At UKRMED in Kyiv, salivary duct stone removal is planned around the stone’s actual position. If it sits in a reachable part of the duct, the surgeon may be able to remove the blockage through the mouth and leave the gland itself in place.
The complaint can sound almost too specific. “My jaw swells when I eat.” Not all day Not at random. Usually during a meal. A few minutes after eating starts, the area under the jaw becomes fuller and tighter. Then it gradually goes down again. That pattern immediately makes the duct worth checking.
Food switches saliva production into a higher gear. Normally, nobody notices. The fluid simply runs through the duct and enters the mouth. If a small stone is sitting there, the passage becomes narrow or blocked. The gland does not know that. It keeps producing saliva.
That is why the pressure appears at exactly the moment the patient starts eating. Once the gland becomes quieter again, the swelling may settle too.
The duct of the gland under the jaw runs along the floor of the mouth. A stone near the front can sit very close to the surface. The surgeon may feel it under the tissue with a finger. That gives a very direct idea of where the problem is.
A stone farther back is more annoying. The symptoms can be obvious, but nothing is easy to see or feel under the tongue. Then the surgeon needs another way to work out where it is.
That depends on the case. If the stone can already be felt, extra imaging may add little. For a deeper calculus, ultrasound can be useful. Sometimes CT gives the clearer answer. The important thing is not the name of the test.
It is whether the surgeon can answer:
How far back is the stone?
What part of the duct is it in?
Can that area be reached from inside the mouth?
If the calculus is accessible, the operation can be done through the mouth. The surgeon works in the floor-of-mouth area and reaches the affected section of the duct. The stone is then freed and removed. Quite often, it looks tiny.
That does not mean the symptoms were exaggerated. A narrow tube does not need a large object to become blocked. Afterwards, the surgeon checks the area where the stone was sitting and whether saliva can move again.
If possible, yes. The gland may be perfectly capable of working once the blockage is gone. In that situation, there is little reason to remove the whole gland just because a stone formed in its duct. Some cases are less simple. The stone may be located far back.
Or the gland may have been swollen and inflamed again and again for a long time. That can change the treatment plan. But for a reachable duct stone, removing the obstruction without removing the gland is often the point.
That tells a slightly different story. At first, swelling may appear during food and then disappear. Later, it may remain sore for hours. A bad taste can appear. Sometimes the patient notices discharge under the tongue.
That means the area may no longer be dealing with blockage alone. The gland can become inflamed after repeated problems with drainage. Doctors call this sialadenitis. If the stone is still there, the cause of the blockage still needs attention too.
The operated area is usually inside the mouth. For several days, the floor of the mouth can feel sensitive. The tongue may keep brushing against the wound. Eating feels a little different at first. Then the area gradually becomes less noticeable.
There is one thing patients themselves can watch very easily afterwards. Does the old swelling still start with meals? If that familiar pattern disappears, it is usually a very obvious change.
At UKRMED in Kyiv, the surgeon first works out where the stone sits.
Close to the duct opening?
Further back?
Easy to feel?
Only visible on imaging?
The next question is whether the duct can be cleared while preserving the gland.
That determines the actual treatment plan.
Because the gland becomes more active during meals. If the duct is blocked, pressure can build up quickly.
Yes, if it sits close enough to the front of the duct.
Often, yes, when the stone is in a reachable part of the duct.
Usually not if the gland still works and the stone can be removed separately.
It is the term used for stones that form in a salivary gland or its duct.
Mainly the stone’s position, the difficulty of access, anaesthesia and the amount of surgery needed.
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