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Muacevic A, Adler JR, Browning S. Sweet Shop Sialagogues: A Sour Solution to Sialolithiasis. Cureus 2022; 14:e32097. [PMID: 36601206 PMCID: PMC9803858 DOI: 10.7759/cureus.32097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/03/2022] Open
Abstract
Historically, boiled sweets have been recommended by ear, nose, and throat surgeons for their sialagogue effect in patients with sialolithiasis. This study presents an in vivo analysis of boiled sweets and solutions to determine sialagogue superiority. Six high-street boiled sweets (lemon sherbets, rhubarb sweets, mint humbugs, Werther's Original® (August Storck, Germany), Fox's Glacier Fruits® (Fox's Confectionery, Braunstone, Leicester, United Kingdom), and Chupa Chups® lollipops (Perfetti Van Melle, Breda, Netherlands)) and two solutions (malt vinegar and lemon juice) were compared to two controls (no sweet and inert plastic) in two healthy participants. Malt vinegar and lemon juice produced the highest salivary flow. The best-performing boiled sweets were Chupa Chups lollipops and lemon sherbet. Substances with the highest concentrations of citric or lactic acid were the best sialagogues. This pilot study provides a proof of concept for further investigation in this cohort of patients.
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Mathew J, Pothanikat JJK, Vinod Kumar RB, Padikadan NO, Arakkal NJ. Extremely Large Submandibular Sialolith Removal - A Case Report. Ann Maxillofac Surg 2022; 12:237-239. [PMID: 36874773 PMCID: PMC9976846 DOI: 10.4103/ams.ams_75_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023] Open
Abstract
The Rationale Sialoliths are calcified organic matter that form within the secretory system of the salivary glands. They rarely measure more than 1.5 cm. Giant sialoliths are rare and defined as a size of 3.5 cm or larger. Patient concerns Patient complained of the pain and swelling in the right submandibular area for two years with increase in size during meals. Diagnosis Based on the clinical and radiological investigations. Treatment Sialolith measuring 39 mm and weighing 7.02 g, was removed in a minimally invasive manner through transoral sialolithotomy using diode 810 µm LASER unit under local anaesthesia. Outcomes Patient was relieved of the preoperative symptoms and was on follow-up for one year. Take-Away Lessons Various newer treatment modalities are effective alternatives to conventional surgical treatment of sialoliths. However, transoral sialolithotomy remains the mainstay of management.
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Affiliation(s)
- Justin Mathew
- Department of Oral and Maxillofacial Surgery, The Malabar Dental College, Malappuram, Kerala, India
| | | | - R. B. Vinod Kumar
- Department of Oral and Maxillofacial Surgery, The Malabar Dental College, Malappuram, Kerala, India
| | - Naveen Odiyil Padikadan
- Department of Oral and Maxillofacial Surgery, The Malabar Dental College, Malappuram, Kerala, India
| | - Neeta Joy Arakkal
- Department of Oral and Maxillofacial Surgery, The Malabar Dental College, Malappuram, Kerala, India
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Abstract
Sialolithiasis is a commonly encountered disease of the salivary glands, reported to represent up to 30% of all salivary gland diseases. However, the condition is rarely encountered in the pediatric population. The formation of a salivary stone is believed to be secondary to the deposition of calcium salts around a nidus. The formation of a nidus is commonly associated with desquamated epithelial or sloughing from a recent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. Neglected and poorly treated acute infection may progress to life-threatening abscess formation. Here we are describing our encounter with a 10-year-old boy with recurrent submandibular sialolithiasis. He was initially treated with conservative measures and antibiotics regimen. Failure of medical treatment and recurring symptoms led to submandibular gland excision followed by a full recovery.
