Salivary Stone Disease (Sialolithiasis): Diagnostic Tests

The diagnosis of sialolithiasis (salivary stone disease) is usually made on the basis of the patient’s history, clinical course, and physical examination. Further medical device diagnostics may be required for differential diagnosis.

Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics – for differential diagnostic clarification.

  • Radiographs
    • Panoramic overview image
      • Shading: concretions are detectable only with sufficient lime content and a minimum size of 2-3 mm
      • Required for clarification of dentogenic (tooth-related) relationships.
    • Oral floor survey images
      • For sialolithiasis of the submandibular (submaxillary) and sublingual (sublingual) glandulae.
  • Sonography (ultrasound): scanning sonography – Diagnostic method of first choice (especially parotid gland (parotid gland) easily accessible)Sialoliths:
    • 90% detection reliability from 2 mm stone size.
    • Typical hard echocomplex with dorsal (back) marginal shadow, internal texture homogeneous.
    • Detection also not X-ray shadow giving stones
    • Distinction between intraductal (“inside the duct”) and intraglandular (“inside the gland”) location.
    • Detection of accompanying inflammatory reactions
  • Sialography (contrast imaging of the salivary gland excretory ducts; the salivary glands are made visible on the X-ray by contrast agent introduced ascending (ascending) into the duct system. – The procedure is rarely indicated now; instead, sonography, computed tomography (CT), and magnetic resonance imaging (MRI) are used for diagnosis.Indications:
    • Detection of pathologic parenchymal changes.
    • Contrast agent recess in the region of sialoliths.
    • Detection of gait abnormalities
    • Delineation of a tumor event
    • Delimitation of periglandular (“around the gland”) diseases.

    Contraindication (contraindications): acute inflammation.

  • Computed tomography (CT), with and without contrast medium – in individual cases; if sonography does not provide sufficient clarification; to differentiate between inflammatory, cystic and tumorous changes.
  • Magnetic resonance imaging (MRI) – in individual cases.
  • Sialendoscopy (salivary duct endoscopy), refers to the mirroring of the salivary glands or the duct system within a salivary gland – to detect sonographically inapparent (“clinically silent”) sialoliths or other obstructions (complete occlusion) such as stenoses (constrictions) or kink formations; for simultaneous therapy of mobile stones.