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{{Sialolithiasis}}
{{Sialolithiasis}}
{{CMG}}; {{AE}}{{MA}}
{{CMG}}; {{AE}}{{MA}} [mailto:malihash@bidmc.harvard.edu]
==Overview==
==Overview==


==Historical Perspective==
==Historical Perspective==
Sialolithiasis was first discovered by Küttner in 1986. Sialadenoscope were used for the first time in 1991.


==Classification==
==Classification==
There is no established system for the classification of sialolithisis, but it may be classified according to location of the stone, [[radiopaque]] or radiolucent, [[symptomatic]] or [[asymptomatic]].


==Pathophysiology==
==Pathophysiology==
Sialolithiasis is the presence of stones within the [[Salivary gland|salivary glands]] or the salivary gland ducts.The exact pathogenesis of sialolithiasis not fully understood but the relative stagnation of salivary flow and calcium concentration may be important. 75 percent of sialolithiasis cases are single. 3 percent of stones are bilateral and most of them are located in [[Parotid gland|parotid glands]]. Stone formation is 80 to 90 percent in the [[submandibular gland]], 6 to 20 percent in the [[Parotid gland|parotid glands]] and 1 to 2 percent in the [[Sublingual gland|sublingual]] or minor salivary glands. Sialoadenitis is inflammation of a salivary gland. Acute sialoadenitis may be caused by [[Virus|viral]] or [[bacterial]] infection. Chronic sialoadenitis is caused by repeated episodes of inflammation. On [[gross pathology]], hard yellow -white spherical depositions usually less than 1 cm are seen. On microscopic pathology, dilated ducts with squamous metaplasia or calculi are usually present.


==Causes==
==Causes==
The exact etiology of sialolithiasis is not well understood, but relative stagnation of salivary flow and calcium concentration may be important.


==Differentiating Hereditary pancreatitis from Other Diseases==
==Differentiating Hereditary pancreatitis from Other Diseases==
Sialolithiasis must be differentiated from other diseases that cause swelling in [[Salivary gland|salivary glands]], such as acute bacterial [[sialadenitis]], chronic bacterial [[sialadenitis]], viral [[sialadenitis]], [[Human Immunodeficiency Virus (HIV)|human immunodeficiency viru]]<nowiki/>s, [[Radiation therapy|radiation]], and systemic diseases such as, [[sarcoidosis]], and [[sjögren's syndrome]].


==Epidemiology and Demographics==
==Epidemiology and Demographics==
The incidence of sialolithiasis is approximately 100 per 100,000 individuals in [[autopsy]] studies worldwide. The prevalence of sialolithiasis is approximately 450 per 100,000 individuals worldwide. Sialolithiasis commonly affects individuals between the ages of 30 and 60 years. There is no racial predilection to sialolithiasis. Men are more commonly affected by sialolithiasis than women.


==Risk Factors==
==Risk Factors==
Common risk factors in the development of sialolithiasis include [[dehydration]], [[Diuretic|duiretics]], local [[trauma]], [[Sjögren's syndrome|sjögrens]].


==Screening==
==Screening==
There is insufficient evidence to recommend routine screening for sialolithiasis.


==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


 
If left untreated, patients with sialolithiasis may progress to develop secondary infection and chronic sialadenitis. Common complications of sialolithiasis include infection and recurrence. Prognosis is generally good.
==Diagnosis==
==Diagnosis==
===Diagnostic Criteria===
===Diagnostic Criteria===
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[[Category:Primary care]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]​​
[[Category:Up-To-Date]]
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Revision as of 16:57, 7 February 2018

Sialolithiasis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2] [3]

Overview

Historical Perspective

Sialolithiasis was first discovered by Küttner in 1986. Sialadenoscope were used for the first time in 1991.

Classification

There is no established system for the classification of sialolithisis, but it may be classified according to location of the stone, radiopaque or radiolucent, symptomatic or asymptomatic.

Pathophysiology

Sialolithiasis is the presence of stones within the salivary glands or the salivary gland ducts.The exact pathogenesis of sialolithiasis not fully understood but the relative stagnation of salivary flow and calcium concentration may be important. 75 percent of sialolithiasis cases are single. 3 percent of stones are bilateral and most of them are located in parotid glands. Stone formation is 80 to 90 percent in the submandibular gland, 6 to 20 percent in the parotid glands and 1 to 2 percent in the sublingual or minor salivary glands. Sialoadenitis is inflammation of a salivary gland. Acute sialoadenitis may be caused by viral or bacterial infection. Chronic sialoadenitis is caused by repeated episodes of inflammation. On gross pathology, hard yellow -white spherical depositions usually less than 1 cm are seen. On microscopic pathology, dilated ducts with squamous metaplasia or calculi are usually present.

Causes

The exact etiology of sialolithiasis is not well understood, but relative stagnation of salivary flow and calcium concentration may be important.

Differentiating Hereditary pancreatitis from Other Diseases

Sialolithiasis must be differentiated from other diseases that cause swelling in salivary glands, such as acute bacterial sialadenitis, chronic bacterial sialadenitis, viral sialadenitishuman immunodeficiency virus, radiation, and systemic diseases such as, sarcoidosis, and sjögren's syndrome.

Epidemiology and Demographics

The incidence of sialolithiasis is approximately 100 per 100,000 individuals in autopsy studies worldwide. The prevalence of sialolithiasis is approximately 450 per 100,000 individuals worldwide. Sialolithiasis commonly affects individuals between the ages of 30 and 60 years. There is no racial predilection to sialolithiasis. Men are more commonly affected by sialolithiasis than women.

Risk Factors

Common risk factors in the development of sialolithiasis include dehydrationduiretics, local traumasjögrens.

Screening

There is insufficient evidence to recommend routine screening for sialolithiasis.

Natural History, Complications, and Prognosis

If left untreated, patients with sialolithiasis may progress to develop secondary infection and chronic sialadenitis. Common complications of sialolithiasis include infection and recurrence. Prognosis is generally good.

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

References


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