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Affiliation(s)
- How Kit Thong
- Otolaryngology - Head and Neck Surgery, Hospital Sultan Ismail, Johor Bahru, MYS.,Otolaryngology - Head and Neck Surgery, KPJ Healthcare University College, Nilai, MYS
| | - Hafiz Mohamad Mahbob
- Otolaryngology - Head and Neck Surgery, Hospital Sultan Ismail, Johor Bahru, MYS
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Gellrich D, Bichler M, Reichel CA, Schrötzlmair F, Zengel P. Salivary Gland Disorders in Children and Adolescents: A 15-year Experience. Int Arch Otorhinolaryngol 2020; 24:e31-e37. [PMID: 31929831 PMCID: PMC6952288 DOI: 10.1055/s-0039-1697993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 08/04/2019] [Indexed: 11/07/2022] Open
Abstract
Introduction
Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections.
Objective
To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years.
Methods
A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016.
Results
Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolaryngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties – resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improvements in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis.
Conclusions
Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unnecessarily long period of suffering despite a favorable outcome following the correct treatment.
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Affiliation(s)
- Donata Gellrich
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Moritz Bichler
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christoph A Reichel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Florian Schrötzlmair
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Pamela Zengel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
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Abstract
This study aimed to evaluate the association between cholelithiasis and sialolithiasis using a national sample cohort in Korea.The Korean National Health Insurance Service-National Sample Cohort (patients ≥20 years old) was collected from 2002 to 2013. In study I, we extracted cholelithiasis patients (n = 21,170) and 1:4 matched control I subjects (n = 84,680) and analyzed the occurrence of sialolithiasis. In study II, we extracted sialolithiasis patients (n = 761) and 1:4 matched control II subjects (n = 3044) and analyzed the occurrence of cholelithiasis. Hazard ratios (HRs) were determined using the stratified Cox proportional hazard model.The HR for sialolithiasis was 1.49 (95% CI = 0.88-2.52) in the cholelithiasis group (P = .14), and the HR for cholelithiasis was 1.18 (95% CI = 0.53-2.59) in the sialolithiasis group (P = .69).We did not find an association between cholelithiasis and sialolithiasis.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam
| | | | - Hyun Lim
- Department of Internal Medicine, Hallym University College of Medicine, Anyang
| | - Man Sup Lim
- Department of General Surgery, Hallym University College of Medicine, Chuncheon
| | - Miyoung Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang
| | - Il-Seok Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Dongtan, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery
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Kessler AT, Bhatt AA. Review of the Major and Minor Salivary Glands, Part 1: Anatomy, Infectious, and Inflammatory Processes. J Clin Imaging Sci 2018; 8:47. [PMID: 30546931 PMCID: PMC6251248 DOI: 10.4103/jcis.jcis_45_18] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 10/06/2018] [Indexed: 11/18/2022] Open
Abstract
The major and minor salivary glands of the head and neck are important structures that contribute to many of the normal physiologic processes of the aerodigestive tract. The major salivary glands are routinely included within the field of view of standard neuroimaging, and although easily identifiable, salivary pathology is relatively rare and often easy to overlook. Knowledge of the normal and abnormal imaging appearance of the salivary glands is critical for forming useful differential diagnoses, as well as initiating proper clinical workup for what are often incidental findings. The purpose of this review is to provide a succinct image-rich article illustrating relevant anatomy and pathology of the salivary glands via an extensive review of the primary literature. In Part 1, we review anatomy as well as provide an in-depth discussion of the various infectious and inflammatory processes that can affect the salivary glands.
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Affiliation(s)
- Alexander T Kessler
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Alok A Bhatt
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
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Faizal B, Gangadharan S, Thankappan K. Comparison between Sialendoscopy and Conventional Methods in the Treatment of Sialolithiasis. Malays J Med Sci 2017; 24:94-100. [PMID: 29386976 DOI: 10.21315/mjms2017.24.5.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 09/07/2017] [Indexed: 10/18/2022] Open
Abstract
Background Sialendoscopy is gaining in popularity in treating calculus disease. The delicacy of the instrument and the diameter of the salivary ducts are factors that limit the ability to achieve complete success. There is also continued speculation regarding the utility of the procedure, especially among clinicians who are masters of conventional methods like sialadenectomy and sialodochotomy. Objective To assess the efficacy of sialendoscopy over conventional methods in treating sialolithiasis. Methods A prospective case control study was conducted in a tertiary care centre; this study involved 50 patients of sialolithiasis, and it extended over a 36-month period. All had undergone treatment, either by conventional methods or interventional sialendoscopy. All patients with nonpalpable calculi smaller than 6 mm underwent interventional sialendoscopy. Failed sialendoscopies and larger nonpalpable calculi were removed through sialadenectomy. The outcome variables studied included calculus removal, postoperative symptoms, and gland preservation. Results The success rate in terms of calculus removal by sialendoscopy was 88%, versus 100% by sialadenectomy. The salivary gland was preserved in 88% of the cases in the sialendoscopy group. Only 12% of patients were symptomatic. Conclusion Sialendoscopy was effective in removing calculi of various sizes; it was definitely superior to conventional methods. Sialadenectomy should be reserved for cases either not suitable for sialendoscopy or in which there was an intervention failure.
