Salivary stone of the parotid gland

Definition

Like other organs such as the gallbladder, stones can form in the salivary glands. The salivary stones are formed by the calcium phosphate contained in the saliva in connection with an organic matrix. Salivary stones occur mainly in the lower jaw salivary gland, but can also be found in the parotid gland (Parotid gland) or sublingual gland.

causes

The formation of salivary stones can have various causes, but has not yet been fully clarified. The reason, however, is usually an increase in the calcium level in the saliva, an obstruction of the drainage of the duct or an underlying disease of the entire body system. If salivary stones appear frequently, the attending physician should rule out gout, diabetes mellitus and cystic fibrosis, among other things.

Local problems in the immediate vicinity of the affected salivary gland can also play a role. For example, a scarring or a tumor can narrow the salivary gland duct and thus lead to the formation of a salivary stone. The same applies to the viral disease mumps, here too the gland swells and the gland ducts can narrow.

Read more on the topic: Causes of a salivary stone

Symptoms

Since a salivary stone in most cases leads to an inflammation of the salivary gland, the typical symptoms of salivary gland inflammation occur here

• The gland swells around the ear, becomes hard, and begins to hurt.
• severe pain when eating, as the saliva that is formed cannot drain away and thus exerts pressure on the parotid gland, which is already inflamed
• This inflammation can also radiate locally to the surrounding tissue and trigger pain in the temporomandibular joint, muscles or when chewing
• Cheek heats up and turns red
• Fever bouts
• Tinnitus
• Pus formation, which is released into the mouth via the gland duct

Read more about the symptoms of a salivary stone below: This is how you recognize a salivary stone

Earache

The parotid gland is located in the depths of the tissue on both sides of the face in a very central position. A little below and in front of the ear, it is mostly in a space adjacent to muscles and bones, in which there are many other nerves and vessels. One of these nerves, the facial nerve, leads to the ear, and there specifically to the eardrum. It mainly transmits touch and pain stimuli. The salivary stone can cause a slight inflammation of the gland, which irritates the nerve. As a result, after a while, a salivary stone also causes earache.

Read more on the topic: Inflammation of the parotid gland

diagnosis

The salivary stones are usually determined by the dentist. To make a diagnosis, the dentist can scan the salivary glands, take an X-ray, or perform an ultrasound examination. Once the diagnosis has been made, the dentist can usually initiate therapy immediately.

Duration

The duration of the illness depends entirely on the size of the salivary stone and when it is discovered. If you notice the stone in the parotid gland right at the beginning of its development, the doctor will try to remove it using so-called "conventional" methods. The gland should be spared and the stone should be flushed out.

If these methods work, the stone can be removed in a matter of minutes. Only an existing inflammation lasts longer and causes discomfort for a few days. However, if the salivary stone has already grown in, the only thing that will help is an operation in which the entire gland has to be removed. The healing then takes a little longer because it is a surgical procedure with all its side effects.

Salivary stone therapy

In favorable cases, the salivary stones can be removed conservatively. For this purpose, acidic drops are sucked, which promote the secretion of saliva and thus flush the saliva stone towards the "exit". If the stone is close enough to the opening of the execution duct, the stone can be massaged out by the dentist. If this is not possible, the duct can be surgically cut and connected to the oral cavity. The stone is removed and at the same time a new opening of the duct is created, as it is assumed that otherwise a new salivary stone formation would be likely.

Read more on the topic: This is how you can effectively remove salivary stones

If the salivary stones are very close to the same or even within the gland, it may be necessary to remove the entire salivary gland. For this purpose, an incision is made from the outside under general anesthesia and then the gland is removed. If there is an acute inflammation of a salivary gland, an antibiotic should be taken.

To avoid salivary stones as much as possible, you should drink enough fluids. A lack of water changes the saliva composition and the saliva becomes thicker, which can promote the formation of stones. The prognosis for salivary stones is usually good. However, if salivary stones repeatedly form in the same gland, or if the stone is inside the gland, the salivary gland must be removed. However, the loss of one gland can be compensated for by the other salivary glands present.

surgery

If a salivary stone does not go away on its own or with the help of conservative methods, in most cases surgery is necessary to prevent chronic inflammation of the gland. Depending on where the salivary stone is located, the gland must be completely or partially removed.

Surgery is only performed under general anesthesia as it is a major procedure. An incision is made through the skin in front of the ear up to the neck. You try to cut into folds of the skin as best you can so that you don't leave a large scar later. After the operation, a drain must usually be placed for two days to drain off the wound fluid.

Although this procedure is not uncommon, it can have many complications. In addition to the general operational risks, such as increased bleeding, infections or the like, there is another problem here - the risk of injury to the facial nerve. Since the so-called "facial nerve" has a close positional relationship to the parotid gland, it can quickly be damaged by the operation. A transection can lead to the inability of various facial muscles to move. However, the surgeon will explain the exact course of the operation, the dangers and the benefits beforehand. Further questions can then be clarified there.

Home remedies for salivary stones of the parotid gland

So-called saliva looseners are particularly helpful as home remedies. These are foods and drinks that stimulate the flow of saliva and thus promote saliva production in the parotid gland. Lemon juice has proven itself here, especially in the form of candy and chewing gum. The increased saliva produced in the case of a small stone can cause it to be carried outside. Similar to lemon, other acidic foods - such as sweets or pickles - have a stimulating effect on the flow of saliva. The newly formed saliva can then build up a certain pressure in the blocked duct of the gland and thus propel the stone towards the mouth.

You can also try using your hand to massage the gland and push the stone outwards. However, this self-treatment should only be continued as long as there is no severe pain. Because then it comes to an inflammation, which should be treated by a doctor.

Read more on the topic: Home remedies for salivary stones

Can you remove a saliva stone yourself?

In principle: Yes, you can remove a saliva stone yourself. However, there are a few rules that should be followed so that the situation does not get worse. As with the methods described above, you can try to bring the stone into the light of day yourself. However, if you experience pain or if the gland swells, you should see a doctor directly. A bacterial infection can develop, which should definitely heal under medical supervision.