Sialolithiasis management: the state of the art.

S ialolithiasis is the main cause of unilateral diffuse parotid or submandibular gland swelling. Its incidence has been poorly studied but seems to be much higher than the classic data published by Rauch of 1 case per 300000 people per year. In a recent study, based on hospital admission figures in England, Escudier and McGurk estimated this incidence to be between 1 per 15000 and 1 per 30000. Personal observations of an incidence between 1 per 10000 and 1 per 20000 seem to confirm these results (F.M. and P.D., unpublished data, 2002). Sialolithiasis results in a mechanical obstruction of the salivary duct, causing repetitive swelling during meals, which can remain transitory or be complicated by bacterial infections. Traditionally, recurring episodes necessitate treatment by open surgery, and sialolithiasis still represents the most frequent reason for submandibular gland resection. Interestingly, parotid gland resection remains less frequent, probably because of the higher incidence of postoperative complications such as facial paresis.