Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ Key Features ++ Calculus formation is more common in Wharton duct (draining the submandibular glands) than in Stensen duct (draining the parotid glands) ++ Clinical Findings ++ Patient may note postprandial pain and local swelling, often with a history of recurrent acute sialadenitis ++ Diagnosis ++ Stones in Wharton duct are usually large and radiopaque, whereas those in Stensen duct are usually radiolucent and smaller Stones very close to the orifice of Wharton duct may be palpated manually in the anterior floor of the mouth and removed intraorally by dilating or incising the distal duct ++ Treatment ++ Stones more than 1.5–2 cm from the duct are too close to the lingual nerve to be removed safely in this manner Dilation of Stensen duct, located on the buccal surface opposite the second maxillary molar, may relieve distal stricture or allow a small stone to pass Sialoendoscopy for the management of chronic sialolithiasis is superior to extracorporeal shock-wave lithotripsy and fluoroscopically guided basket retrieval Repeated episodes of sialadenitis are usually associated with stricture and chronic infection If the obstruction cannot be safely removed or dilated, excision of the gland may be necessary to relieve recurrent symptoms GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessMedicine 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessMedicine Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options