Goubaa Mohamed MD Djerba Tunisia

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A 30 year-old men with a 5-year history of sialolithiasis presented with pain which is made worse by eating. The stone was located in the right submandibular gland. Patient âgé de 30 ans, avec une histoire de lithiase salivaire connu depuis 5 ans. Il présente une douleur intense lors de la prise d'aliments. La lithiase est localisée dans glande sous maxillaire droite.



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ultrasound images demonstrate a large stone within the right submandibular salivary gland . It has a characteristic appearance, a bright hyperechoic rim representing the portion of the gallstone closest to the transducer with a sharp well-defined distal acoustic shadow. L'echographie démontre une grosse lithiase dans la glande salivaire sous maxillaire avec son aspect typique d'opacité arciforme du coté de la sonde et derriere avec son cone d'ombre postérieur.
Sialolithiasis Lithiase salivaire



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Sialolithiasis is one of the most common diseases of the salivary glands.
Symptoms are those of recurrent swelling of the affected gland and pain which is made worse by eating. The problem is typically recurrent.
With ultrasonography, the calculi were correctly diagnosed in 90% of the patients (6).
Salivary stones were recognized as high-level reverberation echoes accompanied by posterior acoustic shadows.
Sialoliths predominated among patients aged 30 and 70 years, with no male/female predilection. 80% of the salivatory stones is found in the submandibular gland, 15% of them belongs to the parotid and the sublingual gland comes up with 5%
The submandibular gland is predisposed to stone formation by the following characteristics: high calcium concentration, dependent position, small duct opening, high pH saliva, and long curved duct
.A simultaneous stone disease of the urinary tract or the bile duct system occurred by chance (4%) (1 ; 5).
salivatory stones contain calcium phosphate, 74%; calcium carbonate 11%; soluble salt, 6%; organic elements, 2% and water.
All salivary gland stones greater than 1-2 mm could be detected ultrasonographically and Mineral composition was found to influence the radiological study but not sonographic pictures of sialoliths. If sialolithiasis is suspect clinically, ultrasonography with a linear scanner must be considered the diagnostic procedure of choice (2 ; 3 ; 4).

: HNO. 1999 Nov;47(11):963-9. [Clinical and diagnostic findings of sialolithiasis] Zenk J, Constantinidis J, Kydles S, Hornung J, Iro H. Klinik und Poliklinik fur Hals-Nasen-Ohrenheikunde, Universitatskliniken des Saarlandes, Homburg/Saar. hnojzen@med-rz-uni-sb.de
2: HNO. 1992 Jul;40(7):259-65. [Sonography and plain roentgen image in diagnosis of salivary calculi--experimental studies] Fodra C, Kaarmann H, Iro H. Klinik und Poliklinik fur Hals-Nasen-Ohrenkranke, Universitat Erlangen-Nurnberg. 3: Radiol Med (Torino). 1990 Mar;79(3):220-
3. [Echography in the study of sialolithiasis] Angelelli G, Favia G, Macarini L, Lacaita MG, Laforgia A. Istituto di Radiologia, Universita, Bari.