Evidence of a microbial etiology for sialoliths
At a Glance
Section titled “At a Glance”| Metadata | Details |
|---|---|
| Publication Date | 2019-03-12 |
| Journal | The Laryngoscope |
| Authors | W. Katherine Kao, Richard A. Chole, Margaret Ogden |
| Institutions | Washington University in St. Louis |
| Citations | 34 |
Abstract
Section titled “Abstract”Objectives Sialolithiasis is the primary etiology for parotid and submandibular swelling, potentially resulting in discomfort, bacterial infections, and hospitalization. The etiology of sialolith formation is unknown. Currently, the proposed etiologies range from inflammation, coalescence of organic molecules, sialomicrolith formation, pH changes, and biofilm formation. In this study, we performed a descriptive analysis of images obtained through electron microscopy of sialoliths. Based on our findings and descriptive analysis, we hypothesize that sialolith formation is likely multifactorial and begins with biofilm formation. Biofilm formation then triggers a host immune response, and it is the interaction of biofilm with host immune cells and calcium nanoparticles that forms the nidus and creates a favorable environment for calcium precipitation. Methods Sialoliths were extracted from patients and imaged under light and scanning electron microscopy. Specimens for light microscopy were prepared using a diamond saw. Specimens for electron microscopy were freeze‐fractured, thus providing an undisturbed view of the core of the sialolith. Results We were able to identify clear evidence of biofilm caves at the core of each sialolith. These biofilm caves were complex with the presence of bacteria and dehydrated extrapolysaccharide matrix, host cells (immune cells, platelets and erythrocytes), and calcium nanoparticles. Conclusion The etiology of sialolith formation is likely multifactorial. We propose that biofilm formation within a single salivary gland or duct leads to local ductal injury, which results in the influx of host immune cells that interact with the biofilm and calcium nanoparticles, creating a scaffold upon which further calcium deposition can occur. Level of Evidence NA Laryngoscope , 130:69-74, 2020
Tech Support
Section titled “Tech Support”Original Source
Section titled “Original Source”References
Section titled “References”- 1842 - On the spontaneous discharge of calculi
- 1960 - [A contribution to the genesis of sialolithiasis]