Stones are most commonly seen in which salivary gland: March 2005, 2007

Ans. A: Submandibular Sialolithiasis Most common disease of salivary glands Twice as common in males as females 80-95% occur in submandibular gland or duct ( because their secretion is highly viscous) Stones are most common cause of acute and chronic infection of salivary glands 80% of submandibular stones are opaque; 60% of parotid are opaque Consist of mainly calcium phosphate Not associated with systemic calcium abnormalities Very unusual for patients to have a combination of radio-opaque and non-opaque stones - Signs and symptoms Pain and swelling of involved gland Sialolithiasis causes pain and swelling of the involved salivary gland by obstructing the food-related flow of salivary secretions Calculi may cause stasis of saliva facilitating bacterial ascent into the gland and subsequent infection Some may be asymptomatic - Imaging Plain radiography Opaque stone in course of Whaon's (submandibular) or Stensen's (parotid) ducts CT Stone in duct Ductal dilatation