Sialolithiasis (Salivary calculi - Salivary stones)
Salivary Gland Stone
What is a salivary gland stone?
Salivary gland stone (also called salivary canal stone) is a calcified structure that can form in a salivary gland or canal. Saliva stone can prevent the flow of saliva in the mouth.
Most stones affect the submandibular glands located at the base of the mouth. Less common stones affect the parotid glands in the cheeks or the sublingual glands below the tongue (sublingual salivary gland stone). Most patients with stones in the salivary gland can be seen in more than one stone at the same time.
There are a total of three pairs of large salivary glands. Salivary duct stones are common in the ducts connected to the submandibular glands (Submandibular salivary gland canal - wharton canal) . These are glands on both sides of our jaws behind our mouths.
Under our ears, stones may form in the channels connected to the parotid glands on both sides of your face. The stones in the submandibular glands are generally larger than the stones formed in the parotid glands.
One or more stones may appear in the saliva channel. Approximately 25 percent of patients usually develop more than one stone. Although this occurs at all ages, it is most common in people aged 30-60 years. It is much more common in men than women.
Causes of salivary gland stones?
Saliva stones are formed when saliva chemicals accumulate in the canal or gland. They contain mostly calcium. The exact cause is unknown. However, factors contributing to less saliva production and / or concentrated saliva may be risk factors for salivary stones. These factors include: dehydration, poor nutrition, and the use of certain drugs (such as antihistamines), blood pressure medications, psychiatric drugs and bladder control drugs. Trauma to the salivary glands can also increase the risk of salivary stones.
Saliva flows through the salivary glands continuously. Sometimes, the chemicals in the saliva can crystallize and form a small stone. Salivary gland stones ('saliva stone') can be kept in the channel that prevents the flow of saliva starting from the salivary gland. This may cause swelling and pain in the gland. The stones are mostly made of calcium and most of them are smaller than 1 mm and less than 1 cm in diameter which can vary up to a few centimeters.
It is not known why salivary gland stones are caused and interestingly, the salivary gland stone may occur without any calcium imbalance elsewhere (a stone formation may be associated with changes in the saliva flow from the salivary gland. eating increases the flow of saliva) The risk of developing the saliva stone is increasing).
What is the most common salivary gland stone?
The most common salivary stone appears in the submandibular glands (about 8-9 in 10 patients). The submandibular canal is a tube extending from the tongue to the submandibular gland. Large parotid glands are thinner than the saliva produced by the submandibular glands and the fluid produces saliva, and the duct of the submandibular gland is angled upwardly perpendicular to gravity. This means that the stones are less likely to form in the parotid glands and other salivary glands. It is rare in the sublingual gland of salivary gland stone. "Why does the salivary gland stone occur?" In response to the question, reduction in salivary fluidity, unknown factors and structural reasons come to mind.
Symptoms of salivary gland stone
The stones do not produce any symptoms when they occur, but if they reach a size that obstructs the ducts, they enter the salivary gland and cause pain and swelling. One of the symptoms of salivary stone is the swelling and pain of the salivary gland while eating. You can feel pain and pain immediately and it can get worse. Symptoms may be followed by inflammation and infection within the affected gland. Salivary gland swelling symptoms in the neck lymph node enlargement or other infection due to swelling of the head at the beginning, salivation is triggered, eating or chewing gum in cases such as swelling and pain is increasing gradually. Since the most common salivary gland stone is a subcutaneous salivary gland stone, most of the patients complain of swelling under the jaw.
How do you know that you have a salivary gland stone?
If the stone is too small and does not block the channel, there may be no symptoms.
A larger stone can be seen when you open your mouth wide. If the stone is large enough to cause symptoms, these symptoms will usually continue until the stone disappears or is removed.
Slight pain and swelling in the salivary gland
If the stone partially clogs the duct and stops part of the saliva flow, it may cause the following symptoms:
• dull pain if you go on the affected diaper
• swelling of the diaper can swell up and down over time
• the infection of the gland - can be very painful and become an abscess
Severe pain and swelling after a meal
If the salivary glands are completely blocked, you may experience sudden, intense pain after you start eating. This is usually reduced in the hours following a meal.
Bloating and pain occur because the saliva cannot get out of the blocked canal, so it can be trapped and settled into the diaper.
The main symptom of salivary duct stones is pain on your face, mouth or neck, and worsens before or during meals. This is because the salivary glands produce saliva to facilitate eating. If the slobber does not flow from the canal, it settles into the gland and causes swelling and pain.
Other common symptoms include tenderness and swelling in the face, mouth or neck. You may also have a dry mouth and you may have trouble swallowing or opening your mouth.
Bacterial infections can occur when the diaper is filled with stagnant saliva. As a sign of infection, fever, bad taste in your mouth and redness in the affected area may occur.
What happens if the salivary gland is not removed?
In the salivary gland recurrent salivary gland swellings seen at the beginning of the stone symptoms and painful infection at the end of the attacks, spontaneous salivary gland stones do not fall; In the salivary gland, a decrease in salivary gland function or salivary gland abscess may occur.
