What Is Salivary Gland Stone?
Salivary gland stones are calcifications in the salivary gland or in the tubes (ducts) that drain the salivary glands. They create a blockage that obstructs the flow of saliva. Salivary gland stones are the most common cause of inflammatory salivary gland disease.
Three out of four salivary stones occur in the submandibular gland. In rare cases, stones can occur in more than one gland. Although uncommon, people can also get recurring stones.
Causes of Salivary Gland Stones
The underlying cause of salivary gland stones is unknown. No foods or drinks have been shown to cause salivary gland stones. The only known risk factors are dry mouth and dehydration. Therefore, staying well-hydrated is the only preventative measure to date.
Symptoms of Salivary Gland Stones
Symptoms may include any of the following:
- Pain and discomfort
Exams and Tests for Salivary Gland Stones
Your doctor will perform a physical exam and may order ultrasounds, CT scans, or MRI scans to help guide treatment. Sialendoscopy may also be used to assess the stone(s).
Stones are categorized by the size of their diameter:
- Small: 4 millimeters or smaller
- Medium: 5-6 millimeters
- Large: 6 millimeters or larger
Treatment of Salivary Gland Stones
Sometimes an infection can lead to swelling that pushes a small stone out on its own. Stones can also break into multiple smaller stones that may come out on their own.
However, treatment is usually needed to remove stones or fragments. People with salivary gland stones should never attempt to break or remove stones on their own as it may cause damage or scarring.
At Penn, minimally-invasive procedures are the most common form of treatment used to address salivary gland stones. Unlike traditional salivary gland surgery, these procedures treat glands instead of removing them entirely, allowing patients to avoid the side effects of removal. Surgical gland removal is only performed in rare cases where minimally-invasive procedures aren’t able to remove the stone.
Small and some medium salivary gland stones are primarily treated with sialendoscopy, a minimally-invasive outpatient procedure that extracts the stones. Penn ENT is a national leader in this cutting-edge treatment and one of only two institutions in the Philadelphia region offering it.
General anesthesia is typically used for sialendoscopy; however, topical anesthesia may be used for simple procedures. Recovery is almost instantaneous, and there are no stitches, scars, or lasting pain.
Medium or large stones, commonly in the parotid gland, can be broken up using a laser (lithotripsy), but this procedure is also rarely needed.
Because of their location, larger salivary gland stones usually require a surgical procedure combined with sialendoscopy to remove them. The surgeon will make an incision either in the back of the mouth or near the ear. If the salivary duct is narrow, the surgeon may place a stent in the duct to hold it open. Stents can be removed two to four weeks after the procedure.
After a surgical procedure, you may be sore at the incision site. Recovery can take up to two weeks. It’s important to eat soft foods and take pain medication as required during recovery.
If it’s difficult to reach a salivary stone because of its size, location or quantity, your surgeon may use TORS-sialo or sialo-TORS-sialo. TORS is a revolutionary minimally invasive procedure invented at Penn to provide access to areas of the mouth and throat that are difficult to reach with traditional surgery.
Robotic technology can help your surgical team get a clearer picture of the area and move around better in tight spaces. In addition, it allows the surgeon to use a much smaller incision, which helps to protect the nerves in the mouth and prevent scarring.
Learn more about the treatment Penn ENT's Salivary Gland Center provides for salivary gland disorders
Outlook (Prognosis) for Salivary Gland Stones
After removing a stone, the gland almost always recovers. Penn ENT’s Salivary Gland Center has a gland preservation rate of over 95 percent. Even with large stones, the gland is rarely removed, allowing patients to avoid the side effects of resection surgery.
When to Contact a Medical Professional
Call your doctor if you have any of the following:
- Swelling or pain in your mouth
- An infection in your mouth
Penn Programs & Services for Salivary Gland Stone
Penn Ear, Nose and Throat offers one of the region’s only dedicated salivary gland centers. Our specialists are nationally-recognized experts in diagnosing and treating salivary gland disorders.