DOI QR코드

DOI QR Code

Clinical, statistical and chemical study of sialolithiasis

  • Lim, Ho-Kyung (Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital) ;
  • Kim, Soung-Min (Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital)
  • Received : 2011.08.26
  • Accepted : 2011.11.24
  • Published : 2012.02.29

Abstract

Introduction: Sialolithes are initiated by localized deposition of calcified material in the salivary glands. And that may even cause various symptom especially swelling and pain. This study purposes to collect statistical data of sialolithiasis for clinical analysis. Materials and Methods: Among forty seven patients who have visited Seoul National University Dental Hospital during 2004-2009, patients' age, sex, location and size of stone, radiodensity of stone, symptom, surgical procedure were investigated. Statistical correlation between size, location, symptom was evaluated. Chemical composition was analyzed for 3 sialolithes. Results: The average age was 41.4 years. Sialolithiasis had slight female predilection (57.4%). Most cases occurred in the submandibular glands (91.5%). And most cases had radiopaque features (95.8%). The average size was 7.17 mm. The most frequent location of the stones were the duct orifice and the submandibular gland hilum (16 cases in each), followed by the middle part of the duct (n=8), the intraglandular area (n=4), and the proximal part of the duct (n=3). Eleven cases were asymptomatic. Thirty six cases had complaints of pain, swelling, hardness, and decrease in saliva flow (multiple symptoms). Various methods of surgery was performed. Two cases were self-removed. Thirty seven cases underwent procedure involving stone removal alone. Six cases underwent gland extirpation, and two cases underwent ductoplasty. Conclusion: There was no statistical correlation between size, location, and symptoms. Sialolith was composed of Ca (58.5-69.3%), P (30.7-35.7%), organic material, and trace inorganic material.

