Difference between revisions of "Sialolithiasis"

Revision as of 12:19, 14 October 2011

Introduction

A sialolith is a calcified stone within the salivary ducts. The sialolith is formed of an organic nucleus, surrounded by concentric layers of calcium phosphate crystals.

In horses the salivary gland involved is usually the parotid gland, and sialoliths usually obstruct the major duct close to the parotid papilla.

In chronic cases, the stone builds up gradually and the duct is only partially obstructed. When obstruction is acute and total, the gland may become painfully inflamed and the duct may rupture.

Pathogenesis

An ascending foreign body, such as a grass awn, is normally the cause of the formation of a single sialolith within a salivary duct. Calcium carbonate can also be deposited around a nidus created by inflammatory cells within the duct.

In small animals, calcification of inspissated saliva in salivary mucoceles may also result in the formation of multiple small sialoliths.

A single, large sialolith in a salivary duct can cause some retention of saliva, however it is not thought to cause a salivary mucocele.

Clinical Signs

A sialolith presents clinically as a palpable elongated swelling over the affected salivary duct.

Radiographic or ultrasonographic examination of the affected salivary gland (most often the parotid gland) may be useful to identify any internal swelling or inflammation.

If the obstruction is acute and complete, the salivary gland may swell, and there may be rupture of the duct and formation of a fistula. There will then be a visible lesion with saliva discharging from the wound.

Treatment

Some sialoliths can be removed from the salivary duct opening using forceps.

If this is not possible, treatment involves direct surgical incision onto the calculus and removal of the stone.

Complications include the formation of a parotid duct fistula after surgery.

Sialolithiasis Learning Resources
Flashcards Test your knowledge using flashcard type questions	Veterinary Dentistry Q&A 08

References

Verstraete, F. J. M. (1998) Self-Assessment Colour Review - Veterinary Dentistry Manson

Knottenbelt, D. (2003) Diseases and disorders of the horse Elsevier Health Sciences

Mair, T. (1998) Equine Medicine, Surgery and Reproduction Elsevier Health Sciences

@@ Line 1: / Line 1: @@
+==Introduction==
 A sialolith is a '''calcified stone within the salivary ducts'''. The sialolith is formed of an '''organic nucleus''', surrounded by concentric layers of '''calcium phosphate crystals'''.
+In horses the salivary gland involved is usually the '''parotid gland''', and sialoliths usually obstruct the major duct close to the parotid papilla.
+In chronic cases, the stone builds up gradually and the duct is only partially obstructed. When obstruction is acute and total, the gland may become painfully inflamed and the duct may rupture.
 ==Pathogenesis==
-An '''ascending foreign body''', such as a grass awn, is normally the cause of the formation of a single sialolith within a [[Salivary Glands - Anatomy & Physiology|salivary duct]]. In small animals, calcification of '''inspissated saliva''' in [[Salivary Mucocele|salivary mucoceles]] may also result in the formation of multiple small sialoliths.
+An '''ascending foreign body''', such as a grass awn, is normally the cause of the formation of a single sialolith within a [[Salivary Glands - Anatomy & Physiology|salivary duct]]. Calcium carbonate can also be deposited around a nidus created by '''inflammatory cells''' within the duct.
+In small animals, calcification of '''inspissated saliva''' in [[Salivary Mucocele|salivary mucoceles]] may also result in the formation of multiple small sialoliths.
 A single, large sialolith in a salivary duct can cause some retention of saliva, however it is not thought to cause a [[Salivary Mucocele|salivary mucocele]].
-==Clinical Signs & Treatment==
+==Clinical Signs==
-A sialolith present clinically as a '''palpable elongated swelling over the affected salivary duct'''.
+A sialolith presents clinically as a '''palpable elongated swelling over the affected salivary duct'''.
-The treatment involves '''surgical removal''' of the sialolith.
+'''Radiographic''' or '''ultrasonographic''' examination of the affected salivary gland (most often the parotid gland) may be useful to identify any internal swelling or inflammation.
+If the obstruction is acute and complete, the salivary gland may swell, and there may be '''rupture of the duct''' and formation of a '''fistula'''. There will then be a visible lesion with saliva discharging from the wound.
+==Treatment==
+Some sialoliths can be removed from the salivary duct opening using '''forceps'''.
+If this is not possible, treatment involves direct '''surgical incision''' onto the calculus and removal of the stone.
+'''Complications''' include the formation of a parotid duct fistula after surgery.
 {{Learning
@@ Line 18: / Line 34: @@
 ==References==
 Verstraete, F. J. M. (1998) '''Self-Assessment Colour Review - Veterinary Dentistry''' ''Manson''
+Knottenbelt, D. (2003) '''Diseases and disorders of the horse''' ''Elsevier Health Sciences''
+Mair, T. (1998) '''Equine Medicine, Surgery and Reproduction''' ''Elsevier Health Sciences''
 [[Category: To Do - Siobhan Brade]]
 [[Category:To Do - Manson review]]
+[[Category:To Do - Review]]