removed simultaneously. […] Best Screening Test for Salivary Stones– CT Scan […] Best Study/Procedure Diagnosis– Sialendoscopy […] Best Treatment Option– Sialendoscopy can be diagnostic and therapeutic.

• #37 Salivary Gland Disease – Otolaryngology

  https://www.uab.edu/medicine/otolaryngology/clinical/clinical-expertise/salivary-gland-disease

  The most common cause of salivary obstruction in adults is salivary stones. Approximately 90% of stones occur in the submandibular glands, with the other 10% occurring in the parotid glands. […] While some stones can be seen with simple X-rays or CT scans, approximately 60% are invisible to x-rays and require other tests, such as ultrasonography, for accurate detection. […] The UAB Department of Otolaryngology is one of the few institutions in the US to offer minimally-invasive procedures for the diagnosis and treatment of salivary gland obstruction. Sialendoscopy is a technique that has been developed and successfully applied in Europe over the last decade, but only recently has been introduced in the United States. This procedure can be performed under general anesthesia, sedation, or local anesthesia and is typically performed as an outpatient procedure. The technique uses semi-rigid, ultra-thin scopes that are inserted into the gland’s natural opening in the mouth in order to visualize and diagnose the cause of the obstruction.

• #38 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Further treatment is dictated based on the sialolith’s size, number, and location if conservative management is unsuccessful. […] External shockwave lithotripsy (ESWL) is an option for not palpable stones or visualized under endoscopy. […] Surgical excision of the submandibular gland should be a last resort. […] Salivary stones within the parotid duct that measure less than 7 mm and are mobile require endoscopic removal. […] The differential diagnosis for salivary gland swelling includes: Sialolithiasis, Sialadenitis (inflammatory or infectious), Neoplasm. […] Sialolithiasis has an excellent prognosis, and the majority of patients can be managed conservatively with sialogogues and nonsteroidal anti-inflammatory drugs. […] The primary complications of sialolithiasis are the development of sialadenitis, acute or chronic, and atrophy of the affected salivary gland. […] An interprofessional approach and open communication among providers can aid in ensuring patients receive appropriate initial management resulting in a quicker resolution of symptoms.

• #39

  https://journals.lww.com/em-news/fulltext/2008/04000/diagnosis__salivary_gland_stone_sialolith.10.aspx

  Sialoliths are most the common cause of acute and chronic infections of salivary glands. […] Some sialoliths may be asymptomatic and identified incidentally during jaw imaging. […] To identify the degree of obstruction, the emergency physician can try to squeeze saliva from the gland to see if it is blocked. […] The differential diagnosis of salivary calculi includes infections (bacterial and viral), inflammatory conditions (Sjgren’s, sarcoidosis, radiotherapy reaction), and masses (neoplastic and nonneoplastic). […] Diagnostic imaging to identify presumed salivary calculi include conventional radiography, sialography, and ultrasonography. […] Currently, high-resolution noncontrast computerized tomography scanning is the imaging modality of choice for the evaluation of salivary stones.

• #40 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Further treatment is dictated based on the sialolith’s size, number, and location if conservative management is unsuccessful. […] External shockwave lithotripsy (ESWL) is an option for not palpable stones or visualized under endoscopy. […] Surgical excision of the submandibular gland should be a last resort. […] Salivary stones within the parotid duct that measure less than 7 mm and are mobile require endoscopic removal. […] The differential diagnosis for salivary gland swelling includes: Sialolithiasis, Sialadenitis (inflammatory or infectious), Neoplasm. […] Sialolithiasis has an excellent prognosis, and the majority of patients can be managed conservatively with sialogogues and nonsteroidal anti-inflammatory drugs. […] The primary complications of sialolithiasis are the development of sialadenitis, acute or chronic, and atrophy of the affected salivary gland. […] An interprofessional approach and open communication among providers can aid in ensuring patients receive appropriate initial management resulting in a quicker resolution of symptoms.

• #41

  https://journals.lww.com/em-news/fulltext/2008/04000/diagnosis__salivary_gland_stone_sialolith.10.aspx

  Sialoliths, or salivary stones, are the most common disease of the salivary glands in middle-aged patients. […] The exact etiology of sialolith formation remains unknown, but it is thought that the more alkaline, viscous, mucus-rich saliva, which contains a higher percentage of calcium phosphates, in addition to the long and sinuous position of Wharton’s duct, contributes to stasis, making the submandibular salivary system more prone to the development of sialoliths than the parotid gland. […] It is known that systemic diseases (gout, Sjgrens), medications (anticholinergics, antisialogogues), local trauma, head and neck radiotherapy, being elderly, and renal impairment also can predispose patients to sialolith formation. […] Most salivary calculi are small, usually less than 1 cm, but megaliths or giant calculi have been reported.