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Affiliation(s)
- Bini Faizal
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham, Kochi, India
| | - Sangeetha Gangadharan
- Department of ENT, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham, Kochi, India
| | - Krishnakumar Thankappan
- Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeedham, Kochi, India
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Rzymska-Grala I, Stopa Z, Grala B, Gołębiowski M, Wanyura H, Zuchowska A, Sawicka M, Zmorzyński M. Salivary gland calculi - contemporary methods of imaging. Pol J Radiol 2010; 75:25-37. [PMID: 22802788 PMCID: PMC3389885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Accepted: 06/15/2009] [Indexed: 11/21/2022] Open
Abstract
Sialolithiasis is the most common disorder of major salivary glands. The main site of salivary stones' formation is submandibular gland, followed by parotid and sublingual gland. The aim of this article was to present current diagnostic imaging modalities carried out in patients suspected with salivary stones on the basis of own material and review of literature.Current diagnostic imaging tools used in the imaging of salivary stones were described and illustrated in this paper. These are: conventional radiography, sialography, ultrasonography, computed tomography, magnetic resonance sialography and sialoendoscopy.Digital subtraction sialography and ultrasonography are the methods of choice in the imaging of salivary gland calculi. Although sialography is a very old diagnostic method, still it is the best diagnostic tool in the imaging of subtle anatomy of salivary gland duct system. Digital subtraction sialography can show the exact location of salivary stone and enables imaging of salivary ducts' pathology (e.g. stenoses), which is especially important when sialoendoscopy is planned. Sialography is also used as the treatment method, i.e. interventional sialography. Nonenhanced computed tomography is recommended when multiple and tiny salivary stones are suspected. Magnetic resonance imaging is the evolving alternative diagnostic method. In this diagnostic modality there is no need for salivary ducts' cannulation and administration of contrast material. Thus magnetic resonance sialography can also be carried out in the acute sialoadenitis. In the future, sialoendoscopy may become one of the main diagnostic and treatment procedures for salivary duct disorders, especially in salivary stone cases.
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Affiliation(s)
- Iwona Rzymska-Grala
- I Institute of Clinical Radiology of the Medical University of Warsaw, Warsaw, Poland,Author’s address: Iwona Rzymska-Grala, I Institute of Clinical Radiology of the Medical University of Warsaw, Chałubińskiego 5 Str., 02-004 Warsaw, Poland, e-mail:
| | - Zygmunt Stopa
- Cranium, Jaw & Face Surgery Clinic of the Medical University of Warsaw, Warsaw, Poland
| | - Bartłomiej Grala
- Department of Pathology of the Military Institute of Medicine, Warsaw. Poland
| | - Marek Gołębiowski
- I Institute of Clinical Radiology of the Medical University of Warsaw, Warsaw, Poland
| | - Hubert Wanyura
- Cranium, Jaw & Face Surgery Clinic of the Medical University of Warsaw, Warsaw, Poland
| | - Anna Zuchowska
- I Institute of Clinical Radiology of the Medical University of Warsaw, Warsaw, Poland
| | - Monika Sawicka
- I Institute of Clinical Radiology of the Medical University of Warsaw, Warsaw, Poland
| | - Michał Zmorzyński
- Cranium, Jaw & Face Surgery Clinic of the Medical University of Warsaw, Warsaw, Poland
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