Removal of a calculus from the salivary gland duct

A salivary stone (sialolith) forms in a salivary gland or its duct and blocks the flow of saliva. A blockage causes pain and swelling under the jaw or tongue during meals and, without treatment, leads to inflammation — sialadenitis. At UKRMED Maxillofacial Surgery, salivary gland stone removal is performed by surgeon Anna Kravchenko, aiming to preserve the gland itself.

Why stones form

Saliva contains calcium salts. When flow slows — due to a narrowed duct, dehydration, inflammation or some medicines — the salts settle and form a stone. Most stones form in the submandibular gland, whose duct is long and runs upwards and whose saliva is thicker. In a 2026 series of almost 100 cases, the submandibular glands accounted for 74% of cases. The parotid and sublingual glands are affected less often.

Symptoms

• pain and swelling under the jaw or tongue during meals — "salivary colic";
• swelling that subsides a few hours after eating;
• a palpable lump under the tongue;
• dry mouth and an unpleasant taste;
• with inflammation — redness, pus from the duct and fever.

Sialadenitis

Sialadenitis is inflammation of a salivary gland. A stone blocks flow, saliva stagnates and infection develops. It is treated with antibiotics and saliva stimulants, but if a stone is the cause, flare-ups return until it is removed. An acute purulent process with an abscess needs incision and drainage.

Diagnosis

The doctor examines and palpates the gland and duct. The stone is confirmed by ultrasound or CT, showing its size, number and location — in the duct or deep in the gland.

Sialolithiasis treatment options

• Through the mouth — if the stone is in the duct near its opening, it is removed through a small incision under the tongue (sialolithotomy). The gland is preserved and recovers.
• Sialendoscopy — a thin endoscope examines the duct and retrieves the stone with a basket. In the series mentioned, complete removal was achieved in 79% of cases, with lower chances for stones over 10 mm, stones inside the gland or multiple stones.
• Gland removal — when stones are multiple or deep, or sialadenitis keeps returning. See salivary gland removal.

Recovery

After removal through the mouth, the wound heals in one to two weeks. Drink plenty of water and, if the doctor advises, suck sour sweets or lemon slices to boost saliva flow and flush the duct. Keep up careful oral hygiene.

Prevention

To prevent new stones, drink enough fluids, keep your mouth clean, treat decay and gum inflammation and have regular professional cleanings.

Salivary stone removal cost at UKRMED

The surgeon gives the cost after examination and diagnosis — it depends on the stone's position and the removal method.

Sources

1. Althobaiti M., Amin M. U., Elbana A. et al. Sialendoscopy in the management of obstructive sialadenitis: clinical experience and treatment outcomes. Ann Saudi Med, 2026. https://doi.org/10.5144/0256-4947.2026.287