The unique characteristics of sialolithiasis following drug-induced hyposalivation.

OBJECTIVES: Assess clinical, imaging, operative, and post-operative characteristics of drug-induced vs. non-drug-induced sialolithiasis that are termed 'other etiologies of sialolithiasis.' MATERIALS AND METHODS: Data collected from a retrospective cohort of 96 patients who underwent intra-oral sialolith removal operations were categorized as patient disease characteristics, physical examination results, and imaging and therapeutic features. Patients were divided into two groups based on having drug-induced sialolithiasis (DIS) vs. other etiologies of sialolithiasis (OES). Patients who consumed any medication for chronic conditions were regarded as DIS. Statistical analyses were conducted to elucidate differences and similarities between the two groups. RESULTS: There were 60 patients in the DIS group and 36 in the OES group. DIS patients were significantly older (average age 57.9 vs. 39.8 years, respectively), with no gender predilection. Statins and anti-hypertensive medications were most commonly consumed. Presenting symptoms including number of past swellings, salty tasting saliva, pain, and antibiotic treatment were similar between the groups; mealtime-related swelling of the gland was noted in a higher proportion of OES patients (51.5% vs. 37%, respectively). Analysis of sialolith size and location from fixed anatomical landmarks on the mandible were not different between groups, and the most frequent sialolith location was the hilus gland in DIS vs. intra-glandular in OES patients. Sialolith removal operation time was significantly shorter for DIS patients (45 ± 11.5 vs. 61.1 ± 18.1 minutes). CONCLUSION: Drug-induced sialolithiasis may be regarded as a unique entity with a typical clinical age, presenting symptoms, imaging characteristics, and surgery duration. CLINICAL RELEVANCE: Clinicians should be aware of the above-mentioned differences when treating patients with sialolithiasis and anticipate a more challenging sialolith removal procedure for other etiologies of sialolithiasis, possibly due to underlying anatomical factors of the duct system. When treating drug-induced sialolithiasis, clinicians can expect a shorter operation time with a similar success rate and hospitalization time as with a younger, healthier population with other sialolithiasis etiologies.

Possible Drug-Associated Sialolithiasis From the Bicarbonate Anhydrase Inhibitor Topiramate: A Case Report and Literature Review.

Topiramate is an antiepileptic drug indicated for the treatment of seizure disorders, migraine prophylaxis, and, more recently, weight loss. This new indication will likely increase the use of this agent significantly. As a carbonic anhydrase inhibitor, topiramate can affect the pH of bodily fluids and is known to increase the risk of nephrolithiasis. However, as discussed in the present report, these properties also result in an as yet unaddressed risk of the development of sialoliths, calcified stones formed in the salivary duct or glands. The physiologic mechanisms for stone development in the salivary gland are reviewed and the pharmacologic effects of topiramate on sialolith formation discussed. The present report describes a female patient treated with topiramate for migraine prophylaxis who subsequently presented with a sialolith in the left submandibular duct.

[The effect of the hypercalcaemia on the major salivary glands of the rat]. / E epidrase tes hyperasbestiaimias stous megalous sialogonous adenes. Peiramatike melete se epimys.

Although hypercalcaemia is considered to be aetiological factor of nephrocalcinosis and uroliths formation, its effect on the major salivary glands, where lithiasis is frequent, has not been studied enough. The purpose of this project was the parallel histologic study of the effect of experimentally induced hypercalcaemia on the kidney and the major salivary glands of the rat. Temporary hypercalcaemia was induced in 17 females rates after 8 daily intraperitoneal doses 1.5 ml of 10% calcium gluconate. After the fixation of the tissues in 4% formaldehyde containing 1% CaCl2, serial sections were stained with haematoxylin and eosin and Von Kossa's method for calcified deposits. In the kidneys calcified deposits were observed in the cytoplasm of the cells of the proximal convoluted tubules, in the basement membrane, and their lumen. The major salivary glands were normal. Calcified deposits were not observed in the glandular parenchyma either in the lumina. The results suggest that during hypercalcaemia the transcellular transport of the calcium continue to be under the normal influence of the autonomic nervous system, preventing the formation of calcified deposits.