Non-neoplastic salivary gland diseases in children: a 10-year review at a tertiary center.

OBJECTIVES: Non-neoplastic salivary gland diseases are rare in children. This paper aims to present the spectrum of encountered non-neoplastic salivary gland diseases at a tertiary center by describing the demographics, clinical characteristics, and outcomes in this patient population. METHODS: A review of electronic medical records was performed from 2010 until 2020. Relevant data were retrieved and charted according to the type of salivary gland disease. A comparison between diseases was made for demographics, presenting symptoms, treatment, and outcomes. RESULTS: Fifty patients with 11 different non-neoplastic salivary gland diseases were identified. Sialolithiasis was the most prevalent condition (12/50), with 83% localized in the submandibular gland. In contrast to gender, age, and symptoms, the location of pathology was significantly associated with the diagnosis (p < 0.001). In patients with sialolithiasis, a hybrid procedure (combined endoscopy and lithotomy) resulted in 100% resolution of symptoms. For (plunging) ranula, marsupialisation had a relative risk of recurrence of 9.6 compared to (partial) extirpation of the sublingual gland. CONCLUSIONS: Children with salivary gland diseases present with overlapping symptoms, making clinical diagnosis challenging. The present study may aid physicians and specialists in diagnosing the most prevalent conditions in children. Although no gold standards exist for their treatment, hybrid procedures (sialolithiasis) and subglingual gland extirpation (ranula) showed superior results over alternatives.

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.

The association between sialolithiasis and smoking, alcohol drinking and obesity in Korea: a nested case-control study.

BACKGROUND: Smoking and alcohol consumption are the most common social habits in patients with sialolithiasis. Moreover, obesity has been reported to have a significant association with poor oral hygiene, one of the causes of sialolithiasis. The purpose of this study was to evaluate the relationships among tobacco smoking, drinking alcohol, obesity and sialolithiasis in a Korean population. METHODS: The Korean National Health Insurance Service-Health Screening Cohort, which includes patients ≥40 years old, was assessed from 2002 to 2013. A total of 947 sialolithiasis participants were matched with 3788 control subjects at a ratio of 1:4 with respect to age group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed the participants' previous histories of smoking (current or past smokers compared to nonsmokers) and alcohol consumption (≥ 1 time per week compared to < 1 time per week) in the sialolithiasis and control groups. Obesity was measured using body mass index (BMI, kg/m2), which was categorized as < 18.5 (underweight), ≥ 18.5 and < 23 (normal), ≥ 23 and < 25 (overweight), ≥ 25 and < 30 (obese I), and ≥ 30 (obese II). Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression analyses. RESULTS: The rate of smoking was higher in the sialolithiasis group (32.4% [307/947]) than in the control group (29.1% [1103/3788], P = 0.047). The adjusted OR of smoking for the sialolithiasis group was 1.31 (95% CI = 1.08-1.59, P = 0.006). Alcohol consumption and obesity were not statistically significantly related to sialolithiasis. CONCLUSION: The odds of smoking were increased in sialolithiasis patients compared with control subjects in the population ≥ 40 years of age.

Salivary Gland Disorders in Children and Adolescents: A 15-year Experience

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 otorhinolar- yngologists, 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 improve- ments 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 unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.

A case-control study of the association between sialolithiasis and osteoporosis.