Keywords

References

  1. Escudier MP, McGurk M. Symptomatic sialoadenitis and sialolithiasis in the English population, an estimate of the cost of hospital treatment. Br Dent J 1999;186:463-6.
  2. Gorlin RJ, Goldman HM. Thoma's oral pathology. 6th ed. St. Louis: C.V. Mosby; 1970.
  3. Haubrich J. Clinical aspects of non-tumorous diseases of the salivary glands. Arch Otorhinolaryngol 1976;213:1-59.
  4. Lustmann J, Regev E, Melamed Y. Sialolithiasis. A survey on 245 patients and a review of the literature. Int J Oral Maxillofac Surg 1990;19:135-8.
  5. Nahlieli O, Eliav E, Hasson O, Zagury A, Baruchin AM. Pediatric sialolithiasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:709-12.
  6. Ledesma-Montes C, Garcés-Ortíz M, Salcido-García JF, Hernández-Flores F, Hernández-Guerrero JC. Giant sialolith: case report and review of the literature. J Oral Maxillofac Surg 2007;65:128-30.
  7. Bodner L. Giant salivary gland calculi: diagnostic imaging and surgical management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:320-3.
  8. Bodner L. Salivary gland calculi: diagnostic imaging and surgical management. Compendium 1993;14:572.
  9. Capaccio P, Bottero A, Pompilio M, Ottaviani F. Conservative transoral removal of hilar submandibular salivary calculi. Laryngoscope 2005;115:750-2.
  10. Escudier MP. The current status and possible future for lithotripsy of salivary calculi. Atlas Oral Maxillofac Surg Clin North Am 1998;6:117-32.
  11. Harrison JD, Triantafyllou A, Garrett JR. Ultrastructural localization of microliths in salivary glands of cat. J Oral Pathol Med 1993;22:358-62.
  12. Marchal F, Kurt AM, Dulguerov P, Lehmann W. Retrograde theory in sialolithiasis formation. Arch Otolaryngol Head Neck Surg 2001;127:66-8.
  13. Teymoortash A, Buck P, Jepsen H, Werner JA. Sialolith crystals localized intraglandularly and in the Wharton's duct of the human submandibular gland: an X-ray diffraction analysis. Arch Oral Biol 2003;48:233-6.
  14. Norman JED, McGurk M. Color atlas and text of the salivary glands diseases, disorders and surgery. London: Mosby-Wolfe; 1995.
  15. Kasaboğlu O, Er N, Tümer C, Akkocaoğlu M. Micromorphology of sialoliths in submandibular salivary gland: a scanning electron microscope and X-ray diffraction analysis. J Oral Maxillofac Surg 2004;62:1253-8.
  16. Yamamoto H, Sakae T, Takagi M, Otake S. Scanning electron microscopic and X-ray microdiffractometeric studies on sialolithcrystals in human submandibular glands. Acta Pathol Jpn 1984;34:47-53.
  17. Anneroth G, Eneroth CM, Isacsson G. Crystalline structure of salivary calculi. A microradiographic and microdiffractometric study. J Oral Pathol 1975;4:266-72.
  18. Koutsoukos PG, Nancollas GH. Crystal growth of calcium phosphates-epitaxial considerations. J Cryst Growth 1981;53:10-9.
  19. Schratter M, Steiner E, Imhof H. Conventional roentgen diagnosis of the salivary glands. Still of clinical value or "traditional care"-. Radiologe 1994;34:248-53.
  20. Avrahami E, Englender M, Chen E, Shabtay D, Katz R, Harell M. CT of submandibular gland sialolithiasis. Neuroradiology 1996;38:287-90.
  21. Becker M, Marchal F, Becker CD, Dulguerov P, Georgakopoulos G, Lehmann W, et al. Sialolithiasis and salivary ductal stenosis: diagnostic accuracy of MR sialography with a three-dimensional extended-phase conjugate-symmetry rapid spin-echo sequence. Radiology 2000;217:347-58.
  22. Wackym PA, Rice DH, Schaefer SD. Minimally invasive surgery of the head, neck and cranial base. Philadelphia: Lippincott Williams & Wilkins; 2002.
  23. Gundlach P, Hopf J, Linnarz M. Introduction of a new diagnostic procedure: salivary duct endoscopy (sialendoscopy) clinical evaluation of sialendoscopy, sialography, and X-ray imaging. Endosc Surg Allied Technol 1994;2:294-6.
  24. Hald J, Andreassen UK. Submandibular gland excision: shortand long-term complications. ORL J Otorhinolaryngol Relat Spec 1994;56:87-91.
  25. Beahrs OH. The facial nerve in parotid surgery. Surg Clin North Am 1963;43:973-7.
  26. Dulguerov P, Marchal F, Lehmann W. Postparotidectomy facial nerve paralysis: possible etiologic factors and results with routine facial nerve monitoring. Laryngoscope 1999;109:754-62.
  27. Ellies M, Laskawi R, Arglebe C, Schott A. Surgical management of nonneoplastic diseases of the submandibular gland. A follow-up study. Int J Oral Maxillofac Surg 1996;25:285-9.
  28. Berini-Aytes L, Gay-Escoda C. Morbidity associated with removal of the submandibular gland. J Craniomaxillofac Surg 1992;20:216-9.
  29. Bates D, O'Brien CJ, Tikaram K, Painter DM. Parotid and submandibular sialadenitis treated by salivary gland excision. Aust N Z J Surg 1998;68:120-4.
  30. Moody AB, Avery CM, Taylor J, Langdon JD. A comparison of one hundred and fifty consecutive parotidectomies for tumours and inflammatory disease. Int J Oral Maxillofac Surg 1999;28:211-5.
  31. Amin MA, Bailey BM, Patel SR. Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study. Br J Oral Maxillofac Surg 2001;39:348-52.
  32. Makdissi J, Escudier MP, Brown JE, Osailan S, Drage N, McGurk M. Glandular function after intraoral removal of salivary calculi from the hilum of the submandibular gland. Br J Oral Maxillofac Surg 2004;42:538-41.
  33. Yoshimura Y, Morishita T, Sugihara T. Salivary gland function after sialolithiasis: scintigraphic examination of submandibular glands with 99mTc-pertechnetate. J Oral Maxillofac Surg 1989;47: 704-10.
  34. Marchal F, Kurt AM, Dulguerov P, Becker M, Oedman M, Lehmann W. Histopathology of submandibular glands removed for sialolithiasis. Ann Otol Rhinol Laryngol 2001;110:464-9.
  35. Nahlieli O, Shacham R, Bar T, Eliav E. Endoscopic mechanical retrieval of sialoliths. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:396-402.
  36. Nahlieli O, Nakar LH, Nazarian Y, Turner MD. Sialoendoscopy: A new approach to salivary gland obstructive pathology. J Am Dent Assoc 2006;137:1394-400.
  37. Ziegler CM, Steveling H, Seubert M, Muhling J. Endoscopy: a minimally invasive procedure for diagnosis and treatment of diseases of the salivary glands. Six years of practical experience. Br J Oral Maxillofac Surg 2004;42:1-7.