Sialolithiasis pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mahda Alihashemi M.D. [2]

Overview

Sialolithiasis is presence of stones within the salivary glands or the salivary gland ducts.The exact pathogenesis of sialolithias is not fully understood but 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 inflamamtion 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 usullay present.

Pathophysiology

Pathogenesis

Sialolithiasis :

  • The exact pathogenesis of sialolithias is not fully understood but relative stagnation of salivary flow and calcium concentration may be important.
  • Component of salivary stones include: [1]
    • Calcium phosphate
    • Hydroxyapatite
    • Magnesium
    • Ammonium
    • Potassium
  • 75 percent of sialadenosis cases are single
  • 3 percent of stones are bilateral and most of them are located in parotid glands.
  • Submandibular stones are the largest ones and are often located in the wharton ducts.
  • Parotid stones are the smaller than submandibular stones, and they are more located within the glands and they are more multiple.
  • Stones occur equally on the right and left sides.

Sialoadenitis

Associated Conditions

Gross Pathology

Sialolithiasis- By PGA (Own work), via Wikimedia Commons[6]
  • On gross pathology, hard yellow -white spherical depositions usually less than 1 cm in diameter is characteristic finding of sialolithiasis.[5]















Microscopic Pathology

References

  1. Williams MF (1999). "Sialolithiasis". Otolaryngol. Clin. North Am. 32 (5): 819–34. PMID 10477789.
  2. Mandel L (2014). "Salivary gland disorders". Med. Clin. North Am. 98 (6): 1407–49. doi:10.1016/j.mcna.2014.08.008. PMID 25443682.
  3. 3.0 3.1 McKenna JP, Bostock DJ, McMenamin PG (1987). "Sialolithiasis". Am Fam Physician. 36 (5): 119–25. PMID 3318353.
  4. Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L (2007). "Modern management of obstructive salivary diseases". Acta Otorhinolaryngol Ital. 27 (4): 161–72. PMC 2640028. PMID 17957846.
  5. 5.0 5.1 5.2 Moghe S, Pillai A, Thomas S, Nair PP (2012). "Parotid sialolithiasis". BMJ Case Rep. 2012. doi:10.1136/bcr-2012-007480. PMC 4543829. PMID 23242089.
  6. <"http://www.gnu.org/copyleft/fdl.html">GFDL, <"http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0 or <"https://creativecommons.org/licenses/by-sa/2.5-2.0-1.0">CC BY-SA 2.5-2.0-1.0], <"https://commons.wikimedia.org/wiki/File%3ASialolithiasis.jpg">

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