Sialolithiasis

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.