Salivary gland obstruction
Salivary duct stenosis or obstruction refers to a narrowing (stenosis) or blockage (obstruction) in your salivary glands. The blockage may occur spontaneously or it may be caused by the presence of calcified stones in one of your salivary glands or ducts, or by an autoimmune disease. Salivary stones occur in 1.2% of the population and patients are usually between 30-60 years old.
If there is an obstacle in one of your salivary ducts, the saliva created in the duct will stagnate in the duct and form small calcified stones. Symptoms of a salivary duct stenosis or blockage include pain, tenderness, swelling, redness and swollen lymph nodes.
If the blockage is caused by an infection, the infected area will produce pus and redness in the floor of your mouth. If there is an obstruction in a salivary duct, you may find that no saliva is released from the duct.
Your doctor will diagnose you based on your medical history and a physical examination. Imaging methods can detect the presence of calcified stones in around 80% of cases. One possible imaging method is a sialogram, in which X-rays are used to show the whole length of the duct so that any problems can be revealed. A sialogram is performed under local anaesthesia and is an out-patient procedure.
There are a number of treatments available. Conservative treatments include citrus fruits (which increase the amount of saliva you produce, which may dislodge the stone), hydration, moist heat therapy, medication, massage or shock wave therapy.
Alternatively, you may undergo a sialendoscopy, a minimally invasive treatment in which the narrowing or obstruction is treated using an endoscope (an imaging tool). Another possible treatment option is to have a surgical procedure, such as cannulation (surgically inserting a tube into the affected duct to keep the area clear) or removal of the duct.