Dr. Abdul Hafeez
BACKGROUND Sialoliths often referred to as salivary calculi constitute 0.45% in regular clinical practice and mainly characterize the ducts of parotid and submandibular salivary glands. Sialolith is composed of both organic and mineral substances. However, only few studies exist on the characterization and distribution of the inorganic and organic matter in the sialolith. In our study, we aim at correlating the patient’s serum characteristics to the inorganic materials in the sialolith in order to deduce an association between the two. METHODS 14 patients were included in study (11 males and 3 females). Only patients with sialoliths in submandibular gland proper were included and those with sialoliths in ducts were excluded. Radiological investigations and confirmation of provisional diagnosis was done followed by blood tests that were given in fasting state. Removal of submandibular gland along with sialolith was done under general anaesthesia through submandibular approach. The excised gland and sialolith were sent to lab for histopathological and mineral analysis respectively. The results of both serum values and mineral analysis of sialolith were compared statistically. RESULTS The mean age group of the entire study group was 52.5 ± 8.7 years. Submandibular gland sialoliths were found on the right side in 8 patients (57.14%). The mean dimensions of the submandibular gland sialolith measured from the CT scan was: supero-inferiorly 19 ± 8.7 mm, antero-posteriorly 20.4 ± 8.1 mm, and medio-laterally 9.4 ± 4.7 mm. All the sialoliths that were included in study were more than 1.5 cm which is regarded as giant in size. The histopathological examination was suggestive of chronic sialadenitis in all cases. The average weight of all salivary stones was found to be 1107.9 ± 503.2 mg. CONCLUSIONS There seemed to be very little or no correlation between the increased serum values and the presence of the corresponding inorganic substance in the sialolith. Thus, the propensity for sialolith formation is attributed to tortuous course of the salivary ducts and consistency of salivary flow seem to be the majorly proven factor and cannot be substituted for any other justifications till date.
