Salivary glands are located in the oral cavity and their main function is the production of saliva. Saliva enters the oral cavity through small ducts known as excretory ducts of the salivary glands. However, in some cases the excretory ducts may become blocked, due to the formation of stones in the salivary glands, preventing the drainage of saliva. This particular condition is known as sialolithiasis, which can in some cases be treated with salivary gland stones removal.

The production of saliva from the salivary glands is important in order to moisten the oral cavity and avoid oral infections, to prevent unpleasant diseases of the teeth and gums, and to facilitate the assimilation of food. The salivary glands include the parotid, submandibular and sublingual glands as well as the minor salivary glands.

Salivary gland stones: Causes

Salivary gland stones occur when microscopic stone-like formations form either inside the excretory ducts or inside the salivary gland and are carried into the excretory ducts by the circulation of saliva. They have a hard texture and a spherical or oblong shape. Their color can be white, yellowish or brown. The location of salivary gland stones is most common in the area of ​​the submandibular glands, which are found at the base of the oral cavity. These stones are mainly composed of calcium, the accumulation of which contributes to their formation, but they also contain magnesium, potassium and ammonium.

Salivary gland stones are found more frequently in the middle-aged male population. Certain factors are responsible for the appearance of the condition, which are related to the production of thick saliva, such as dehydration, the administration of drugs such as antihistamines or blood pressure drugs, the existence of some trauma to the salivary glands or reduced food consumption.

Salivary gland stones: Symptoms

Depending on the location and size of the stone, the presented symptoms vary. Although most salivary gland stones are asymptomatic or cause minimal discomfort, larger stones can obstruct the flow of saliva and cause pain and swelling. The majority of salivary gland stones are noticed when they have grown large enough to block the excretory duct and cause obstruction or interruption in the flow of saliva to the mouth.

The main symptom is the appearance of swelling at the base of the oral cavity or on the cheek. The symptoms may intensify during chewing food, causing severe pain due to the inability to drain saliva, especially when eating particularly sweet or acidic foods.

In the case of a partial blockage, the pain and swelling subside with the end of the meal, and reappear with the next food intake. The pain presents an acute intensity and causes difficulties in the movements of the mouth or in the process of speaking. In advanced cases, an infection or even an abscess may appear in the salivary glands, which is why early treatment is very important.

Treatment options & when salivary gland stones removal is indicated

This condition in the first stage is treated conservatively by increasing the consumption of liquids, along with the consumption of acidic or bitter foods that encourage salivation and the application of warm compresses. At the same time, an antibiotic is administered to avoid infection of the salivary glands. In case of larger stones, which are located deeper in the excretory duct, salivary gland stones removal via surgery is recommended.

Salivary gland stone removal: Surgical options

In some cases, high-energy sound waves may be used to break the stone into smaller pieces. This procedure is called exosomal lithotripsy, where the broken parts of the stones are removed with saliva. Salivary gland stone removal is performed by ENT Surgeon in Athens Dr. Olga Papadopoulou with the use of flexible endoscopes, through a minimally invasive method known as sialendoscopy.

This method is both diagnostic and therapeutic, for the bloodless removal of stones located in the salivary gland, with the administration of local anesthesia. The endoscope is inserted into the excretory duct, which reaches the area of ​​the stone, which is then either removed, or lithotripsy is performed in case a stone is significantly large in size.

Salivary gland stones removal: When is sialolithotomy indicated

To remove salivary gland stones located in the submandibular gland, a sialolithotomy can be performed, in which an incision is made in the excretory duct to remove the stone. This procedure is performed under general anesthesia if the stone is located close to the opening of the duct, otherwise, in case it is located deeper, the procedure is performed surgically under general anesthesia. In advanced cases or in a chronic form of the condition, the surgeon may remove part or the entire salivary gland.