RECURRENCE OR MISDIAGNOSIS?

Abstract

Sialolithiasis is a benign condition associated with the formation of calculi in the ducts of
major salivary glands :parotid , submandibular and sublingual glands[1] or minor salivary
glands, with most common predisposition of about 85% within the duct of submandibular
gland owing to the mucinous nature of the secretions and torturous anatomy of the duct[2]
.
The submandibular gland also produces more alkaline saliva, which predisposes to
precipitation of inorganic salts (i.e., calcium and phosphate), further leading to salivary stone
formation. Approximately 15% of salivary stones occur within the parotid gland, and less
than 5% occur within the sublingual and minor salivary glands[4][5]
. It is the most frequent
cause of salivary gland swelling, with a reported incidence of 1 in 10000 to 1 in 30000,with
primary age of diagnosis between 30 and 60 years[3]
. In some cases, sialoliths can obstruct the
salivary ducts, leading to inflammation, superimposed bacterial infection termed sialadenitis,
or in rare cases, abscess formation. There are various presenting symptoms, with the most
common being cyclical postprandial swelling of the affected gland and decreased salivary
flow.