Conservative Management of Sialoliths

Abstract

Background: Sialoliths are calcified structures found within the ducts of salivary glands, frequently located in the submandibular gland (84%), than in the parotid gland (13%). Diagnosis is based on history of pain and swelling associated with eating and conventional mandibular occlusal radiograph. Conservative management of salivary stones consists of salivary gland massage and use of sialagogues.

Case description: 24 year female presented to the department with chief complain of swelling below left side of tongue since 10 month which was insidious onset, gradually progressive associated with swelling on eating. On clinical examination single, localized, well-defined swelling roughly oval approx. size about 5.5cm*3.5cm in maximum dimension on left side of floor of mouth extending antero-posteriorly from 31 to 37, mediolaterally from sublingual fold to mucogingival junction . Two hard granular structure of size approximately 3mm*4mm and 2mm*2mm dimension could be palpated lingual to 31 and 33. Mandibular occlusal radiograph revealed two non-homogenous radiopacities. First one was oval shaped, regular border size approximately 5mmx5mm on lingual aspect of 31, 5mm anterior to soft tissue shadow of tip of tongue and second one with irregular shape and border, size approximately 5mm*9 mm on lingual aspect 5mm posteriorly and laterally to the first one. Vitamin C was prescribed and patient was advised to take adequate fluid. Retrieval of both sialoliths was done by stimulating the salivary gland with the help of lemon and milking posterioanteriorly.

Conclusion: Conservative management can be done in case of small and accessible calculi to prevent post-operative complications.