Diagnosing Salivary Gland Stones

About Dr. Ryan Osborne

Ryan F. Osborne, M.D. is the Director of Head and Neck Surgery at OHNI and is an internationally renowned expert in head and neck oncology. He has developed a special interest for the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery.

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About Dr. Jason Hamilton

Jason S. Hamilton, M.D. is the Director of Plastic and Reconstructive Surgery for the Osborne Head and Neck Institute based at Cedar-Sinai Medical Towers. Dr. Hamilton has advanced training in plastic and reconstructive surgical techniques involving the face, head, and neck, and limits his practice to the treatment of these areas exclusively.

How are salivary gland stones diagnosed?

Question: I had a consultation for swelling in my right cheek that comes and goes when I eat sour foods.  So times it is painful and the swelling can last from a couple hours to a few days.  I think there may be something wrong with my salivary gland and from reading your website I think I may have a salivary gland stone. How can I tell for sure if I have a salivary gland stone?

Diagnosing a salivary gland stone
Figure 1. Salivary Gland Stone in left submandibular gland.

Discussion:  Swelling of the salivary gland that fluctuates with eating is a common symptom associated with salivary gland stones.  It is more commonly associated with food with high acidic value such as citrus and peppery foods. In response to this stimulus, your brain sends a signal to the salivary glands to contract rapidly sending saliva rushing into the mouth through the salivary gland duct.  If there is a salivary gland stone obstructing the flow of saliva the gland swells with back pressure causing pain.  The best way to make the diagnosis is with a CT Scan of the salivary glands.  Salivary stones contain a lot of calcium deposits and tend to light up brightly within the salivary gland on CT imaging. Some stones however do not show up on CT scan because of low calcium content and are best diagnosed with sialendoscopy where they can be removed simultaneously.

Key Points:

  • Best Screening Test for Salivary Stones– CT Scan
  • Best Study/Procedure Diagnosis– Sialendoscopy
  • Best Treatment Option– Sialendoscopy can be diagnostic and therapeutic

For more information about Dr. Ryan Osborne or salivary stones, visit http://www.parotid.net