From the Guidelines
If you're experiencing a submandibular gland stone with pus from your tonsils, you should seek immediate medical attention as this suggests a possible infection that may require professional treatment. The symptoms of a submandibular gland stone with purulent discharge from the tonsils can include intermittent pain in the trigeminal nerve area, tenderness of the involved salivary gland, and slow or absent salivary flow from the duct, as noted in the study by 1. The recommended approach typically involves antibiotics such as amoxicillin-clavulanate (875/125 mg twice daily for 7-10 days) or clindamycin (300 mg four times daily for 7-10 days) if you have a penicillin allergy. Warm salt water gargles (1/2 teaspoon salt in 8 oz warm water) several times daily can help with discomfort, along with over-the-counter pain relievers like ibuprofen (400-600 mg every 6-8 hours) or acetaminophen (500-1000 mg every 6 hours). Staying well-hydrated and sucking on sugar-free sour candies can stimulate saliva flow to help pass the stone. However, professional intervention is often necessary as the stone may need to be removed by a healthcare provider through massage, specialized instruments, or in some cases, surgery, as indicated by the study 1. This condition occurs when calcium deposits form in the salivary gland ducts, blocking saliva flow and potentially causing infection that can spread to surrounding tissues, including the tonsils, which explains the presence of pus. It's also important to note that while studies like 1 and 1 discuss tonsillectomy in children, they are not directly relevant to the treatment of a submandibular gland stone with purulent discharge from the tonsils, and thus the focus should remain on addressing the infection and the stone directly. The most critical step is to seek medical attention to prevent further complications and to improve quality of life, as the presence of pus indicates a possible infection that requires immediate attention.
From the Research
Symptoms of Submandibular Gland Stone
- Sialolithiasis of the salivary glands is a relatively rare occurrence and is the most common cause of acute and chronic infections 2
- Symptoms may include salivary gland pain or swelling, particularly during mastication 3
- Purulent discharge from the tonsils may be associated with submandibular gland stones, although this is not explicitly stated in the provided studies
Treatment Options for Submandibular Gland Stone
- Palliative therapy combined with conservative therapies, such as the milking of the ducts, can effectively treat small and accessible stones 3
- Surgical therapy, such as transoral removal of proximal or hilar stones, can be considered for larger stones or when conservative approaches have not proven to be effective 4, 5
- Sialadenectomy (removal of the submandibular gland) may be necessary in some cases, but gland-preserving operations are becoming increasingly popular as an alternative 4, 5
- Intraoral endoscopy-assisted sialolithotomy is a promising alternative to submandibulectomy for removal of stones from the superficial lobe of the submandibular gland 5
Treatment Outcomes
- Transoral removal of proximal or hilar stones has been shown to be effective in 99% of cases, with low morbidity and no intra-operative complications 4
- Intraoral endoscopy-assisted sialolithotomy has been shown to have a low rate of postoperative complications and a high rate of patient satisfaction 5
- Salivary flow rates may remain reduced in most of the affected glands upon stone removal, but sonographical follow-up data suggests that the gland can return to a regular size and structure in many cases 5