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      Sialolitos en conductos y glándulas salivales: Revisión de literatura Translated title: Sialoliths in ducts and salivary glands: Literature review

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          Abstract

          La sialolitiasis es una afección que se produce por la obstrucción de una glándula salival o de su conducto excretor por la formación de concreciones calcáreas o sialolitos en el parénquima de los mismos. Existen teorías que afirman que los sialolitos en las glándulas y conductos salivales son originados por la mineralización de varios componentes como: cuerpos extraños, detritus celulares y microorganismos, depositándose inicialmente una matriz orgánica, probablemente de glucoproteínas, para luego posteriormente presentarse el deposito de material inorgánico que inicia su mineralización. Esta patología desencadena una serie de signos y síntomas hasta la obstrucción del conducto que no permite el paso de la saliva, lo que produce sintomatología dolorosa y tumefacción. Existen otras entidades patológicas de glándulas salivales que pueden confundirse con sialolitiasis como sialoadenitis, hipertrofia maseterina, patologías relacionadas con la articulación temporomandibular, osteomielitis, mucocele, otras como quistes de retención mucoso, abscesos sublinguales y otras alteraciones del piso de la boca. Los métodos más comunes utilizados para el diagnóstico de sialolitiasis son la sialografía convencional, ecografía, resonancia magnética nuclear, tomografía asistida por computador, endoscopia, en ocasiones las radiografías laterales de cráneo y radiografías oclusales. Estos métodos diagnósticos son variables según las necesidades del paciente y accesibilidad, localización del sialolito, el tamaño del mismo y los signos y síntomas presente. El manejo de estas alteraciones incluye procedimientos no quirúrgicos y quirúrgicos invasivos o no que implican en ocasiones la eliminación de la glándula.

          Translated abstract

          Sialolithiasis is a clinical condition produced by a blockage of the salivary gland or excretory duct by the formation of calcareous concretions or sialoliths in the parenchyma of the same. There are theories that claim that the sialoliths in the salivary glands and ducts are caused by the mineralization of various components such as foreign bodies, cellular debris and microorganisms, originally deposited an organic matrix, probably of glycoproteins, and then subsequently submitted to the General Assembly Hall of inorganic material which began its mineralization. This condition triggers a series of signs and symptoms to duct obstruction that does not allow the passage of saliva, which causes pain and swelling. There are other pathological salivary glands that can be confused with Sialolithiasis as sialadenitis, Masseteric hypertrophy, diseases related to the joint temporomandidular, osteomyelitis, mucocele, as other mucous retention cysts, abscesses and other disturbances of sublingual floor of the mouth. The most common methods used to diagnose Sialolithiasis are sialograph conventional ultrasound, magnetic resonance imaging, computer tomography, endoscopy, sometimes lateral radiographs of the skull and occlusal X-rays. These diagnostic methods are variable depending on the patient's needs and accessibility, sialolith location, the size of it and the signs and symptoms present. The management of these disorders include non-surgical and surgical procedures or non-invasive sometimes involving the removal of the gland.

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          Most cited references42

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          Sialolithiasis management: the state of the art.

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            Sialolithiasis. A survey on 245 patients and a review of the literature.

            245 patients with sialolithiasis, treated during a period of 20 years, were evaluated and the literature has been reviewed. The submandibular gland was involved in 231 patients, the parotid gland in 11 patients, and the sublingual gland only in 1 patient. There is some indication that patients with sialolithiasis are more prone to develop nephrolithiasis. A relationship with other systemic disorders could not be detected. Laser treatment seems to be a promising treatment modality for stone removal, even in acute phases.
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              Postparotidectomy facial nerve paralysis: possible etiologic factors and results with routine facial nerve monitoring.

              Analyze the incidence and factors responsible for postparotidectomy facial nerve paralysis when the surgery is performed with the routine use of facial nerve monitoring. A prospective, nonrandomized study. Seventy consecutive patients underwent parotidectomy with intraoperative facial nerve monitoring. Two devices were used: a custom mechanical transducer and a commercial electromyograph-based apparatus. All patients were analyzed, including those with cancer and those with deliberate or accidental sectioning of facial nerve branches. The outcome variables were the motor facial nerve function according to the House-Brackmann grading scale (HB) at 1 week (temporary paralysis) and 6 to 12 months (definitive paralysis). Facial nerve grading was performed blindly from reviewing videotapes. The overall incidence of facial paralysis (HB>1) was 27% for temporary and 4% for permanent deficits. Most of the deficits were partial, most often concerning the marginal mandibular branch. Temporary deficits with HB scores of greater than 2 were only present in patients with parotid cancer or infection. Permanent deficits were present in three patients, including one patient with facial nerve sacrifice. Factors significantly associated with an increased incidence of temporary facial paralysis include the extent of parotidectomy, the intraoperative sectioning of facial nerve branches, the histopathology and the size of the lesion, and the duration of the operation. Despite a stringent accounting of postoperative facial nerve deficits, these data compare favorably to the literature with or without the use of monitoring. An overall incidence of 27% for temporary facial paralysis and 4% for permanent facial paralysis was found. Although the lack of a control group precludes definitive conclusions on the role of electromyograph-based facial nerve monitoring in routine parotidectomy, the authors found its use very helpful.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                December 2009
                : 25
                : 6
                : 311-317
                Affiliations
                [03] orgnameUniversidad Javeriana
                [01] orgnameFundación Universitaria San Martín orgdiv1Sede Caribe
                [02] orgnameUniversidad de Cartagena
                [04] orgnameUniversidad del Norte
                Article
                S0213-12852009000600002
                10.4321/s0213-12852009000600002
                ea9da602-cea7-4ffa-bd92-dd214583bc82

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 19 February 2009
                : 25 February 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 7
                Product

                SciELO Spain


                Sialolitiasis,glándulas salivales,diagnóstico,Sialolithiasis,salivary glands,diagnosis

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