Sialolithiasis: mineralogical composition, crystalline structure, calculus site, and epidemiological features.

The purpose of this paper was to describe the characteristics of salivary calculi and their relationship to epidemiological factors, through a cross-sectional study. We analysed 100 calculi obtained in 2017-2021. Patient data including age, time since onset of symptoms, gland involved, and site of location in the salivary system were studied. The calculi were studied to determine their morphological features using scanning electron microscopy and energy dispersive plain radiographic analysis. Most of the calculi had formed in the submandibular gland (SG) (82%). The mean age of patients at onset was 45.83 years; patients presenting parotid gland (PG) stones were somewhat older (p = 0.031). The mean time since the onset of symptoms was longer in PG calculi (p = 0.038). The most common lithiasis site was the main duct (74%), followed by the hilum (22%). Hilar stones were the largest (p < 0.05) and heaviest (p = 0.028). Octacalcium phosphate (OCP) was the most common crystalline phase (Cp) founded, followed by hydroxyapatite (HA) and whitlockite (WH). Specifically, OCP had a higher presence in PG calculi (p = 0.029) and WH was the most common phase in SG calculi (p = 0.017). The most prevalent site of lithiasis was the main duct, and the largest and heaviest calculi were found in the SG. PG stones were associated with a longer history of symptoms and older age. OCP was the most frequent Cp of the calculi studied, and the main Cp in PG stones. WH was the predominant Cp in SG stones. The Cp of the calculi was not influenced by location, patient age, or time of symptoms.

Risk Factors for Complications of Intraoral Removal of Submandibular Sialoliths.

PURPOSE: Intraoral removal of submandibular sialoliths is a surgical technique for the treatment of sialolithiasis and is reported to have excellent outcomes. The aim of this study was to determine the risk factors leading to complications of this procedure. PATIENTS AND METHODS: The medical records of 200 patients who had undergone intraoral removal of sialoliths from January 2006 through June 2015 were retrospectively reviewed. A telephone survey was used to check postoperative symptoms. Dry mouth, wound infection, lingual nerve dysfunction, and recurrence were considered complications. Computed tomograms of the neck were reviewed for location, shape, number, and size of the stone. RESULTS: Forty-four patients reported a complication. The incidence of complications was significantly higher in patients with stones in the proximal region of the salivary duct (proximal group) than in those with middle or distally located stones (middle/distal group; P < .05). The average stone size was larger in the proximal group; the operation time and length of admission also were longer in the proximal group, with a statistically significant difference (P < .05). Complaints of lingual nerve dysfunction were significantly higher in the proximal group than in the middle/distal group (P < .05). CONCLUSION: Patients with proximally located stones had more complications, especially lingual nerve dysfunction, than those with middle or distally located stones. The former group also required a longer operation time and hospital stay.

[Calcifications of the parotid space. A review]. / Calcifications de la loge parotidienne. Mise au point.

INTRODUCTION: Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space. MATERIAL AND METHODS: We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded. RESULTS: Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases. DISCUSSION: Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.

Evaluation of the prevalence of residual sialolith fragments after transoral approach of Wharton's duct.

Transoral submandibular duct sialolith removal is a simple technique with very few complications. Nevertheless, following this procedure, we have observed long-term calculus recurrence in a number of patients. We therefore elected to evaluate these cases. This was a monocentric prospective study performed between November 2013 and June 2014. All patients received surgery for submandibular gland lithiasis by intraoral removal of submandibular duct calculi. Between the day following the procedure and 3 months postsurgery, these patients systematically underwent an ultrasound examination of the submandibular gland. The study comprised 15 males and 15 females aged between 19 and 87 years, of which one male presented with bilateral calculi (n = 31). Asymptomatic sialolith fragments were found in 16% of patients. A statistically significant risk (p < 0.05) of residual sialolith was demonstrated in cases in which the calculus or multiple calculi fragmented perioperatively. Our aim was to remove the sialolith as non-traumatically as possible and to perform sialendoscopy at the end of the procedure to check the patency of the anterior ductal segment and to ensure that no residual calculus fragments were present despite the loss of fluid tightness subsequent to the opening of the hilum.

The incidence and composition of salivary stones (sialolithiasis) in Iran: analysis of 95 cases--a short report.

In a 3 year period 95 patients with sialolithiasis were studied, giving an annual incidence of 7.3 per 1000 admissions. The male to female ratio was 2.5:1. Salivary gland stones comprised 73.68 per cent (N = 70 patients). Chemical analysis of calculi taken from 88 patients, showed that 89.77 per cent (N = 79 patients) were with phosphate salts stones, 7.98 per cent (N = 7 patients) were with oxalate salts, and 2.27 per cent (N = 2 patients) were with urate salts. Salivary gland infection was present in 91.57 per cent (N = 87 patients) of whom 75.86 per cent (N = 66 patients) and 24.14 per cent (N = 21 patients) were females. A high ambient temperature and dehydration with poor oral hygiene are probable causative factors.