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Salivary gland stones

Authors
Sara B Fazio, MD
Kevin Emerick, MD
Section Editor
Daniel G Deschler, MD, FACS
Deputy Editor
H Nancy Sokol, MD

INTRODUCTION

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 [1], 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 [2].

The presentation, evaluation, and treatment of salivary gland stones will be reviewed here.

ANATOMY

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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Literature review current through: Nov 2016. | This topic last updated: Tue Feb 16 00:00:00 GMT+00:00 2016.
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