• #42 Managing Your Salivary Gland Stones – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/salivary-gland-stone

  How Are Salivary Gland Stones Diagnosed? The health care provider usually makes a diagnosis from symptoms and a physical examination. Symptoms tend to come and go. These periodic painful attacks may be called salivary colic. The stone can sometimes be felt by an examining hand. If the health care provider feels a swollen mass, computed tomography (CT) may be done to see the mass and rule out other causes, such as tumors, dental abscesses, swollen lymph glands, lymphoma, sarcoidosis, and sialadenitis (salivary gland infection). Rarely, x-rays may be taken of the gland (sialography), after a dye is injected into the duct to confirm the diagnosis. The health care provider may also order blood tests.

• #43

  https://journals.lww.com/em-news/fulltext/2008/04000/diagnosis__salivary_gland_stone_sialolith.10.aspx

  Sialoliths are most the common cause of acute and chronic infections of salivary glands. […] Some sialoliths may be asymptomatic and identified incidentally during jaw imaging. […] To identify the degree of obstruction, the emergency physician can try to squeeze saliva from the gland to see if it is blocked. […] The differential diagnosis of salivary calculi includes infections (bacterial and viral), inflammatory conditions (Sjgren’s, sarcoidosis, radiotherapy reaction), and masses (neoplastic and nonneoplastic). […] Diagnostic imaging to identify presumed salivary calculi include conventional radiography, sialography, and ultrasonography. […] Currently, high-resolution noncontrast computerized tomography scanning is the imaging modality of choice for the evaluation of salivary stones.

• #44 Diagnosis and Imaging Techniques for Salivary Gland Stones

  https://www.darwynhealth.com/ear-nose-and-throat-health/ear-nose-and-throat-disorders/mouth-and-throat-disorders/salivary-gland-stones/diagnosis-and-imaging-techniques-for-salivary-gland-stones/?lang=en

  In conclusion, early diagnosis of salivary gland stones is crucial for prompt treatment and prevention of complications. […] This article has highlighted the various imaging techniques available for detecting salivary gland stones, including ultrasound, CT scan, and sialography. […] These imaging techniques play a vital role in accurately diagnosing the presence and location of salivary gland stones. […] Timely diagnosis and appropriate treatment can help alleviate symptoms and prevent further complications.

• #45 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Further treatment is dictated based on the sialolith’s size, number, and location if conservative management is unsuccessful. […] External shockwave lithotripsy (ESWL) is an option for not palpable stones or visualized under endoscopy. […] Surgical excision of the submandibular gland should be a last resort. […] Salivary stones within the parotid duct that measure less than 7 mm and are mobile require endoscopic removal. […] The differential diagnosis for salivary gland swelling includes: Sialolithiasis, Sialadenitis (inflammatory or infectious), Neoplasm. […] Sialolithiasis has an excellent prognosis, and the majority of patients can be managed conservatively with sialogogues and nonsteroidal anti-inflammatory drugs. […] The primary complications of sialolithiasis are the development of sialadenitis, acute or chronic, and atrophy of the affected salivary gland. […] An interprofessional approach and open communication among providers can aid in ensuring patients receive appropriate initial management resulting in a quicker resolution of symptoms.

• #46 Diagnosis and Imaging Techniques for Salivary Gland Stones

  https://www.darwynhealth.com/ear-nose-and-throat-health/ear-nose-and-throat-disorders/mouth-and-throat-disorders/salivary-gland-stones/diagnosis-and-imaging-techniques-for-salivary-gland-stones/?lang=en

  In conclusion, early diagnosis of salivary gland stones is crucial for prompt treatment and prevention of complications. […] This article has highlighted the various imaging techniques available for detecting salivary gland stones, including ultrasound, CT scan, and sialography. […] These imaging techniques play a vital role in accurately diagnosing the presence and location of salivary gland stones. […] Timely diagnosis and appropriate treatment can help alleviate symptoms and prevent further complications.

