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Salivary Stones or Sialolithiasis

Frequently Asked Questions Regarding Salivary Stones

What symptoms do they cause?
Pain and swelling of the salivary glands that can be assocaited with meals

How frequently do they occur?
Incidence of salivary stones in the general population is about 1.2 percent. They are more frequently found in the salivary glands below the jaw (the submandibular salivary gland) and less frequently in the salivary gland in front of the ear (parotid gland)

How fast do they grow?
Salivary stones usually grow at the rate of 1mm per year. Most salivary stones are in the range of 5-8 mm in size. However, they can range from a 2 millimeters to larger sizes  greater than 15 mm. When the grow larger than 15 mm in size, they are often referred to as 'megaliths' or 'giant stones'

Are there any life threatening complications of salivary stones?
Salivary stones can cause symptoms or may be at times present without symptoms. However, they do have the potential to cause infections and abscesses within the salivary glands that can be at times life threatening if not treated appropriately. More commonly recurrent symptoms and gland infections as well as swelling cause quality of life impairment.

How does one treat salivary stones?
Traditional treatment includes removal of the salivary gland. However, the new technology of sialendoscopy allows management of stones in a minimally invasive fashion without the need for gland removal.

What are the advantages of sialendoscopy over traditional gland excision?
- Sialendoscopy is a minimally invasive, same day surgery procedure that does not involve external incisions
-it allow endoscopic stone removal with preservation of the salivary gland that is important for oral and dental hygeine and also swallowing and speeech function
-Open surgery for gland excsion is often associated with risks of bleeding, infection, damage to important nerves which are responsible for movement of the tongue and angle of the mouth as well as sensation of the tongue for the submandibular gland and nerves that are responsible for facial movement i.e. the facial nerve for the parotid gland. These risk are eliminated when sialendoscopic stone removal is possible.

What is the size of stones that can be managed with sialendoscopy?
-Utilizing sialendoscopy as well as the variety of tools that fit through the miniature scopes, the majority of stones can be managed. Stones that are large or are not amenable to endoscopic removal (glandular stones), can still be removed with sialendoscopy assistance. This hybrid or endoscopy assisted approach allows stone removal of almost any size with gland preservation making a limited incision either in the mouth or externally to delivery the stone but still preserve the gland.

Dr.Walvekar recently described and perforned the first robot assisted stone removal for large stone within the submandibular gland. This is an additional advance in the management of large salivary stones that makes the procedure even more precise.

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