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COMMONLY ASKED QUESTIONS

What causes salivary gland stones?
The vast majority occur in the submandibular gland, approximately 80%. The submandibular gland has a longer/larger caliber duct (more room to produce a stone), is in a dependent portion of the neck (saliva flows against gravity), and has a different type of saliva that it produces (higher mucus/calcium content) which makes it prone to forming stones.

What can I do if I have a stone? You can do several things.
1) Apply warm compresses to the enlarged area two to three times a day. After applying the warm compress, massage the gland and swollen areas. Massage in a downward motion working it towards the mouth.
2) Suck on hard sour candy, such as sugar free lemon drops or tarts as often as possible. The candy stimulates production of saliva and helps to clear obstruction.
3) Stay hydrated. Increase your fluid intake to at least 1-2 liters a day. Carbonated beverages are also ok. Try to eliminate caffeine; it works as a diuretic and can dehydrate the body.
4) See a doctor when possible. You may require antibiotics.

What are the symptoms of a salivary gland blockage or salivary gland stone? Obstruction can be partial or complete.
If it is a partial obstruction, it usually presents with recurrent pain, swelling, and a foul taste in mouth associated with eating.
If it is a complete obstruction, then you will have constant pain and swelling.

How long does the procedure take to perform? A typical sialodochoplasty and sialolithotomy takes 20-30 minutes.

What is the recovery time like? Typically patients are back to normal and feeling well in 1-2 hours.

What happens if I have a stent placed into the duct? We may have to leave the duct in place for 7-10 days in order to have the duct properly heal. You will be on antibiotics, and come back for the stent removal in 7-10 days. Typically the stent doesn’t cause much of a annoyance and most patients don’t feel it. At times, it needs to be trimmed down.

I’ve read that this done in the hospital. Do I need to stay overnight? I have been performing this procedure in the outpatient clinic setting under local anesthesia for several years now. It is very safe and well tolerated. There are a small number of patients that require a trip to the operating room.

Any dietary restrictions after the surgery? None. You may eat and drink normally after your procedure. I also encourage sour candies and drinking lots of fluids to keep the saliva thin and flowing. This helps to avoid narrowing of the duct.

Can I speak after the procedure? You may use your voice immediately after the procedure.

Will I be sent home with any medications? You will be given pain medications, antibiotics, and a short dose of steroids. We will monitor you for 20-30 minutes after the procedure to make sure that you are well, and then you can be sent home or back to work.

What types of activities can I perform after the procedure? You can resume all activity after the procedure.

When do I come in for my follow-up visit? You should be seen 1-2 weeks following surgery.

Will my stitches need to be removed? Stitches will be removed only if you have a stent placed. Otherwise, if you did require stitches, they will be dissolvable, and we do not need to remove any of them.

What are the risks? Aside from possible bleeding and infection, the risks are fairly minor. The duct may become narrowed again, which may cause your tongue or saliva gland to swell. If this happens, you should call the office immediately.

WHY IS ULTRASOUND SO IMPORTANT IN THE WORK-UP OF SALIVARY GLAND DISEASES?

When performed by someone who does it often, it is fast, easy to perform, and repeatable. There is no radiation used and the technique is painless.

Ultrasound also gives you important clues to the nature of the gland. We can tell whether there has been long-standing evidence of infection, narrowing of the ducts, or a stone in the gland or the duct.

Additionally, stones may be missed on CT scan. Ultrasound is able to see the stones that are missed on CT scan.

Additionally, ultrasound gives us important clues as to the success of endoscopic removal of a salivary gland stone. Based on the ultrasound results, I will be able to give a reasonable estimate of how likely a stone is able to be removed using sialendoscopy or sialolithotomy.