Large sialolith in the submandibular gland of a child

Recurrent Submandibular Sialolithiasis in a Child

Sialolithiasis is a commonly encountered disease of the salivary glands, reported to represent up to 30% of all salivary gland diseases. However, the condition is rarely encountered in the pediatric population. The formation of a salivary stone is believed to be secondary to the deposition of calcium salts around a nidus. The formation of a nidus is commonly associated with desquamated epithelial or sloughing from a recent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. Neglected and poorly treated acute infection may progress to life-threatening abscess formation. Here we are describing our encounter with a 10-year-old boy with recurrent submandibular sialolithiasis. He was initially treated with conservative measures and antibiotics regimen. Failure of medical treatment and recurring symptoms led to submandibular gland excision followed by a full recovery.