Diagnosis of salivary gland stone
If you have symptoms of salivary gland stone, you can usually control the stones with physical examination. However, stones that are too small to obstruct the canal and do not show any symptoms are rarely encountered during neck ultrasonography or a CT scan. In patients with recurrent salivary gland swelling when eating, if the stone can not be palpated in the examination of the salivary gland and salivary duct, tests such as X-ray, CT scan or ultrasound may be desirable.
If the stone is not on the x-ray film, one of the following detailed scans may be required:
• Computed tomography (CT) scan using X-ray and computer to create detailed images within the head and neck region.
• A magnetic resonance imaging (MRI) scan using strong magnetic fields and radio waves to produce detailed images.
• Sialography - inject a contrast agent into the gland before taking an x-ray.
• Sialendoscopy - insert a thin tube with a small light at the end and a camera (endoscope) so that the doctor can look inside the diaper. If a stone appears, it can be removed at the same time.
Treatment of salivary gland stone
Does the salivary gland stone fall spontaneously?
If a stone is found, the purpose of treatment is to remove it. For small stones, sucking a lemon or sour candies can drain the slob, causing the stone to pass by itself. In other cases where the stones are small, the doctor or dentist may massage the stone or push the stone towards the canal.
For larger, stiffer protruding stones to remove stones, doctors usually perform a small incision in the mouth. The doctor or dentist can try to push it out by pressing on either side of the channel. Deep or large stones in your channel should be surgically removed.
How does a salivary gland move?
If the salivary gland stone has grown too much, it is not trapped inside the canal; regular massage, to increase the consumption of water in order to make the fluid more fluid, to increase saliva consumption of sour products, sometimes with the use of muscle relaxant tablets and expectorant drugs can be provided to fall into the mouth.
A fine blunt instrument and a gentle probing through the mouth into the tube (duct) may sometimes release a stone falling into the mouth (this is done by a doctor!).
Salivary gland stone and lemon
Normally, if the stone does not block the channel exactly, you can try to move the stone by sucking the lemon to encourage drooling. If the stone channel is fully occluded, if the pain is increasing gradually, please consult a CBD specialist and listen to the recommendations from the physician.
Removal of saliva stone with salivary gland endoscopy (sialendoscopy)
They use a newer, less invasive technique called sialendoscopy to remove salivary gland stones. Sialendoscopy, which has been successfully developed and used in Europe for ten years, uses tiny lighted endoscopes placed in the mouth of the gland in the mouth to visualize the salivary duct system and find the stone. Then, using micro-instruments, the surgeon can remove the stone to alleviate congestion. The procedure is performed under local or mild general anesthesia; this allows the patient to go home immediately after the procedure.
With therapeutic sialendoscopy, the tube is pushed into the duct using a very thin tube (endoscope) with a camera and light at the end. If a stone is seen, it can also be pulled into the stone mouth by means of a small basket or holding clip attached to the pipe to grab and remove the stone.
This requires special tools and a very thin, easily breakable (or flexible) endoscope. The endoscopic removal of saliva can be performed in hospitals (salivary gland stone surgery) in this system.
Salivary gland stone surgery
Your doctor may try to free your stone by scanning it with a thin, blind device.
If this does not work, you may need a procedure called therapeutic sialendoscopy. A local anesthetic is given to numb the mouth and a very thin endoscope is pushed into the canal. If a stone is seen, a small tool at the end of the tube holds and pulls it out.
Information available on the Internet: If the salivary gland stone is large, it may be necessary to break down first by using shock wave treatment (ultrasound waves directed to the stone). This is called an extracorporeal shock wave lithotripsy (ESWL) and allows smaller particles to pass through the channel. During this process, high-energy sound waves are directed to the stone. During this procedure you will probably calm down or under general anesthesia. ESWL is used more frequently to break up other body stones such as kidneys or bladder.
Today, a small incision in the mouth of the saliva stones is rarely required. In the following video, the painful left chin salivary gland swelling and the under-the-chin salivary gland canal that can be seen through the mouth can be cut into the mouth. swelling was observed.
For people with irreversible damage to repetitive stones or salivary glands, surgical removal of the affected salivary gland is necessary. In addition, if the saliva stones cause infection, additional antibiotics are prescribed.
How many hours does salivary gland stone surgery take?
It usually takes 5-10 minutes when salivary gland stone surgery is performed under office conditions. When the endoscopic salivary stone removal procedure is performed under hospital conditions, the total processing time can be 30 - 45 min. "How long does the salivary gland stone operation last?" The answer also varies according to the location of the salivary gland stone and the channel where it is placed. For salivary gland stone removal, sometimes only massage is sufficient.
After the salivary gland stone surgery
Salivary stones are usually a one-off event, and most patients do not develop stones in the salivary gland after stone surgery. When the factors such as drug use, low water drinking, etc., which increases the likelihood of stone formation, saliva stone may occur again.
In patients with salivary gland stone surgery, if another stone develops or develops simultaneously, it may be necessary to remove the salivary gland completely. Your doctor may explain this procedure in detail (enough saliva can be produced from other glands).
