# SIALOLITH...



## sbdivemaster (Nov 13, 2011)

Ever had one? What did you do about it?

Just curious... :icon_smile:


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## hardline_42 (Jan 20, 2010)

I'm no help, but my sister-in-law gets some gnarly tonsil stones! We used to fight over who got to massage them out with a q-tip (I've known her since she was 4 years old). 

Anyway, a quick google search says chewing or sucking on bitter and sour foods helps increase saliva production, which could help them out on their own.


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## JerseyJohn (Oct 26, 2007)

No, but my father once had a sesame seed block one of his salivary ducts, and got a pretty painful inflammation from it. So I can see where salivary gland stones could be a problem. They sometimes treat gallstones with ultrasound and drugs, but I don't know if sialoliths are common enough for this treatment to have been extended to them. Personally, I'd investigate every other option before surgery.


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## zzdocxx (Sep 26, 2011)

I suppose you've seen a good ENT physician?


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## sbdivemaster (Nov 13, 2011)

So, I posted this more on the basis of seeing if the statistics are correct. Everything I read says that about 1.2% of the population gets salivary stones; with only 94 views of this thread, the sample isn't large enough to draw a conclusion either way.

Some background: This started over 20 years ago when I was in college. At that time, it would swell up while eating, but pretty much go back down within 30-45 minutes. I finally saw a ENT a couple weeks after it first started. Very painful "treatment" with piece of wire jammed into the duct and some scissor work thrown in - no anesthetic. Since that didn't do squat, except cause intense pain, this quack said the alternative was to have the entire gland removed with a nice scar and likely facial nerve damage. No thanks.

So, in the following 20 years, I might have had 2-3 flare-ups, nothing too serious. Now, over the last two years, the flare-ups are worse and more frequent. Finally, about 2 weeks ago, the gland just swelled up, and never went back down. Saw an ENT last Thursday, got a CT scan yesterday, and going back to the ENT on Friday. Surprise, it's twins!


Click to enlarge

According to the radiologist's report, the larger stone is 6.6mm (think pencil eraser) and the smaller one is 3mm (think BB). To give you a better idea, here's a pic of some stones:










Fortunately, there is a new procedure for removing the stones using a small endoscope via the duct. This eliminates any of the risks associated with the gland removal surgery. I'm hoping on Friday, the doctor tells me that it can be done with a local anesthetic instead of a general - the large stone is on the borderline for removal by sialendoscopy. Otherwise, the larger stone will need to be fragmented with some frickin' laser beams before they fish it out.

There you have it - more than you ever wanted to know about sialolithiasis.

I'll report back on Friday...


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## arkirshner (May 10, 2005)

sbdivemaster said:


> So, I posted this more on the basis of seeing if the statistics are correct. Everything I read says that about 1.2% of the population gets salivary stones; with only 94 views of this thread, the sample isn't large enough to draw a conclusion either way.
> 
> Some background: This started over 20 years ago when I was in college. At that time, it would swell up while eating, but pretty much go back down within 30-45 minutes. I finally saw a ENT a couple weeks after it first started. Very painful "treatment" with piece of wire jammed into the duct and some scissor work thrown in - no anesthetic. Since that didn't do squat, except cause intense pain, this quack said the alternative was to have the entire gland removed with a nice scar and likely facial nerve damage. No thanks.
> 
> ...


 May the Force be with you.

Good luck.

Alan


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## WouldaShoulda (Aug 5, 2009)

This is why Healthcare costs more today and will continue to increase. 

Because it's better than what we used to put up with and it works!!


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## sbdivemaster (Nov 13, 2011)

So, I saw the doctor on Friday. It turns out that the sialendoscopy procedure is performed under a general anesthetic, here in the US. The cost of the anesthesiologist's fee and the hospital fees will probably be 3x the cost of the procedure itself. Ouch.

In Europe, where the procedure was developed in the 90's, an outpatient procedure performed in a Dr.'s office is the standard of care. It turns out that the cost of airfare and the cost of the procedure will be less than having the procedure done 20 miles away from my home.

Are there any members from Switzerland who could help me out with locating a Dr. in Geneva who can perform the procedure? Hit me up with a PM.

I'll keep you posted...


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## Orsini (Apr 24, 2007)

If your have insurance, out-the-door should be about 20% of the retail total. 

Is the quality of result better in Switzerland? It would certainly be interesting if it was...


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## drlivingston (Jun 21, 2012)

See if you can get the procedure done in Amsterdam. I hear the herbal anesthetic is pretty cheap there and readily available. :wink2:


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## sbdivemaster (Nov 13, 2011)

Orsini said:


> If your have insurance, out-the-door should be about 20% of the retail total.
> 
> Is the quality of result better in Switzerland? It would certainly be interesting if it was...


No insurance; many insurance companies consider the procedure "experimental", so won't necessarily cover it anyway. I suspect that the quality of result wouldn't be much different here or there, but the sialendoscopy training takes place in Switzerland, so I figure I might as well go to the source.



drlivingston said:


> See if you can get the procedure done in Amsterdam. I hear the herbal anesthetic is pretty cheap there and readily available. :wink2:


No need to go to Amsterdam... :icon_smile_wink:


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## MikeDT (Aug 22, 2009)

Don't think I've ever had one of them. I've had lychees and durians though.


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## sbdivemaster (Nov 13, 2011)

*A Stone Is Born!*

Here's an update:

After a 10 day course of Augmentin 875 back in September, my stones had been quiet for months. Well, had a massive flair up towards the end of last week, and spent the weekend in excruciating pain - I'm talking, openly sobbing at times as the pain was so bad. There were points where part of my face was numb; there was so much pressure from the swollen gland, it had to have been pressing up against the submandibular nerve that runs right next to the salivary gland. So, last night I was waiting for sleep, or death, to take me away from all the pain; all of a sudden I felt a little stabbing pain inside my mouth, and it felt like there was a piece of gravel in there. I thought I might have chipped a tooth, but lo and behold, this is what I found:










A 3mm sialolith! (I wish I could get a better pic; trying to borrow a USB microscope from a buddy...)

That must have been working its way through the duct all weekend (think bowling ball forced through a garden hose).

Almost immediately, the pain was gone, the swelling was going down, and within minutes it felt almost normal. I almost passed out from the tremendous relief after days of incredible pain - that weak-in-the-knees feeling.

Well, the 6mm stone is still in there, and who knows when it will make itself known again, but as of now half of the problem is gone.


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