gms | German Medical Science

Introduction: Sialolithiasis is said to be the most common disorder of the major salivary glands. Recurrent swelling and pain at mealtimes are typical symptoms. Ultrasound is an effective method of choice to confirm diagnosis. The present study collects more than 22 years of epidemiological data on patients treated for sialolithiasis

Methods: A retrospective analysis was performed on 2322 patients, between 1987 and 2009. The patients were classified into four different groups depending on their symptoms: 1– painful swelling; 2 – swelling; 3 – pain; 4 – no symptoms. Based on the ultrasound results, the stones were classified by their location and by their maximum diameter: group I: 1–5 mm; group II: 6–10 mm; group III: 11–15 mm; group IV: mm: >15 mm.

Results: 2959 stones were identified. 80.4% were submandibular stones (53% hilar/proximal, 37% distal, 10% intraparenchymal). 19.6% were parotid stones (83% in Stensen’s duct, 17% intraparenchymal). The main group suffered from swelling (50.3%) followed by painful swelling (41.6%) and pain (3.1%). Sialoliths had been discovered beforehand in the submandibular gland (p=0.00024; T-test). Multiple stones were found in 16.9% of patients. Average stone diameter in the submandibular gland was 8.3 mm (range 1–35 mm) and the 46% of the stones were in group II; in the parotid gland average diameter was 6.4 mm (range 1–31 mm) and 51% were in group I.

Conclusion: Nowadays, epidemiologic features and clinical manifestations of sialolithiasis play an important role, assisting not only in diagnosis but also in determining appropriate treatment. Due to their location and smaller diameter, parotid stones in some cases can only be treated using a surgical endoscopic technique. Submandibular stones more often require a combined approach.

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