OBJECTIVE: The purpose of this study was to evaluate the association between osteoporosis and salivary gland stone using a population-based claims database. DESIGN: A case-control design. SETTING: Taiwan. PARTICIPANTS: We retrieved the sample for this case-control study from the Taiwan "Longitudinal Health Insurance Database 2005." All 557 patients aged 40 years or older with a diagnosis of sialolithiasis were cases, and 1671 matched controls (without sialolithiasis) were selected. SUBJECTS AND METHODS: We used the chi-square test to explore differences between cases and controls on socio-demographic characteristics. Furthermore, conditional logistic regressions were used to examine the association of sialolithiasis with previously diagnosed osteoporosis. RESULTS: Of 2228 sampled patients, 171 (7.68%) had ever been previously diagnosed with osteoporosis; 58 (10.41%) among cases and 113 (6.76%) among controls (P = 0.005). Conditional logistic regression analysis found that the odds ratio (OR) of prior osteoporosis for cases was 1.79 (95% confidence interval [CI]: 1.24-2.59, P = 0.002) relative to controls after adjusting for urbanisation and the selected medical co-morbidities. Furthermore, we found that among patients aged ≥65 years, the adjusted OR of prior osteoporosis for cases was 1.89 (95% CI = 1.02-3.51). No significant relationship was observed among patients aged <65 years old. CONCLUSION: This study demonstrates an association between sialolithiasis and osteoporosis. Although the finding warrants further investigation, the results call for more awareness of the possible concurrence of osteoporosis among physicians and patients with salivary gland stones.

Adenoid Cystic Carcinoma With Sialolithiasis of the Left Submandibular Gland: A Case Report and Literature Review.

Adenoid cystic carcinoma is one of the most common salivary gland malignancies with poor long-term prognosis, but the coexistence of sialoliths is extraordinarily rare. In this article, we report a case of 30-year-old woman with a history of submandibular area swelling with intermittent pain increasing during mealtimes that had led her attending physician to diagnose a sialolith in the left submandibular gland on a radiograph 10 years before. However, the surgical specimen proved to be an adenoid cystic carcinoma accompanied with a sialolith. Histopathologically, the submandibular gland was displaced with a fibrous granulation tissue containing a small cribriform carcinoma invading the extracapsular region of the gland. We performed fluorescence in situ hybridization examination with an MYB-NFIB fusion probe of the lesion, with positive results. The patient underwent a supraomohyoid neck dissection as additional procedure because of the possibility of the extracapsular cancer nest remaining around the submandibular gland, but she remains well and disease free 11 years after the first operation.

Incidence of sialolithiasis in Denmark: a nationwide population-based register study.

Sialolithiasis is a frequent disorder affecting the salivary glands. The incidence rate (IR) has been reported to be 2.9-5.5 per 100,000 person-years, but all previous studies have been based on selected hospital data. In this study, we conducted a population-based study evaluating the IR of sialolithiasis and the IR variation according to age, gender and geography in Denmark. We included data from hospitals as well as from private ear, nose and throat (ENT) clinics. The study was based on registry data on all sialolithiasis cases in Denmark between 2003 and 2009 extracted from the Danish National Patient Registry (hospital cohort) and the Danish Regions Centre for Healthcare Statistics (private ENT clinic cohort). To validate the diagnosis, the proportion of visually confirmed cases was estimated based on patient records from subsamples of the two cohorts. The IR was 7.27 and 14.10 per 100,000 person-years based on visually confirmed cases only and on all cases, respectively. The highest IR was observed among 60- to 70-year-olds, in the North Denmark region and among females. In the validation subsamples, 35% of assumed sialoliths were visually confirmed in the private ENT clinic cohort and 59% in the hospital cohort. In this first population-based study of IR on sialolithiasis, we found a substantially higher IR. With respect to both visually confirmed cases and all cases, this is higher than previously reported from studies based on selected hospital data.

Does saliva composition affect the formation of sialolithiasis?

OBJECTIVE: Saliva composition may affect sialolithiasis formation; thus, this study compared the salivary inorganic composition of sialolithiasis patients with that of healthy controls, and determined whether salivary inorganic composition changes after sialolithiasis surgery. METHODS: The study included 40 patients with sialolithiasis and 40 matched healthy controls. Patients were examined before and after sialolithiasis surgery; controls were examined once. Flow rate and the inorganic saliva composition in unstimulated whole saliva were assessed. RESULTS: Patients' salivary flow prior to surgery was significantly lower compared to that of healthy controls, but equalised after surgery. Prior to surgery, patients' saliva exhibited higher concentrations of calcium, magnesium, phosphorous compared to that of healthy controls. The concentration of most ions remained high after sialolithiasis surgery. CONCLUSION: Sialolithiasis patients had increased salivary concentrations of the ions that constitute the main inorganic phase of most sialoliths, and this may confer a risk for developing sialolithiasis.

