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Liu CW, Lo WC. Enormous Asymptomatic Intraoral Sialolithiasis: A Case Report. EAR, NOSE & THROAT JOURNAL 2023:1455613231181221. [PMID: 37329274 DOI: 10.1177/01455613231181221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023] Open
Abstract
Sialolithiasis is one of the most common diseases of salivary glands. More than 80% of the sialoliths occur in the submandibular gland. While most of the calculi are less than 10 mm in size, 7.6% are larger than 15 mm and are classified as giant sialoliths. We demonstrate a rare case of asymptomatic giant sialolith in the left Wharton's duct with a total atrophy of the left submandibular salivary gland. A 48-year-old female patient presented with lumping sensation for 1 month. A left mouth floor mass was found accidentally during examination and was later revealed to be a painless sialolithiasis. Image study revealed a giant sialolith in the left Wharton's duct with duct dilatation and left submandibular gland total atrophy. She underwent transoral sialolithotomy with removal of a huge stone, measuring 3.5 × 1.4 cm in size. Sialolithiasis usually presents with typical symptoms of the involved salivary gland, and the size of calculi is usually less than 20 mm. This is a rare case report of an asymptomatic giant sialolith in the Wharton's duct, causing left submandibular salivary gland total atrophy, and its diagnosis and management.
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Affiliation(s)
- Chia-Wei Liu
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City
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Choi BE, Shin S, Evans S, Singh BB, Bandyopadhyay BC. Ablation of TRPC3 disrupts Ca 2+ signaling in salivary ductal cells and promotes sialolithiasis. Sci Rep 2023; 13:5772. [PMID: 37031239 PMCID: PMC10082769 DOI: 10.1038/s41598-023-32602-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/30/2023] [Indexed: 04/10/2023] Open
Abstract
Clinical studies and structural analyses of salivary stones strongly suggest a linkage between higher saliva calcium (Ca2+) and salivary stone formation, sialolithiasis; however, the process and the mechanism leading to Ca2+ overload during sialolithiasis is not well understood. Here, we show that TRPC3 null (-/-) mice presented with a reduction in Ca2+ entry and current in ductal cells with higher saliva [Ca2+] suggesting diminished transepithelial Ca2+ flux across the salivary ductal cells, leaving more Ca2+ in ductal fluid. Significantly, we found that TRPC3 was expressed in mice and human salivary ductal cells, while intraductal stones were detected in both mice (TRPC3-/-) and patient (sialolithiasis) salivary glands. To identify the mechanism, we found that TRPC3 was crucial in preventing the expression of calcification genes (BMP2/6, Runx2) in ductal cells which may be due to higher extracellular Ca2+ in SMG tissues. Similarly, inflammatory (IL6, NLRP3), fibrotic (FN1, TGFβ1) and apoptotic (Bax1/Bcl2) markers were also elevated, suggesting that the loss of TRPC3 induces genetic changes that leads to salivary gland cell death and induction of inflammatory response. Overall, ablation of TRPC3-/- leads to higher saliva [Ca2+], along with elevated detrimental gene expressions, altogether contributing to salivary gland stone formation.
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Affiliation(s)
- Bok-Eum Choi
- Calcium Signaling Laboratory, 151 Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC, 20422, USA
| | - Samuel Shin
- Calcium Signaling Laboratory, 151 Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC, 20422, USA
- Department of Biomedical Engineering, The Catholic University of America, 620 Michigan Avenue NE, Washington, DC, 20064, USA
| | - Sade Evans
- Calcium Signaling Laboratory, 151 Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC, 20422, USA
| | - Brij B Singh
- Department of Periodontics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Bidhan C Bandyopadhyay
- Calcium Signaling Laboratory, 151 Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC, 20422, USA.
- Department of Biomedical Engineering, The Catholic University of America, 620 Michigan Avenue NE, Washington, DC, 20064, USA.
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Rozas Pozo M, Fiori-Chíncaro GA, Llaguno-Rubio JM. [Narrative review of imaging studies of calcifications of the submandibular gland]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e143. [PMID: 38303738 PMCID: PMC10832393 DOI: 10.21142/2523-2754-1101-2023-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/05/2023] [Indexed: 02/03/2024] Open
Abstract
Sialolithiasis is one of the most common pathologies of the major salivary glands and occurs more frequently in the submandibular glands. Between 80 and 95% of sialoliths develop in the submandibular glands, between 5 and 20% in the parotid gland, and only 1% in the sublingual gland. Sialoliths form within the parenchyma and associated duct systems. In Wharton's duct (80-90%) and only 15% in the gland. Sialolithiasis is the cause of pain and inflammation of the salivary gland by obstructing the duct and preventing salivary secretion, before, during and after food.The objective of this article was to review the different diagnostic imaging methods used for the study of calcifications of the submandibular gland, based on different studies reported in contemporary scientific literature, in order to establish the correct diagnosis. A search of the literature was carried out in the main information sources including Medline (via PubMed), SEVIER, SCIELO, and LILACS, using the search terms with a date limitation of the last 5 years on average. The selected articles included information regarding the calcifications of the salivary glands. Imaging studies of salivary gland calcifications can be obtained with conventional radiographs, Sialography, Ultrasonography (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MR).
