Salivary Gland stones

Salivary gland

There are 3 main salivary glands in the head and neck. There are several small glands in the mouth (minor salivary gland).
Main glands

  • Parotid glands (these are situated in front of the ear/ behind the jaw bone one on each side)
  • Submandibular glands (these are situated under the ¬†jaw bone one on each side)
  • Sublingual glands (these are situated under the tongue one on each side)

Salivary Gland stones – Most common salivary gland problem .

How does it usually present: Most of them are without any symptoms. But the usual presentation is recurrent swelling of the salivary gland during meal times. Usually it resolves spontaneously, but sometimes can cause severe infection (Sialadenitis)

Investigations:
Xray: may show the stones.
Ultrasound:
Sialogram: xrays are taken after injecting a dye in the salivary gland duct.

Treatment: Usually requires removal  if symptomatic. Depending on the location, it is usually done from inside the mouth. Some large stones especially in the submandibular gland requires removal of the gland approached through a neck. Small stones or strictures can sometimes be done through basket removal or balloon dilatation

Blockage of Salivary Glands

Blockage of one of the salivary glands is quite common. Blockage is usually due to stones or strictures (narrowing of duct) within the gland. Symptoms are usually of pain and swelling in relation to one or other glands.

Investigations:

Following a thorough history and examination, further tests may be required This includes Ultrasound and Sialogram.

Ultrasound is a simple, quick and non-invasive test
Sialogram involves injecting a dye into the duct of the gland and viewing the flow of dye through the gland. This is more useful for strictures

Treatment:

If the cause is due to stone this should be removed. The usual way of removing is by an operation. There are now minimally invasive methods of treating stones and strictures. New treatments involve introducing small baskets into the ducts to remove stones
Strictures can be treated with tiny balloons (which can be re-inflated inside the duct) to dilate up strictures. These procedures can often be carried out under local anaesthetic.

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