Submandibular Sialolithiasis: A Series of Three Case Reports with Review of Literature

Abstract

One of the most common disorders of the salivary glands is sialolithiasis. A history of pain or/and swelling in the salivary glands, especially during meal suggests this diagnosis. For small and accessible stones conservative therapies like milking of ducts with palliative therapy can produce satisfactory results. Surgical management should be considered when the stone/stones are inaccessible or large in size as conservative therapies turned out to be unsatisfactory. In this paper, we present three cases of sialolithiasis in the submandibular gland along with a review of existing literature. The purpose of this paper is to add three more cases to the literature and review the theories of etiology, clinical features, available diagnostic and treatment procedures.

Giant Wharton's duct sialolithiasis causing sialo-oral fistula: a rare case report with literature review

“…Thereafter in second phase, layered deposition of organic and inorganic material around the core forms the peripheral layer. [ 2 ] Pain and swelling of involved gland are cardinal features of most of sialolithiasis due to blockage of lumen of gland ducts by stones especially during meals also called 'mealtime syndrome'. The pain and swelling may remain for hours followed by weeks to months of remission.…”

“…Recurrent infections of gland due bacterial translocation from duct to gland parenchyma may cause pain and swelling over gland. [ 2 ] Sialoliths larger than 15 mm and heavier than 1 gram are called giant sialoliths. Sialoliths may attain considerable sizes to be accommodated in ducts.…”

“…Treatment is tailored based on size, location and number of stones. [ 2 ] Conservative non-invasive management of small stones include administration of sialagogues and bimanual palpation and milking of stones through duct orifice after each meal. If stone is large extracorporeal shock wave lithotripsy, laser sialolithectomy or surgical removal of stone or gland should be planned.…”

“…[ 1 ] Sialolithiasis can occur at any age but is most commonly seen between fourth to sixth decades of life with males effected twice as females. [ 2 ] Typical symptoms of sialolithiasis is described as 'mealtimes syndrome’ which manifests as pain and swelling over the affected site during meals. Commonly sialoliths measure from 1 millimetre (mm) to 10 mm while giant sialoliths are characterised by size more than 15 mm and weight more than one gram.…”

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

“…This history of pain or/and swelling in the salivary glands, especially during meals, suggests this diagnosis. [ 4 ]…”