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Sodnom-Ish B, Eo MY, Cho YJ, Seo MH, Yang HC, Kim MK, Myoung H, Lee SK, Kim SM. Identification of biological components for sialolith formation organized in circular multi-layers. Sci Rep 2023; 13:12277. [PMID: 37507401 PMCID: PMC10382579 DOI: 10.1038/s41598-023-37462-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
According to the previous studies of sialolithiasis reported so far, this study is aimed to identify the biological components of sialolith, which show different ultrastructures and chemical compositions from other stones, cholelith and urolith. Twenty-two specimens obtained from 20 patients were examined histologically, and analyzed with micro-CT, scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and transmission electron microscopy (TEM). All sialoliths (n = 22) observed in this study showed a central nidus, which was filled with organoid matrix admixed with exosome vesicles, loose calcium apatite crystals, and many bacteria. The micro-CT and SEM observation clearly defined a single or multiple central nidus(es) encircled by highly calcified compact zone. The circular compact zone showed a band-like calcification, about 1-3 mm in thickness, and usually located between the central nidus and the peripheral multilayer zone. But some sialoliths (n = 5) showed severe erosion of compact zone by expanding multilayered zone depending on the level of calcification and inflammation in sialolith. By observing TEM images, many exosome vesicles and degraded cytoplasmic organelles were found in the central nidus, and some epithelial cells were also found in the calcified matrix of peripheral multilayer zone. Particularly, EDS analysis indicated the highest Ca/P ratio in the intermediate compact zone (1.77), and followed by the central nidus area (1.39) and the peripheral multilayer zone (0.87). Taken together, these data suggest that the central nidus containing many inflammatory exosomes and degraded cytoplasmic organelles has a potential to induce a band-like calcification of compact zone, and followed by the additional multilayer deposition of exfoliated salivary epithelial cells as well as salivary materials. Thereby, the calcium apatite-based sialolith is gradually growing in its volume size, and eventually obstructs the salivary flow and provides a site for the bacterial infection.
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Affiliation(s)
- Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Yun Ju Cho
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Mi Hyun Seo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hyeong-Cheol Yang
- Department of Dental Biomaterials Science, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Min-Keun Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Suk Keun Lee
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea.
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea.
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Şengör GA, Bilgili AM. A Novel Approach for the Treatment of Sialolithiasis that Preserves Salivary Duct Anatomy. Ann Otol Rhinol Laryngol 2021; 131:268-276. [PMID: 34049458 DOI: 10.1177/00034894211018926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The sialendoscopy era in the treatment of salivary gland stones has reduced the use of classical surgical methods. However, the miniature ducts and tools may cause difficulties in removing large sialoliths. Therefore, invasive combined oral surgeries or gland resection may be considered. We searched for the most suitable method in order to stay in line with the minimally invasive approach that preserves the ductus anatomy, and that can reduce the surgical fears of patients. MATERIALS AND METHODS The study included 84 cases (23 parotid and 61 submandibular) in whom stones were fragmented by pneumatic lithotripsy and removed between January 2015 and January 2020. The parotid cases comprised 7 females and 16 males, and the submandibular cases comprised 25 females and 36 males. Intraductal lithotripsy was performed using pneumatic lithotripter. This study has fourth level of evidence. RESULTS Based on total number of cases (n = 84), success rate was 67/84 (79.7%) immediately after sialendoscopy, and overall success rate was 77/84 (91.6%). Based on number of stones treated (n = 111), our immediate success rate was 94/111 (84.6%), and overall success rate was 104/111 (93.7%). The success criteria were complete removal of the stone and fragments in a single sialendoscopy procedure and resolution of symptoms. CONCLUSIONS We successfully treated salivary gland stones, including L3b stones, in our patient cohort with sialendoscopy combined with pneumatic lithotripsy. The lithotripsy method that we have adapted seems to be more useful and cost-effective compared to its alternatives. We were also able to preserve the ductus anatomy and relieve patients' concerns.Level of Evidence: Level IV.
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Affiliation(s)
| | - Ahmet Mert Bilgili
- Medical Faculty Department of Otolaryngology, Cyprus International University, Nicosia, Cyprus
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Nolasco P, Coelho PV, Coelho C, Angelo DF, Dias JR, Alves NM, Maurício A, Pereira MFC, Alves de Matos AP, Martins RC, Carvalho PA. Mineralization of Sialoliths Investigated by Ex Vivo and In Vivo X-ray Computed Tomography. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2019; 25:151-163. [PMID: 30714561 DOI: 10.1017/s1431927618016124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The fraction of organic matter present affects the fragmentation behavior of sialoliths; thus, pretherapeutic information on the degree of mineralization is relevant for a correct selection of lithotripsy procedures. This work proposes a methodology for in vivo characterization of salivary calculi in the pretherapeutic context. Sialoliths were characterized in detail by X-ray computed microtomography (μCT) in combination with atomic emission spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. Correlative analysis of the same specimens was performed by in vivo and ex vivo helical computed tomography (HCT) and ex vivo μCT. The mineral matter in the sialoliths consisted essentially of apatite (89 vol%) and whitlockite (11 vol%) with average density of 1.8 g/cm3. In hydrated conditions, the mineral mass prevailed with 53 ± 13 wt%, whereas the organic matter, with a density of 1.2 g/cm3, occupied 65 ± 10% of the sialoliths' volume. A quantitative relation between sialoliths mineral density and X-ray attenuation is proposed for both HCT and μCT.
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Affiliation(s)
- Pedro Nolasco
- CeFEMA, Instituto Superior Técnico, University of Lisbon,Av. Rovisco Pais, 1049-001 Lisboa,Portugal
| | - Paulo V Coelho
- Service of Maxillofacial Surgery,Centro Hospitalar de Lisboa Central,R. José António Serrano 1150-199 Lisboa,Portugal
| | - Carla Coelho
- Service of Maxillofacial Surgery,Centro Hospitalar de Lisboa Central,R. José António Serrano 1150-199 Lisboa,Portugal
| | - David F Angelo
- NMS/FCM-UNL, Nova Medical School--Medical Sciences Faculty, Nova University of Lisbon,Campo Mártires da Pátria, 130, 1169-056 Lisboa,Portugal
| | - J R Dias
- CDRsp, Polytechnic Institute of Leiria,Rua de Portugal, Zona Industrial,2430-028, Marinha Grande,Portugal
| | - Nuno M Alves
- CDRsp, Polytechnic Institute of Leiria,Rua de Portugal, Zona Industrial,2430-028, Marinha Grande,Portugal
| | - António Maurício
- CERENA, Department of Civil Engineering,Architecture and Georessources, Instituto Superior Técnico, University of Lisbon,Av. Rovisco Pais, 1049-001 Lisboa,Portugal
| | - Manuel F C Pereira
- CERENA, Department of Civil Engineering,Architecture and Georessources, Instituto Superior Técnico, University of Lisbon,Av. Rovisco Pais, 1049-001 Lisboa,Portugal
| | | | - Raul C Martins
- IT, Department of Bioengineering,Instituto Superior Técnico, University of Lisbon,Av. Rovisco Pais, 1049-001 Lisboa,Portugal
| | - Patrícia A Carvalho
- CeFEMA, Instituto Superior Técnico, University of Lisbon,Av. Rovisco Pais, 1049-001 Lisboa,Portugal
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