Spontaneous Expulsion and Compositional Analysis by Infrared Spectroscopy of a Parotid Sialolith: A Case Report

Sialolithiasis, or salivary gland stone formation, is a condition characterized by mineralized deposits in the salivary ducts. This case report highlights the clinical presentation, spontaneous expulsion, and compositional analysis of a salivary stone in a 35-year-old North African male.

A patient with no significant medical history or dental issues presented with a spontaneously expelled salivary stone during a salty meal. The stone, measuring 13 mm and weighing 0.52 g, caused mild pain in the left parotid gland during salty and sour meals. Laboratory tests revealed normal calcium and electrolyte levels. The stone was examined using optical microscopy and Fourier transform infrared spectroscopy (FTIR-ATR), confirming its composition as carbonated apatite with minor organic content.

The formation of sialoliths is attributed to salivary stasis and altered salivary composition, promoting calcium phosphate precipitation. FTIR-ATR analysis demonstrated a structure composed of concentric layers of carbonated apatite, indicating progressive mineralization. Smoking and glandular physiology, including higher calcium content and pH in parotid saliva, were likely contributors. Management strategies for sialolithiasis emphasize conservative measures, with surgical intervention reserved for larger stones.

This case underscores the complex interplay of local and systemic factors in sialolith formation. The detailed compositional analysis enhances understanding of pathogenesis, aiding in improved diagnostic and therapeutic approaches for salivary stones.