Hammett Jonathan T., Walker Christopher
The University of Texas MD Anderson Cancer Center
Wilford Hall Ambulatory Surgical Center
Sialolithiasis is a benign condition involving the formation of stones within the ducts of the major salivary glands: parotid, submandibular, and sublingual glands (see . Neck Computed Tomography, Sialolithiasis in Right Parotid Duct). This condition is the most frequent cause of salivary gland swelling, with a reported incidence of 1 in 10,000 to 1 in 30,000. In some cases, sialoliths can obstruct the salivary ducts, leading to inflammation, superimposed bacterial infection termed sialadenitis, or in rare cases, abscess formation. There are various presenting symptoms, with the most common being cyclical postprandial swelling of the affected gland and decreased salivary flow. In the case of larger salivary stones involving the distal submandibular duct (Wharton duct), diagnosis is often possible based on physical examination. Cases involving smaller stones within the distal submandibular duct or parotid duct (Stenson duct) were historically diagnosed utilizing conventional radiography, sialography, and digital subtraction sialography. Modern diagnostic techniques involve point-of-care ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and direct visualization with sialoendoscopy. A variety of treatment options exist for sialolithiasis, including sialogogues, direct massage of distal stones out of the duct, and other procedures including interventional sialography, lithotripsy, sialoendoscopy, and surgery.
涎石病是一种良性疾病，主要累及腮腺、下颌下腺和舌下腺等大唾液腺导管内结石的形成（见图。颈部计算机断层扫描，右侧腮腺导管涎石病）。这种疾病是唾液腺肿胀最常见的原因，报告发病率为万分之一至三万分之一。在某些情况下，涎石会阻塞唾液导管，导致炎症、称为涎腺炎的叠加细菌感染，或在罕见情况下形成脓肿。有多种表现症状，最常见的是受累腺体餐后周期性肿胀和唾液分泌减少。对于涉及下颌下腺远端导管（沃顿导管）的较大涎石，通常可根据体格检查进行诊断。历史上，对于涉及下颌下腺远端导管或腮腺导管（斯滕森导管）内较小结石的病例，采用传统放射摄影、涎管造影和数字减影涎管造影进行诊断。现代诊断技术包括即时超声、计算机断层扫描（CT）、磁共振成像（MRI）以及通过涎腺内镜直接观察。涎石病有多种治疗选择，包括催涎剂、将远端结石从导管中直接按摩出来，以及其他程序，包括介入性涎管造影、碎石术、涎腺内镜检查和手术。