Pediatric sialendoscopy in Asians: A preliminary report.

BACKGROUND/PURPOSE: The sialendoscopic approach in treating pediatric salivary gland disorders has been reported with great success through the years. Whereas this success has been widely reported in Caucasian populations, relatively little has been reported regarding the use of this procedure in pediatric patients in Asian countries. The purpose of this study is to report our preliminary experience in pediatric sialendoscopy. METHODS: The data from 20 patients (<18years old), who underwent sialendoscopy for obstructive sialoadenitis in the Department of Otorhinolaryngology of Mackay Memorial Hospital between October 2013 and November 2015, were reviewed. RESULTS: Twelve of our 20 patients (60%) were diagnosed with sialolithiasis and 8 of our 20 patients (40%) presented with non-lithiasis obstructive sialoadenitis. Ductal stenosis was found in 13 patients, and 18 patients had debris/mucous plug formation. The overall success rate was 95% (19/20) in our series, and 85% (17/20) of the patients had achieved a complete remission after a single sialendoscopy procedure. CONCLUSIONS: Sialendoscopy is an ideal treatment in the management of obstructive sialoadenitis in Asian pediatric patients. If necessary, Holmium:YAG laser lithotripsy and sialostent placement could be applied, and both procedures are well tolerated in pediatric patients.

Sialolithiasis is associated with nephrolithiasis: a case-control study.

CONCLUSIONS: This study demonstrates an association between sialolithiasis and nephrolithiasis. The results call for more awareness of this association among physicians and patients with nephrolithiasis. OBJECTIVE: Very few empirical studies have been conducted to explore the potential association between sialolithiasis and nephrolithiasis. As such, the association between sialolithiasis and nephrolithiasis still remains unclear. This study aimed to explore the possible association between sialolithiasis and nephrolithiasis using a population-based dataset. METHODS: Using data from the Taiwan Longitudinal Health Insurance Database 2005, this case-control study identified 966 patients with sialolithiasis as cases and 2898 sex- and age-matched subjects without sialolithiasis as controls. Conditional logistic regressions were conducted to examine the association of sialolithiasis with previously diagnosed nephrolithiasis. RESULTS: Out of 3864 sampled patients, 165 (4.27%) had prior nephrolithiasis. Using Chi-square test, it was found that there was a significant difference in the prevalence of prior nephrolithiasis between the cases and controls (10.25% vs 2.28%, p < 0.001). Moreover, by conditional logistic regression analysis, the odds ratio of prior nephrolithiasis for cases was 4.74 (95% CI = 3.41-6.58, p < 0.001) when compared to controls after adjusting for monthly income, geographic location, urbanization level of residence, diabetes, hypertension, heart failure, chronic renal disease, and tobacco use.

Association of sialolithiasis with cholelithiasis: A population-based study.

BACKGROUND: The purpose of this study was to evaluate the association between cholelithiasis and developing sialolithiasis using a population-based coverage database. METHODS: The data for this study were sourced from the Taiwan Longitudinal Health Insurance Database. We included 745 subjects with sialolithiasis as cases and 3725 sex-matched and age-matched subjects without sialolithiasis as controls. RESULTS: Chi-square test revealed a significant difference in the prevalence of prior cholelithiasis between the cases and controls (8.6% vs 4.1%; p < .001). Furthermore, conditional logistic regression analysis indicated that the odds ratio (OR) of prior cholelithiasis for the cases was 2.19 (95% confidence interval [CI] = 1.62-2.98) when compared with the controls after adjusting for monthly income, geographic location, urbanization level, and tobacco use disorder. The adjusted OR of prior cholelithiasis for cases was 2.20 (95% CI = 1.46-3.33) and 2.15 (95% CI = 1.38-3.42) than controls for men and women, respectively. CONCLUSION: This study demonstrates an association between sialolithiasis and cholelithiasis.

Patient-perceived benefit of sialendoscopy as measured by the Glasgow Benefit Inventory.