In most cases, the salivary duct is removed without any complications. If the salivary duct stones or salivary gland infections continue to develop, the affected gland may need surgical removal.
Salivary gland stone surgery risks
Salivary gland stone surgeries are not without risk. The nerves that control various facial movements and sweat production flow along or near the large salivary glands. There is a risk of damaging these structures. During the removal of the stones in the salivary gland canal, there are risks such as shrinkage of the salivary canal, recurrent salivary gland infections, bleeding, damage to the tongue nerves, salivary cyst formation (mucocele). Often, none of these complications will occur. It's best to talk to your doctor about the risks of such surgeries.
Natural solution of salivary gland stone
The most appropriate treatment tool for patients with salivary gland stones is the recommendations and treatments of their physicians. When the salivary gland stone is not completely obscured, you can do the following as domestic measures:
"Your doctor or a dentist may recommend sucking up lemon drops without sugar and drinking too much water. The goal is to increase saliva production and force the stone into the canal. You can also move the stone by applying heat and gently massaging the affected area".
If you exercise frequently, or if you live in a hot climate, consuming plenty of fluid is important to reduce the risk of stone formation.
Salivary gland stone herbal treatment
I have added the following products on the internet very often but I agree with lemon and apple vinegar. Others suspicious ...
In salivary gland stones, which completely obstructs the channel, applications that accelerate the following saliva increase may cause a sudden increase in current complaints. Please observe your doctor's recommendations.
For herbal treatment of salivary gland stones, products that accelerate the flow of saliva are generally recommended.
Here are some remedial measures for salivary gland stones (source: Causes of Salivary Gland Stones & its Treatment, Home Remedies):
1. Lemon, which is written at the beginning of medicinal plants for salivary gland stone:
Lemon juice can be used to lower the salivary gland stones into the mouth. The juice of a fresh lemon can be added to a glass of water and taken every morning. This is a perfect detoxifying drink and helps to alkalize the body.
2. Apple vinegar for salivary gland stones:
Apple cider vinegar is a simple tonic and an effective home remedy for various diseases. It helps to alkalize the body. It is known to be effective in cases of stone formation associated with many calcium deposits. During the day you can use 1 tablespoon of apple cider vinegar in a glass of water to be sipped.
3.Borax (sodium salt derived from boric acid):
On the Internet: Borax is a natural maintenance tool for calcium deposits. A typical dose of borax for men is the consumption of ¼ teaspoon of borax within 1 liter of water within one day. This will be done for 4 consecutive days, 3 consecutive days a week. The dose for women is 1/8 teaspoon of borax in 1 liter of water (I do not like non-evidence-based information, organic apple cider vinegar and lemon juice seem to be the right choice).
Apart from these:
4. Indian oil
5. Vitamin supplements such as magnesium
6. Litotropic herbs can be used to treat salivary gland stones. These herbs can help dissolve salivary gland stones. Chanca piedra is usually such a plant. Dandelion, pebble root and Hydragea are other such lithotropic plants that can be used in the treatment of salivary gland stones. These herbs can be taken as either tea or capsules.
7. Turmeric is a plant that helps with pain, inflammation and infection. 1 teaspoon turmeric milk can be mixed with almond milk and taken twice a day.
8. Partridge extract oil can be used to assist with infections caused by salivary gland stones. They can be brought in a capsule or supplement form and can be taken internally. A drop of oregano extract oil can also be added to 1 teaspoon of infiltrated coconut oil and can be used when sucking oil in the mouth for about 20 minutes.
Removal of submandibular salivary gland stone video
In the examination of the patient who presented with recurrent left chin salivary gland swelling while eating, the salivary gland (submandibular gland) channel (Wharton Canal) opening mouth, oval shaped, approximately 3x6 mm size was observed in the opening mouth and the canal mouth was under local anesthesia. After the expansion with a scalpel, simultaneous intra-oral and under-chin massage was performed and the stone was released into the mouth. You can find many images on video sharing sites to track salivary gland stone surgery.
Here are the images of the patient with 2 stones in the salivary gland under the chin:
Here are the images of the patient with 2 stones in the salivary gland under the chin:
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| Submandibular Salivary Gland Stone |
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| Submandibular Salivary Gland Stone |
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| Submandibular Salivary Gland Stone |
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| Submandibular Salivary Gland Stone |
How is salivary gland swelling treated?
I wrote it because it is related to the topic. In each salivary gland swelling and infection, it is not caused by salivary stones. In the salivary gland infections caused by viruses and transplant, painful salivary gland swelling may occur. In this case, generally the swelling occurs more slowly and slower than eating. In the case of salivary gland treatment, it may be necessary to increase the drinking of water, to use drugs such as antibactics, painkillers and expectorants.
Sources:
Salivary Gland Stones: Symptoms, Causes, and Treatment - WebMD
Salivary gland stones (calculi) - NHSUK
Salivary Duct Stones: Causes, Symptoms, and Diagnosis - Healthline
Salivary Gland Stones (Salivary Calculi) | Health | Patient
Sources:
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Appointment Phone: +90 212 561 00 52
Fax: +90 212 542 74 47
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