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Affiliation(s)
- Marco Rozas Pozo
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Gustavo Adolfo Fiori-Chíncaro
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Jhoana Mercedes Llaguno-Rubio
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
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Badash I, Raskin J, Pei M, Soldatova L, Rassekh C. Contemporary Review of Submandibular Gland Sialolithiasis and Surgical Management Options. Cureus 2022; 14:e28147. [PMID: 36148182 PMCID: PMC9482556 DOI: 10.7759/cureus.28147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
One of the most common disorders of the salivary glands is obstructive sialolithiasis. Salivary gland obstruction is important to address, as it can significantly impact patient quality of life and can progress to extensive cellulitis and abscess formation if left untreated. For small and accessible stones, conservative therapies often produce satisfactory outcomes. Operative management should be considered when stones are inaccessible or larger in size, and options include sialendoscopy, laser lithotripsy, extracorporeal shockwave lithotripsy, transoral surgery, and submandibular gland adenectomy. Robotic approaches are also becoming increasingly used for submandibular stone management. The purpose of this review is to summarize the modern-day management of submandibular gland obstructive sialolithiasis with an emphasis on operative treatment modalities. A total of 77 articles were reviewed from PubMed and Embase databases, specifically looking at the pathophysiology, clinical presentation, diagnosis, and management of submandibular sialolithiasis.
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Abraham ZS, Mathias M, Kahinga AA. Unusual giant calculus of the submandibular duct: Case report and literature review. Int J Surg Case Rep 2021; 84:106139. [PMID: 34216915 PMCID: PMC8258850 DOI: 10.1016/j.ijscr.2021.106139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction and importance Majority of salivary gland stones (sialoliths) occur in the submandibular gland (Wharton's duct and parenchyma) accounting for 80% of cases. A Giant calculus of more than 3 cm is a rare encounter. Case presentation We present a 45-year old male patient who undergone surgical removal of a giant submandibular gland calculus which was reported by the patient as a result of a hard mass beneath the tongue with occasional pain being experienced during intake of meals. Clinical discussion Clinical assessment revealed a painless palpable hard mass beneath the tongue though with some dull pain being experienced during intake of meals. Local examination showed a hard mass at the sublingual region but not adhered to surrounding structures. The overlying intraoral mucosa appeared normal and not inflamed and with neither enlarged ipsilateral submandibular gland nor cervical lymph nodes. The patient was then prepared for surgical removal of the calculus under general anesthesia where a single giant calculus (measuring 4 cm) was extracted by marsupialization of Wharton's duct. Conclusion A giant calculus of more than 3 cm is a rare encounter and they remain to be one of the causes of submandibular gland dysfunction. Most of the salivary gland sialoliths (80%) involve the submandibular gland A Giant calculus of more than 3 cm is rare Flow of saliva against gravity, high calcium and mucin content and its more alkaline pH explains calculi formation. Patients normally present with pain either before or during intake of meals and may have a history of recurrent swelling of the involved gland Intraoral extraction of a calculus should be advocated aiming at gland preservation
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Affiliation(s)
| | - Mary Mathias
- Department of Otorhinolaryngology, Temeke Municipal Hospital, Dar es Salaam, Tanzania
| | - Aveline Aloyce Kahinga
- Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Singh AK, Yeola M, Raghuvanshi P, Singh N. Giant Wharton's duct sialolithiasis causing sialo-oral fistula: a rare case report with literature review. J Family Med Prim Care 2020; 9:5793-5795. [PMID: 33532437 PMCID: PMC7842423 DOI: 10.4103/jfmpc.jfmpc_1525_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/16/2020] [Accepted: 10/02/2020] [Indexed: 11/16/2022] Open
Abstract
Giant submandibular sialolithiasis is uncommon and sialoliths causing sialo-oral fistula are rare. We report a case of giant Wharton's duct sialolithiasis causing sialo-oral fistula in a 40 years male who presented with pain and swelling over right side of floor of mouth for more than two years and visualisation of yellow coloured stone like structure at floor of mouth in the last two days. With diagnosis of Submandibular gland sialolithiasis with sialo-oral fistula, sialolithotomy and marsupialization of Wharton's duct was done under local anaesthesia.
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Affiliation(s)
- Amit Kumar Singh
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India
| | - Meenakshi Yeola
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India
| | - Pratikshit Raghuvanshi
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India
| | - Namrata Singh
- Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India
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Goh LC, Chitra BK, Shaariyah MM, Ng WSJ. Transcervical approach to the removal of a deep-seated giant submandibular calculus and the submandibular gland. BMJ Case Rep 2016; 2016:bcr-2016-217514. [PMID: 27793872 DOI: 10.1136/bcr-2016-217514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Sialolithiasis is among the most common disease affecting the major salivary glands whereby the submandibular gland or its duct is affected in the majority of cases. We report a case of the surgical removal of a giant sialolith along with the submandibular gland using the transcervical approach and its clinical outcome.
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Affiliation(s)
- Liang Chye Goh
- Department of Otorhinolaryngology, University of Malaya Medical center, Kuala Lumpur, Malaysia.,Department of Otorhinolaryngology, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia
| | - Banu Krishnan Chitra
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia
| | - Mohd Mokhtar Shaariyah
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia
| | - Wei Siang Johnson Ng
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia
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