OBJECTIVES/HYPOTHESIS: Evaluate the patient-perceived effect of sialendoscopy on patients with obstructive symptoms from the salivary glands. STUDY DESIGN: Retrospectively identified cohort used for a prospective study of all consecutive patients at the Department of Otorhinolaryngology at Vejle Hospital, Vejle, Denmark, March 2009 to December 2013. METHODS: By chart review we recorded the patient's age, gender, date of the sialendoscopy, type of gland, sialolithiasis, successful extraction of sialolithiasis, stenosis of salivary ducts, dilation, type of saliva, and surgeon. The follow-up was done by applying the Glasgow Benefit Inventory questionnaire by letter and telephone. RESULTS: There were 130 sialendoscopies performed on 116 patients. Of these, 24 patients were excluded due to subsequent surgery. Thus, 92 patients were eligible, of whom 80 responded, giving an 87% response rate. The Glasgow Benefit Inventory score had a predicted overall mean of 13.4 (95% confidence interval: 9.9 to 17.2). Significant positive outcomes by multiple regression were the presence of stones (P = 0.015) and examination of the parotid gland (P = 0.041). CONCLUSIONS: Overall, there is a significant patient-perceived benefit from sialendoscopy, which is comparable to the benefit from tonsillectomy. The benefit is significantly higher if stones are found than not and for examination of the parotid gland as compared to the submandibular gland. LEVEL OF EVIDENCE: 4

Does drinking water influence hospital-admitted sialolithiasis on an epidemiological level in Denmark?

OBJECTIVES: Sialolithiasis, or salivary stones, is not a rare disease of the major salivary glands. However, the aetiology and incidence remain largely unknown. Since sialoliths are comprised mainly of calcium phosphate salts, we hypothesise that drinking water calcium levels and other elements in drinking water could play a role in sialolithiasis. Owing to substantial intermunicipality differences in drinking water composition, Denmark constitutes a unique environment for testing such relations. DESIGN: An epidemiological study based on patient data extracted from the National Patient Registry and drinking water data from the Geological Survey of Denmark and Greenland retrieved as weighted data on all major drinking water constituents for each of the 3364 waterworks in Denmark. All patient cases with International Statistical Classification of Diseases 10th Revision (ICD-10) codes for sialolithiasis registered between the years 2000 and 2010 were included in the study (n=3014) and related to the drinking water composition on a municipality level (n=98). PRIMARY AND SECONDARY OUTCOME MEASURES: Multiple regression analysis using iterative search and testing among all demographic and drinking water variables with sialolithiasis incidence as the outcome in search of possible relations among the variables tested. RESULTS: The nationwide incidence of hospital-admitted sialolithiasis was 5.5 cases per 100,000 citizens per year in Denmark. Strong relations were found between the incidence of sialolithiasis and the drinking water concentration of calcium, magnesium and hydrogen carbonate, however, in separate models (p<0.001). Analyses also confirmed correlations between drinking water calcium and magnesium and their concentration in saliva whereas this was not the case for hydrogen carbonate. CONCLUSIONS: Differences in drinking water calcium and magnesium may play a role in the incidence of sialolithiasis. These findings are of interest because many countries have started large-scale desalination programmes of drinking water.

Incidence of different causes of benign obstruction of the salivary glands: retrospective analysis of 493 cases using fluoroscopy and digital subtraction sialography.

To identify the incidence of different causes of benign obstruction of the salivary glands, we retrospectively analysed 788 anonymised sialography reports of 719 patients referred to the department of dental and maxillofacial radiology between 2006 and 2012. Reports that showed evidence of benign obstruction were included (n=493). Salivary stones were identified in 151 (31%), ductal strictures in 115 (23%), and mucus plugs in 295 (60%). In 67 cases (14%) there was evidence of 2 or 3 causes of obstruction. As previously reported, mucous plugs were the most common finding, possibly because of the use of fluoroscopy or digital subtraction sialography, or both. These methods enable images to be captured during the initial filling of the main duct and are likely to prevent mucus plugs from being obscured by the contrast medium, which is the case in conventional sialography when a single image is produced after the contrast has been injected.

