Salivary gland stones
- Sara B Fazio, MD
Sara B Fazio, MD
- Associate Professor of Medicine
- Harvard Medical School
- Kevin Emerick, MD
Kevin Emerick, MD
- Assistant Professor in the Department of Otology and Laryngology
- Harvard Medical School
Sialolithiasis, the presence of stones or calculi in the salivary glands or ducts, is a relatively common condition. Although a 1 percent incidence is noted in autopsy studies , clinically symptomatic stones are much less frequently noted. A review of 15 health regions in England from 1991 to 1995 revealed an incidence of symptomatic sialolithiasis of 27 to 59 cases per million population per year .
The presentation, evaluation, and treatment of salivary gland stones will be reviewed here.
The three major salivary glands (parotid, submandibular, and sublingual), and occasionally the minor salivary glands, are subject to the development of stones. The anatomy of the glands and ducts affects where stones are likely to lodge and also affects the choice of therapies. (See 'Treatment' below.)
Parotid glands and Stensen's duct — The parotid glands are located on the sides of the face anterior to the external auditory canal, superior to the angle of the mandible, and inferior to the zygomatic arch. Most of the parotid gland is superficial to the masseter muscle. Stensen's duct arises from the anterior border of the parotid gland and is 4 to 7 cm long, narrows to 1.2 mm at an isthmus, and the os is 0.5 mm and is opposite the upper second molar (figure 1).
Submandibular glands and Wharton's duct — The submandibular glands lie beneath the floor of the mouth. Wharton's duct arises from the medial surface and is 5 cm long and 1.5 mm in diameter. The os is 0.5 mm in diameter and located on the floor of the mouth near the frenulum of the tongue (figure 1).
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- Parotid glands and Stensen's duct
- Submandibular glands and Wharton's duct
- Sublingual glands
- Minor salivary glands
- CLINICAL FEATURES
- Physical examination
- Chronic obstruction
- Computerized tomography
- Plain films
- Magnetic resonance imaging
- DIFFERENTIAL DIAGNOSIS
- Viral sialadenitis
- Acute bacterial sialadenitis
- Chronic bacterial sialadenitis
- Human immunodeficiency virus
- Sjögren's syndrome
- Salivary gland tumors
- General approach
- Extracorporeal lithotripsy
- Laser lithotripsy
- Wire basket retrieval
- Surgical intervention
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS