ear, nose, and throat disorders
Salivary Stones
Treatment of Salivary Stones
Local measures (eg, sialagogues, massage) Sometimes manual expression or surgical removal Analgesics, hydration, and massage can relieve symptoms in patients with a salivary stone. Antistaphylococcal antibiotics can be used to prevent acute sialadenitis if started early. Stones may pass spontaneously or when salivary flow is stimulated by sialagogues; patients are encouraged to suck a lemon wedge or sour candy every 2 to 3 hours. Stones right at the duct orifice can sometimes be expressed manually by squeezing with the fingertips. Dilation of the duct with a small probe may facilitate expulsion. Surgical removal of stones succeeds if other methods fail. Stones at or near the orifice of the duct may be removed transorally, whereas those in the hilum of the gland often require complete excision of the salivary gland. Stones up to 5 mm in size may be removed endoscopically ( Treatment references ). 