Sialolitíase: revisão de literatura e levantamento de casos / Sialolithiasis: literature review and survey of cases

Introdução: As sialolitíases são estruturas calcificadas de crescimento lento e gradual, que se desenvolvem no sistema ductal ou no interior de uma glândula, obstruindoou dificultando o fluxo normal de saliva. Objetivo: Realizar uma revisão sistemática da literatura acerca da ocorrência de sialotitíases e realizar um levantamento de casos registrados no Laboratório de Patologia Bucal do Instituto de Ciências Biológicas(ICB) da Universidade de Passo Fundo/ RS (UPF) desde o ano de 1987.Métodos: Para a realização da revisão de literatura foram utilizadas bases de dados pertinentes ao assunto e quanto aos dados encontrados no levantamento epidemiológico, estes, foram coletados e tabulados em planilha eletrônica (Excel) sendo analisados por meio de estatística descritiva de freqüência. Conclusões: pode-se concluir que a sialolitíase é uma patologia comum que consiste na formação de concreções calcificadas no sistema ductal ou no interior de uma glândula, sendo mais prevalentes no ducto da glândula submandibular unilateralmente e em pacientes leucodermas do gênero feminino. Raramente são encaminhadas para exame histopatológico, visto o pequeno número de casos encontrados. O diagnóstico é feito por meio de exame clínico e história médica/odontológica bem realizada e o tratamento depende do tamanho e localização do cálculo, presença deinfecção e da experiência do profissional.

Introduction: The sialolithiasis are calcified structures of slow and gradual growth, that develop in the ductal system or within a salivary gland, obstructing or hindering the normal flow of saliva. Objective: Perform a systematic review of the literature about the occurrence of sialolithiasis and perform a survey of cases registered in the Oral Pathology Laboratory of the Institute of Biological Sciences(ICB) of University of Passo Fundo/RS (UPF). Methods: To perform the literature review were used databases relevant to the subject and the data found in the epidemiologic survey, these were collected and tabulated in a spreadsheet (Excel) and analyzed using descriptive statistics of frequency. Conclusions: it can be conclude that the sialolithiasis is a common condition consisting in the formation of calcified concretions in the ductal system or within a salivary gland, being more prevalent in the duct of the submandibular gland unilaterally and in caucasian female patients. Are rarely sent for histophatology, viewed the small number of cases surveyed. The diagnostic is done by means of clinical history medical / dental well done and treatment depends on the size and location of the calculation, the presence of infection and experience of professional.

[Sialendoscopy in treatment of sialolithiasis--our own experience based on group of 95 patients]. / Sialoendoskopia w leczeniu kamicy slinianek--doswiadczenia wlasne na podstawie 95 przypadków.

OBJECTIVES: The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal due to sialolithiasis. The aim of the analysis was to assess the effectiveness of sialoendoscopy and combined approach in most difficult cases. MATERIAL AND METHODS: prospective study, tertiary university centre (Department of Otorhinolaryngology, Head and Neck Surgery, Poznan), between XII 2008 and V 2012, 207 sialendoscopies were performed in 197 patients. In this number 158 patients had obstructive pathology of salivary glands, 95 confirmed gland or duct sialolithiasis: parotid - 31 and submandibular - 64. RESULTS: In the group of submandibular lithaiasis in 40 cases (62.5%) stones were removed endoscopically. Double approach (sialendoscopy and incision of mucosa of the floor of the mouth with removal of the stone was performed in 21 cases (32.8%). Only in 3 cases removal of submandibular gland was necessary. In the group of parotid sialolithiasis in 17 cases (54%) endoscopy was the definite treatment, in 9 litothrypsy (ESWL) were necessary and in 5 combined approach. This five patients who failed SE were treated by combined transcutaneous (open surgery) and endoscopic procedure. We observed no incidence of salivary fistula after the incision of the duct; there was also no stenosis of the natural ostium due to the insertion of a stent. CONCLUSIONS: Sialoendoscopy is method of choice with high rate of success and gland preservation in small and moderate stones. The combined approach is indicated for large stones, complications and where there is a contraindication to established minimally invasive procedures.