• #47 Etiology, diagnosis, and surgical management of obstructive salivary gland disease – Karwowska – Frontiers of Oral and Maxillofacial Medicine

  https://fomm.amegroups.org/article/view/51653/html

  Obstructive salivary gland disease (OSGD) represents a large subset of salivary gland entities that affect a significant number of patients every year. […] Current management of OSGD revolves around resolution of acute infection, targeted imaging, and definitive surgical management of the causal obstruction. […] Imaging for obstructive salivary gland disorders has shifted away from traditional sialography and plain film radiography in favor of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). […] The use of sialendoscopy represents a minimally-invasive method to treat most OSGD without the morbidity associated with sialoadenectomy or other open procedures. […] This article aims to review the common etiologies of OSGD and discuss proper diagnosis and surgical management of these conditions.

• #48 Etiology, diagnosis, and surgical management of obstructive salivary gland disease – Karwowska – Frontiers of Oral and Maxillofacial Medicine

  https://fomm.amegroups.org/article/view/51653/html

  Evaluation of a patient suspected of having an obstructed salivary gland begins with a detailed history. […] The physical examination involves careful observation of the face for asymmetry, previous scars, swelling, facial nerve weakness or paralysis, and discrete masses. […] Imaging of suspected OSGD has evolved over the last several decades. […] If the underlying obstructive etiology is equivocal, sialendoscopy, a minimally-invasive endoscopic procedure, can be considered. […] Medical management of OSGD revolves around common tenets of treatment regardless of the obstructive etiology. […] Surgical management of OSGD has undergone a marked shift over the past two decades. […] Sialoliths that are more proximal and cannot be removed under direct vision can removed with a solely endoscopic technique, with the approach dependent on the size of the sialolith.

• #49 Etiology, diagnosis, and surgical management of obstructive salivary gland disease – Karwowska – Frontiers of Oral and Maxillofacial Medicine

  https://fomm.amegroups.org/article/view/51653/html

  Obstructive salivary gland disease (OSGD) represents a large subset of salivary gland entities that affect a significant number of patients every year. […] Current management of OSGD revolves around resolution of acute infection, targeted imaging, and definitive surgical management of the causal obstruction. […] Imaging for obstructive salivary gland disorders has shifted away from traditional sialography and plain film radiography in favor of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). […] The use of sialendoscopy represents a minimally-invasive method to treat most OSGD without the morbidity associated with sialoadenectomy or other open procedures. […] This article aims to review the common etiologies of OSGD and discuss proper diagnosis and surgical management of these conditions.

• #50 Current diagnostics and treatment of salivary stones – Medizinonline

  https://medizinonline.com/en/current-diagnostics-and-treatment-of-salivary-stones/

  By no means every patient who visits the doctor with swellings of the large salivary glands suffers from a viral or bacterial inflammation. The cause of swelling can also be a salivary stone. This must be recognized and diagnosed at an early stage so that the patient can be quickly and adequately given the right therapy. The leading symptom of salivary stone disease is always an increase in swelling of the affected gland and discomfort during eating. […] For this reason, it is important to know the diagnosis and symptoms of salivary stones in order to quickly and adequately guide the patient to the right therapy. […] In addition to anamnesis and clinical examination, sonography is primarily suitable for establishing the diagnosis. In the hands of a trained examiner, sonography shows a high sensitivity for salivary stones. […] First of all, it is important to know and diagnose a salivary stone condition. Here, the leading symptom is always an increase in swelling of the affected gland and discomfort when eating.

• #51 Diagnostic imaging of a huge salivary gland calculi – IJMI

  https://www.ijmi.in/html-article/15717

  A 30 year old female patient reported to the Department with a swelling and mild discomfort in the right check region for two weeks. […] Early diagnosis by correlating clinical and imaging features is paramount in the management of such patients. […] The diagnosis of salivary gland arrived by a correlation of clinical findings with imaging features. […] The algorithm for imaging the salivary glands depends on the clinical scenario with which the patient presents to the clinician. […] In the present case, we used CBCT for the diagnosis of sialoliths and identify their location. […] Although a variety of diagnostic tests are used to detect submandibular salivary calculi due to high accuracy combined with low costs, good availability, and limited radiation exposure makes CBCT an ideal first-line imaging modality for patients with signs and symptoms of obstructed major salivary glands.

