Salivary Gland Stones: Symptoms, Risks, and Treatment Options

Regarding salivary gland stones?

The condition began during my sophomore and junior years of high school.
In my senior year, I experienced difficulty swallowing, which led to the removal of my left submandibular gland along with a stone.
However, it was previously discovered that there was also a stone on the right side, but since it was asymptomatic, it has been under observation.
It has remained in my oral cavity for quite some time now, and although there are no symptoms, I feel uneasy about having something potentially harmful in my body for so long.
Recently, I underwent a CT scan at a hospital in Taipei, and they only mentioned that the mass is still present (but there is no calcification).
The doctor said, "It's like a ureteral stone; if there are no symptoms, there's not much to worry about." Is this correct? I am increasingly concerned about the possibility of it becoming cancerous.
I'm a bit worried.
P.S.
People say drinking more water helps, but it doesn't seem to make a difference for me!

Xiao Chen, 20~29 year old female. Ask Date: 2004/11/22

Dr. Ye Dawei reply Otolaryngology

If it is a stone, it should appear white on a CT scan.
If there is a mass that is not moving, it may be considered a tumor.

Reply Date: 2004/11/22

More Info

Salivary gland stones, also known as sialolithiasis, are calcified structures that can form in the salivary glands, most commonly in the submandibular gland. Understanding the symptoms, risks, and treatment options for this condition is crucial, especially for individuals who have experienced symptoms in the past or have a history of stones.

Symptoms of Salivary Gland Stones
The symptoms of salivary gland stones can vary significantly. In many cases, individuals may remain asymptomatic, as you have experienced with your right submandibular gland stone. However, when symptoms do occur, they can include:
1. Swelling: This is often localized to the area of the affected gland, particularly during meals when saliva production increases.

2. Pain: Pain can occur in the area of the stone, especially during eating or when the gland is stimulated.

3. Dry Mouth: If the stone obstructs the duct, it can lead to reduced saliva flow, resulting in a dry mouth.

4. Infection: If the stone causes a blockage, it can lead to infection, which may present as fever, redness, and pus discharge from the duct.

5. Difficulty Swallowing: As you mentioned, swallowing difficulties can occur if the stone is large or if there is significant swelling.

Risks and Concerns
While the presence of a salivary stone does not inherently indicate a risk of cancer, it is understandable to have concerns about long-term implications. Chronic obstruction can lead to inflammation and infection, which may increase the risk of complications. However, the direct association between salivary stones and malignancy is not well-established.
It is important to monitor any changes in symptoms. If you notice persistent swelling, pain, or other unusual symptoms, it would be prudent to consult with a healthcare provider. Regular follow-ups with imaging studies, such as ultrasound or CT scans, can help assess the status of the stone and any potential changes.

Treatment Options
The management of salivary gland stones depends on the size of the stone, the symptoms, and the presence of any complications:
1. Observation: In cases where the stone is asymptomatic, as in your situation, a watchful waiting approach is often recommended. This is particularly true if the stone is small and not causing any issues.

2. Hydration: Increasing fluid intake can help facilitate the passage of smaller stones and improve saliva flow, potentially reducing the risk of stone formation.

3. Sialagogues: These are substances that stimulate saliva production, such as sour candies or lemon juice, which can help dislodge smaller stones.

4. Manual Removal: If the stone is accessible, a healthcare provider may attempt to massage the stone out of the duct.

5. Surgical Intervention: If the stone is large or causing recurrent infections, surgical removal may be necessary. This can involve either minimally invasive techniques or more traditional surgical approaches.

6. Endoscopic Techniques: In some cases, endoscopic procedures can be used to remove stones without the need for larger incisions.

Conclusion
In summary, while the presence of a salivary stone can be concerning, especially if it has been present for a long time without symptoms, many individuals can live with asymptomatic stones without immediate intervention. Regular monitoring and maintaining good hydration are key strategies. If symptoms arise or if there are any changes in your condition, it is essential to seek medical advice. Always feel empowered to discuss your concerns with your healthcare provider, as they can provide personalized recommendations based on your specific situation.

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