Submandibular gland sialolith of unusual size

Abstract

Introduction: Sialolithiasis is the most common disease of the salivary glands. Majority of sialoliths occur in the submandibular gland and is a common cause of acute and chronic infections of the gland. The size varies from one mm to one cm. Size greater than 15 mm are considered unusual or giant sialolith.
 Case report: We present a case of an unusual size sialolith of 16 mm in submandibular gland duct which was removed via transoral incision. The aim of presenting this case report is to understand etio-pathogenesis, clinical presentation and management of submandibular sialolithiasis.
 Conclusion: Submandicular sialolithiasis of more than 15 mm in size though rare are not uncommon. They can be managed intraorally if situated at or near the orifice.

Submandibular duct sialolithiasis of unusual size: a case report

“…8 Kandel et al reported a stone of unusual size located near the opening of the submandibular duct which was removed intraorally. 9 If the stones are located more posterior in the intraglandular portion of the duct, the entire gland must be removed. 8,10 Sengupta et al reported a stone of unusual size about 12×6 mm located in the proximal part of the submandibular duct which was removed along with the submandibular gland.…”

A case report on meal time syndrome

“…3 This results in a flow against gravity, which may facilitate stasis of submandibular saliva. 5 Minerilisation is supported by accumulation of calcium and an increase in pH. 3 It is considered that salivary stasis or decreased salivary flow contributes to the precipitation of calcium.…”

“…4 Most cases present with pain and swelling in submandibular region during meal time and hence the name meal time syndrome. 5,6 The symptoms are pronounced when a stone is located in duct than in gland 7 . It is caused by obstruction of salivary flow in affected gland, resulting in accumulation of saliva and subsequent increase in intra-glandular pressure, which in turn leads to destruction of salivary gland and formation of connective tissue.…”

“…Stones usually have yellow or yellow-brown colour. 5 The weight of stones varies from 1 mg to 6 g, with an average weight of 300 mg. 3 They are considered as "giant salivary stones" when the diameter is 15 mm or more in any direction or when the weight is 1 g or more. Giant salivary stones are usually located in the glandular parenchyma and are rarely found in Wharton"s ducts.…”