We clinically analyzed 251 patients with sialolithiasis who were treated in the First Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University from October 1977 to September 1991. The results were as follows:
1. The male: female ratio of the patients was 1:1.1 and a high incidence was found in the ages of 20 to 59 years.
2. Salivary calculi were most frequently found in the submandibular duct, and no right or left side preference was recognized.
3. The number of calculi ranged from 1 to 11; however, one calculi accounted for 84. 6% of cases.
4. As for the diameter of the calculi, most of them were less than 5 mm, and the largest one was 37mm.
5. The interval from the first recognition of symptoms to presentation at our clinic ranged from 1 day to 37 years. Most patients presented after more than 1 year.
6. The commonest symptom was the swelling of the submandibular gland, associated with the ingestion of food in about half of the cases.
7. In about 80% of all cases, removal of the calculus was performed.
8. In 13.1% of all cases, the following post-operative symptoms appeared: tenderness, swelling, hardening of the submaxillary region, and sensory paralysis of the hypoglossus and facialis nerves. However, symptoms improved in all cases. These results indicate that sialithiasis tends to be accompanied by swelling of the submandibular region rather than by salivary colic. Correct diagnosis is therefore difficult. Multiple calculi were found frequently; however, some of them were difficult to recognize radiologically. Therefore, care must be taken to avoid leaving stores behind and to avoid injury to the surrounding tissue.