Sialolitectomía intraoral con láser de CO2: reporte de un caso / Intraoral sialolithectomy performed using a CO2 laser: a case report

La sialolitiasis es una enfermedad común de las glándulas salivares mayores, representa el 11% al 70 % de la patología glandular obstructiva.Consiste en la obstrucción mecánica delconducto salival excretor o del parénquima glandular, por una formación calcárea llamada sialolito; afecta con mayor frecuencia a laglándula submandibular (78 por ciento), en menor grado a la glándula parótida (20 por ciento) y a la glándulasublingual (2 por ciento). Se reporta una predilección mayor en hombres (2:1) y preferentemente entrela cuarta y sexta década de la vida.Para el diagnóstico de una sialolitiasis de la glándula submandibular, la clínica es bastante sugestiva, porque la obstrucción del conducto de Wharton produce tumefacción en el piso de boca y dolor intenso que varía durante el día, aumentando especialmente después de las comidas por sobresestimulaciónde la glándula. El diagnóstico por imagen más sencillo y económico para evidenciar un sialolito es la radiografía oclusal de la arcada inferior; otrosestudios de imagen demuestran la localización exacta del cálculo dentro de la glándula como: la ultrasonografía, la tomografía computarizada, resonancia magnética nuclear, sialografías,y endoscopia. El tratamiento depende del compromiso de la funcionalidad de la glándula según la cronicidad de la inflamación y el tamaño del sialolito.La sialolitectomía intraoral con laser CO2 , es el tratamiento que ofrece buenos resultados en términos de conservación de la glándula ybaja morbilidad, que en casos bien seleccionados es una técnica mínimamente invasiva y con bajo índice de complicaciones.

Etiologic factors in sialolithiasis.

OBJECTIVES: The purpose of this study was to investigate etiologic factors for sialolithiasis in a population of patients from the United States. STUDY DESIGN: Retrospective, cohort study. SETTING: Tertiary university. MATERIALS AND METHODS: Charts for all patients diagnosed with sialolithiasis between January 2001 and February 2010 were retrospectively reviewed. Demographic factors, smoking history, comorbid medical conditions, and medication history were recorded. Statistical analyses were then performed on the collected data. Population prevalences of smoking, diuretic usage, cholelithiasis, and nephrolithiasis were obtained through literature review. RESULTS: A total of 153 patients with sialolithiasis were identified. Of these patients, 125 (82%) had submandibular sialolithiasis, and 28 (18%) had parotid sialolithiasis. Positive smoking histories were present in 67 individuals (44%). Both the current rate of smoking and the rate of a history of smoking were higher in our cohort when compared with the general population, although the differences did not reach statistical significance. Smoking history did not correlate with the size of the primary sialolith. Diuretic usage in the cohort was observed at a rate of 20%, higher than reported population rates of diuretic use of 8.7%. The prevalences of cholelithiasis and nephrolithiasis were not different from observed population rates. CONCLUSIONS: Sialolithiasis is an uncommon condition of unclear etiology. This study represents an initial attempt to quantify the prevalence of smoking and diuretic therapy in a population of patients with sialolithiasis.

Diseases of the salivary glands in infants and adolescents.

BACKGROUND: Diseases of the salivary glands are rare in infants and children (with the exception of diseases such as parotitis epidemica and cytomegaly) and the therapeutic regimen differs from that in adults. It is therefore all the more important to gain exact and extensive insight into general and special aspects of pathological changes of the salivary glands in these age groups. Etiology and pathogenesis of these entities is still not yet fully known for the age group in question so that general rules for treatment, based on clinical experience, cannot be given, particularly in view of the small number of cases of the different diseases. Swellings of the salivary glands may be caused by acute and chronic inflammatory processes, by autoimmune diseases, by duct translocation due to sialolithiasis, and by tumors of varying dignity. Clinical examination and diagnosis has also to differentiate between salivary gland cysts and inflammation or tumors. CONCLUSION: Salivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach. The rareness of salivary gland tumors is particularly true for the malignant parotid tumors which are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy.