Sialolithiasis is the presence of calculi or stones in the salivary glands or ducts, which typically form due to stagnation of saliva rich in calcium. Risk factors include medications like diuretics, dehydration, gout, smoking, and chronic periodontal disease. Clinical features range from being asymptomatic to intermittent facial swelling associated with eating that can be painful or painless. Diagnosis involves ultrasound or radiographs of the affected gland. Most cases are managed conservatively with hydration and sialagogues. If infected, antibiotics may be used. Definitive management includes interventional radiology procedures to extract stones or surgery to remove difficult stones or the entire gland if symptoms persist chron

1. Sialolithiasis

2. Introduction
• Sialolithiasis is the presence of calculi in the
salivary glands or ducts.

3. • Stones will form in the salivary gland or ducts
following the stagnation of saliva; they are
typically composed of calcium phosphate and
hydroxyapatite, as the saliva is rich in calcium

4. Risk Factors
• Medication, commonly diuretics or anti
cholinergics
• Dehydration
• Gout
• Smoking
• Chronic periodontal disease
• Hyperparathyroidism

5. Clinical Features
• asymptomatic,
• intermittent facial swelling associated with
eating, which can be painful or painless.
• Symptoms are usually unilateral in nature.
• When the gland is palpated, saliva can be seen
at the duct orifice, along with the presence of
small stones.
• On palpation, a stone may be palpable in the
duct and the gland may feel tender in the
presence of infection.

7. Investigations
• Most cases of suspected sialolithiasis are
investigated* with either ultrasound or
radiographs.

8. Management
• Most patients are managed conservatively
with oral hydration, analgesia, and
sialologues, such as lemon juice, which
promote saliva production. Milking /
massaging the gland can help as well.
• If the gland becomes infected and the patient
develops sialedenitis, then antibiotics are
typically indicated.

9. Definitive Management
• Interventional radiology procedures are most
commonly trialled, which involve fluoroscopic
control such that the stones are visualised in
the duct and then extracted with a basket.

10. • A surgical approach can be used to remove
some more difficult stones; a transoral
approach can be used if the stones are distal
or a transcervical approach for proximal
stones (or where the transoral approach has
been unsuccessful).

11. • Gland removal is last resort. Excision of the
parotid or submandibular gland are only
performed for patients with chronically
persisting symptoms.