• #52 Diagnostic imaging of a huge salivary gland calculi – IJMI

  https://www.ijmi.in/html-article/15717

  A 30 year old female patient reported to the Department with a swelling and mild discomfort in the right check region for two weeks. […] Early diagnosis by correlating clinical and imaging features is paramount in the management of such patients. […] The diagnosis of salivary gland arrived by a correlation of clinical findings with imaging features. […] The algorithm for imaging the salivary glands depends on the clinical scenario with which the patient presents to the clinician. […] In the present case, we used CBCT for the diagnosis of sialoliths and identify their location. […] Although a variety of diagnostic tests are used to detect submandibular salivary calculi due to high accuracy combined with low costs, good availability, and limited radiation exposure makes CBCT an ideal first-line imaging modality for patients with signs and symptoms of obstructed major salivary glands.

• #53 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Sialolithiasis is the most frequent cause of salivary gland swelling, affecting the major salivary glands: parotid, submandibular, and sublingual glands. […] In the case of larger salivary stones involving the distal submandibular duct (Wharton duct), diagnosis is often possible based on physical examination. […] Modern diagnostic techniques involve point-of-care ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and direct visualization with sialoendoscopy. […] Clinical diagnosis of sialolithiasis can be challenging as patients may not be symptomatic unless the stone obstructs the salivary ducts, termed sialadenitis. […] Conventional radiographs using occlusal views were the initial diagnostic choice in the past. […] While conventional radiography can still be useful in the initial workup of salivary stones, modern imaging techniques using ultrasound or CT scans can accurately diagnose the sialoliths and provide their exact location.

• #54 Diagnosis and Imaging Techniques for Salivary Gland Stones

  https://www.darwynhealth.com/ear-nose-and-throat-health/ear-nose-and-throat-disorders/mouth-and-throat-disorders/salivary-gland-stones/diagnosis-and-imaging-techniques-for-salivary-gland-stones/?lang=en

  In conclusion, early diagnosis of salivary gland stones is crucial for prompt treatment and prevention of complications. […] This article has highlighted the various imaging techniques available for detecting salivary gland stones, including ultrasound, CT scan, and sialography. […] These imaging techniques play a vital role in accurately diagnosing the presence and location of salivary gland stones. […] Timely diagnosis and appropriate treatment can help alleviate symptoms and prevent further complications.

• #55 Etiology, diagnosis, and surgical management of obstructive salivary gland disease – Karwowska – Frontiers of Oral and Maxillofacial Medicine

  https://fomm.amegroups.org/article/view/51653/html

  In cases where minimally-invasive methods fail, or if the stone is located in the gland parenchyma itself and is symptomatic, a sialoadenectomy is indicated. […] Sialendoscopy is a minimally-invasive diagnostic and therapeutic modality that avoids the morbidity associated with sialoadenectomy and can successfully treat many causes of salivary gland obstruction.

• #56 Diagnosis and Imaging Techniques for Salivary Gland Stones

  https://www.darwynhealth.com/ear-nose-and-throat-health/ear-nose-and-throat-disorders/mouth-and-throat-disorders/salivary-gland-stones/diagnosis-and-imaging-techniques-for-salivary-gland-stones/?lang=en

  In conclusion, early diagnosis of salivary gland stones is crucial for prompt treatment and prevention of complications. […] This article has highlighted the various imaging techniques available for detecting salivary gland stones, including ultrasound, CT scan, and sialography. […] These imaging techniques play a vital role in accurately diagnosing the presence and location of salivary gland stones. […] Timely diagnosis and appropriate treatment can help alleviate symptoms and prevent further complications.

• #57 Sialolithiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549845/

  Further treatment is dictated based on the sialolith’s size, number, and location if conservative management is unsuccessful. […] External shockwave lithotripsy (ESWL) is an option for not palpable stones or visualized under endoscopy. […] Surgical excision of the submandibular gland should be a last resort. […] Salivary stones within the parotid duct that measure less than 7 mm and are mobile require endoscopic removal. […] The differential diagnosis for salivary gland swelling includes: Sialolithiasis, Sialadenitis (inflammatory or infectious), Neoplasm. […] Sialolithiasis has an excellent prognosis, and the majority of patients can be managed conservatively with sialogogues and nonsteroidal anti-inflammatory drugs. […] The primary complications of sialolithiasis are the development of sialadenitis, acute or chronic, and atrophy of the affected salivary gland. […] An interprofessional approach and open communication among providers can aid in ensuring patients receive appropriate initial management resulting in a quicker resolution of symptoms.

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