An extraoral surgical approach to treat chronic submandibular sialolithiasis - A case series

Abstract

Sialolithiasis is the most common cause of sialadenitis in the submandibular gland, in which the highest incidence of this condition occurs, among the major salivary glands. This could be explained by the anatomy of Wharton's duct, and the chemical composition of the saliva produced by this gland. There are several alternatives and techniques for the treatment of sialolithiasis, including lithotripsy, sialoendoscopy, and conservative removal of the sialoliths or complete removal of the submandibular gland, through the transoral and extraoral routes for access to the gland. To determine the form of treatment, characteristics such as topography, diameter, and location of the sialolith in the duct are observed. The aim of this case series was to show our experience gained in two clinical cases of submandibular gland excision through an extraoral approach, using the submandibular access technique. In addition, we discussed the cause of sialolithiasis in these patients and after follow-up, compared the clinical results we obtained with this technique with those reported in the current literature. The submandibular approach or Risdon access continues to be a safe approach to removing the submandibular gland, as it is a commonly used technique and obtained satisfactory results, as shown in these cases. However, the major disadvantages were the less favorable esthetic results and paralysis of the marginal mandibular branch of the facial nerve.

Sialoendoscopia: el fin de la adenectomía abierta en enfermedad salivar benigna

“…En Medellín se usa desde En la literatura, la glándula más afectada en el 80 % es la submandibular en comparación con este estudio, en el que la más afectada fue la glándula parótida (3,4), debido a la longitud del conducto de Wharton (50 mm), su disposición ascendente y su diámetro (1,5 mm) en comparación con un 20 % en la parótida, que tiene un conducto más horizontal, más corto (40 mm) y más amplio (3 mm) (5). Es más común en hombres entre 40 y 60 años, y se caracteriza por episodios recurrentes de tumefacción de la glándula y dolor durante la ingesta de alimentos (3,4). A diferencia de la serie reportada en el presente estudio, el compromiso glandular se distribuyó equitativamente y se encontraron muchas más mujeres; esto puede obedecer a un sesgo de selección de los pacientes.…”

Tratamento conservador de sialoadenite esclerosante crônica

“…No que diz respeito ao perfil epidemiológico de pacientes mais acometidos por SEC, relatos prévios afirmam que homens com idade entre 40 e 60 anos mostraram a maior incidência 8 . Tais informações clínicas e histopatológicas demonstram a tipicidade do caso de SEC ora descrito e a concordância dos aspectos epidemiológicos reportados pela literatura, o que denota a importância do conhecimento de tais aspectos pelo clínico.…”

“…Embora amplamente preconizada na literatura como melhor tratamento, a ressecção da glândula afetada possui limitações estéticas e funcionais, como paralisia temporária do nervo facial marginal e cicatriz remanescente proveniente de um acesso extra oral 8,11 .…”