Thx Stef. Hello all, I also hope my salivary stone (submandibular sialolith) story may help someone too.
My stone is 11mm, too big to squeeze out, but its cut out as of yesterday, Im recovering well.
It is a scary thing to happen to you, but you are not alone and it can be quick to resolve. In short and sweet summary - do your due diligence, but act fast.
Not everyones situation is the same, this is my 2 weeks of hell.
Couple of years ago I got very very sick after a week long celebration at the beach bar, I thought it was just cumulative effect of so much alcohol. A huge lump swells up under one side of my jaw and its incredibly painful in the mouth area, hard to swallow anything, impossible to eat solids. Bedridden.
My GP suspects stone, prescribes antibiotics and refers me to specialist surgeon. Scans and surgeon confirm its a 10mm (at that time) submandibular stone. He says wait for the antibiotics to settle the infection then get the whole gland removed. It does settle after pus massaged/worked its way out (unpleasant yet relieving), I dont however get the gland out right away (glad in hindsight). I spoke to a second surgeon and researched about removing just the stone to retain my gland. General consensus was too big a stone, too much chance of damaging gland/reoccurrence etc. Came across all sorts of suggestions such as breaking the stone with ultrasound, herbals, iodine etc, also some articles about stone excision such as Surgical management of an unusually large sialolith of the Wharton’s duct: A case report - ScienceDirect
and various excision articles on researchgate.net but my thoughts were dismissed by the 3 doctors I talked to…
Several years go by without incident and I all but forget about the stone. But its still there and the inevitable blocking and infection comes back last week… with a vengeance. I had felt it start before and gone straight to the GP for antibiotics but still was bedridden the next days, had a little repreive as I stayed in bed, stopped eating and survived on the occasional sip of smoothie/water. But the infection gets the better of me and I end up admitted to emergency, on a drip and in incredible pain. One of the ENT docs said something about trying to intraoral excise the stone if it settled but by this point I was begging them to take the whole gland out, with the original 3 docs warnings ringing in my sore ears. They would not remove the gland while so inflamed however, instead tried to aspirate (suck out the pus) first with an ultrasound guided syringe and local anasthetic.. which went wrong. Haemorageing, ridiculous pain, pus, horror.
Into the 3rd day on IV, body shutting down drugged up on endone etc I was massaging and working my tongue around when an epussphany (I now know a fistula) erupts in my mouth filling it with pus and stale blood. But pressure/pain relieves too. I improve out of sight within seconds I can walk and talk!!! The ENT doc happens to hear about it and she gets me in her chair for a looksee. Tells me fistula broke through and shes going to help it by making it bigger… just a little numbing spray and nick with the scalpel. Upon doing so she says ‘I think I can see it, lets try get it out’ bit more numbing spray (no needles) long pair of pliers and hey presto im ecstatically holding my 11mm stone and instantly feel even better again.
Literally singing&skipping out the door I am amazed at how simple and easy that was in the end, and the massive difference it made in but a moment. ‘Just wish I did it soon as I felt it coming on 2 weeks ago’.
A day later and in retrospect, I recommend soonest possible intraoral (inside your mouth) removal of stones over extraoral entire gland removal because:
- It was a really simple process, just numbing spray instead of serious surgery
- Ive still got my gland and if it heals great, if not I can still get it out if need be
- In the mean time my recovery is instantly better than after serious surgery
- No scar on my neck, and I can already feel some saliva function returning!
- None of the serious surgery risks/costs, facial nerve risk, anesthetics etc.
I am on cephalexin 500mg and sticking to smoothies for a few days to minimise irritation, also using a zero alcohol mouthwash and brushing twice daily. Im virtually pain free (apart from where the aspiration went wrong). So far so good. Good luck to you too.
Sumup - if it can be cut and pulled out through your mouth without duct damage, do it asap.