Salivary Stone Disease (Sialolithiasis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic and therapeutic steps.

Extraoral examination

  • Inspection
    • Facial asymmetries
    • Soft tissue swelling
    • Fistulas
    • Skin florescences
  • Palpation
    • Bimanual (symmetry comparison)
    • Lymph node
    • Nerves, nerve exit points

Oral cavity

  • Floor of mouth
    • Bimanual (“with both hands”): from intraoral (“inside the oral cavity“) with counterpalpation from extraoral (“outside the oral cavity”) [salivary stones palpable in the submandibular duct or hilus of the submandibular gland/mandibular gland].
  • Cheek soft tissues
    • [in slender patients may be palpable indurations]
    • [Stenon duct of the parotid gland/parotid gland often swollen in inflammatory change]
    • [Papilla of Stenon’s duct often reddened during inflammatory change]
  • Palpation dolence/painfulness on palpation [dolent/painful in acute purulent sialadenitis]
  • Saliva
    • Spontaneous flow [impaired in obstruction (complete occlusion)/sialolith]
    • Quantity [decreased]
    • Consistency
      • [flaky: undissolved constituents: concretions]
      • [cloudy, bloody: acute bacterial superinfection]
  • Probing the excretory ducts [obstruction].

Square brackets [ ] indicate possible pathologic (pathological) physical findings.