Regarding the Lack of Evidence for a Microbial Etiology of Sialolithiasis

Harrison, J. D.

doi:10.1002/lary.28047

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…According to this theory, a reduction in salivary flow rate may also have a prominent role in retrograde bacterial spread. 18 In our study, several observations argued in favor of saliva stagnation due to a duct condition. Firstly, the majority of lithiasis were located in the areas where saliva flow could be slowed: in the posterior third of the submandibular duct, posterior to the elbow formed by the crossing with the lingual nerve and in the middle third of the parotid duct, posterior to the duct angle in front of the masseter, through the buccinator.…”

Section: Discussionsupporting

confidence: 51%

Salivary Gland Lithiasis Recurrence After Minimally‐Invasive Surgery: Incidence, Risk Factors and Prevention

et al. 2020

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The aim of this study was to evaluate the recurrence rate of lithiasis following minimally invasive surgery to identify risk factors and mechanisms for recurrence of salivary gland lithiasis. Study Design: Retrospective case series. Methods: A retrospective study was conducted including all patients treated for salivary gland lithiasis by minimally invasive surgery, such as sialendoscopy, intracorporeal lithotripsy, extracorporeal lithotripsy, transoral approach, and combined approach in our Department. We analyzed the recurrence rate of salivary lithiasis, their topography and timeline. Result: Three hundred four patients were included in this study, the mean age was 49 years (range 12-90 years), and the mean duration of follow-up was 19.8 months (range 0-66 months). Fifteen patients (5%) presented secondary lithiasis. In all but one case, recurrences involved the same gland as primary lithiasis, and most frequently the submandibular gland. Recurrences occurred from 3 to 46 months postoperatively. Fourteen patients, who presented recurrence, had been initially treated by transoral approach. Recurrent lithiasis were treated by transoral approach or submandibulectomy. Conclusion: Salivary gland lithiasis recurrence was rare after minimally invasive salivary gland surgery. This study reinforced the concept that salivary gland lithiasis should be considered as a duct pathology.

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Section: Discussionsupporting

confidence: 51%

Salivary Gland Lithiasis Recurrence After Minimally‐Invasive Surgery: Incidence, Risk Factors and Prevention

et al. 2020

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“…Both clinical pictures are associated with a disturbed gland function, a reduced salivary flow rate, and the presence of leucocytes in saliva [ 33 , 34 ]. Altered ion concentrations in saliva [ 21 ] leading to crystal formation as well as the presence of cellular debris, foreign bodies, or bacteria have been considered to contribute to sialolith formation in the past [ 22 , 23 , 24 , 67 , 68 , 69 ]. The most solid observations on the development of salivary stones describe the occurrence of sialomicroliths, having been found to be present in the salivary glands of asymptomatic individuals [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Neutrophil Extracellular Traps Promote the Development and Growth of Human Salivary Stones

Mantsopoulos

Koch

Weidner

et al. 2020

Cells

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Salivary gland stones, or sialoliths, are the most common cause of the obstruction of salivary glands. The mechanism behind the formation of sialoliths has been elusive. Symptomatic sialolithiasis has a prevalence of 0.45% in the general population, is characterized by recurrent painful periprandial swelling of the affected gland, and often results in sialadenitis with the need for surgical intervention. Here, we show by the use of immunohistochemistry, immunofluorescence, computed tomography (CT) scans and reconstructions, special dye techniques, bacterial genotyping, and enzyme activity analyses that neutrophil extracellular traps (NETs) initiate the formation and growth of sialoliths in humans. The deposition of neutrophil granulocyte extracellular DNA around small crystals results in the dense aggregation of the latter, and the subsequent mineralization creates alternating layers of dense mineral, which are predominantly calcium salt deposits and DNA. The further agglomeration and appositional growth of these structures promotes the development of macroscopic sialoliths that finally occlude the efferent ducts of the salivary glands, causing clinical symptoms and salivary gland dysfunction. These findings provide an entirely novel insight into the mechanism of sialolithogenesis, in which an immune system-mediated response essentially participates in the physicochemical process of concrement formation and growth.

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“…Although the development of a clinical sialadenitis is not per se associated with the presence of sialoliths and vice versa, these two constellations occur in parallel, mutually reinforcing each other 23 . Altered ion concentrations in saliva 21 leading to crystal formation as well as the presence of cellular debris, foreign bodies or bacteria have been considered to contribute to sialolith formation in the past 22,23,24,62,63,64 . However, it was unknown to date whether these mechanisms are interconnected and how microscopic crystals in the salivary ducts can form and grow to macroscopic concrements.…”

Section: Discussionmentioning

confidence: 99%

Development and Growth of Human Salivary Stones by Neutrophil Extracellular Traps

Mantsopoulos

Koch

Weidner

et al. 2020

Preprint

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Salivary gland stones, or sialoliths, are the most common cause of the obstruction of salivary glands. Symptomatic sialolithiasis has a prevalence of 0.45% in the general population, is characterized by recurrent painful periprandial swelling of the affected gland and often results in sialadenitis with the need for surgical intervention. The mechanism behind the formation of sialoliths has been elusive. Here we show that neutrophil extracellular traps (NETs) initiate the formation and growth of sialoliths. The deposition of neutrophil granulocyte extracellular DNA around small crystals results in their dense aggregation, and the subsequent mineralization creates alternating layers of dense mineral, predominantly calcium salt deposits and DNA. Further agglomeration and appositional growth of these structures promotes the development of macroscopic sialoliths that finally occlude the efferent ducts of the salivary glands, causing clinical symptoms and salivary gland dysfunction. These findings provide an entirely novel insight into the mechanism of sialolithogenesis in which an immune system mediated response essentially participates in the physico-chemical process of concrement formation and growth.

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Regarding the Lack of Evidence for a Microbial Etiology of Sialolithiasis

Cited by 3 publications

References 7 publications

Salivary Gland Lithiasis Recurrence After Minimally‐Invasive Surgery: Incidence, Risk Factors and Prevention

Salivary Gland Lithiasis Recurrence After Minimally‐Invasive Surgery: Incidence, Risk Factors and Prevention

Neutrophil Extracellular Traps Promote the Development and Growth of Human Salivary Stones

Development and Growth of Human Salivary Stones by Neutrophil Extracellular Traps

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