Giant submandibular sialolith conservatively treated

Long-term rare giant sialolithiasis for 30 years: A case report and review of literature

BACKGROUND

Sialolithiasis is one of the most common salivary gland disorders, most commonly affecting the submandibular gland. Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments. Treatment selection was based on the ductal system anatomy and the size and location of the stones. This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables.

CASE SUMMARY

This report presents a case of a long-term, rare, and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult. Our patient presented with painless right submandibular swelling. Computed tomography revealed a calcified mass measuring 35 mm × 20 mm within the right submandibular gland. In this case, the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland. Thus, right submandibular sialoadenectomy was performed via the transcervical approach. After the surgery, the patient recovered without any complaints, side effects, or complications.

CONCLUSION

Tailored management is important for preserving gland function, maintaining low risk, and reducing patient discomfort.

Long-term rare giant sialolithiasis for 30 years: A case report and review of literature

BACKGROUND

Sialolithiasis is one of the most common salivary gland disorders, most commonly affecting the submandibular gland. Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments. Treatment selection was based on the ductal system anatomy and the size and location of the stones. This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables.

CASE SUMMARY

This report presents a case of a long-term, rare, and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult. Our patient presented with painless right submandibular swelling. Computed tomography revealed a calcified mass measuring 35 mm × 20 mm within the right submandibular gland. In this case, the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland. Thus, right submandibular sialoadenectomy was performed via the transcervical approach. After the surgery, the patient recovered without any complaints, side effects, or complications.

CONCLUSION

Tailored management is important for preserving gland function, maintaining low risk, and reducing patient discomfort.

Role of Ultrasonography Supplemented by Sialendoscopy in Submandibular Steinstrasse Sialolithiasis

The submandibular gland is the most common major salivary gland vulnerable to sialadenitis secondary to sialolithiasis. We report a case of submandibular steinstrasse causing sialadenitis in a 45-year-old male and describe the appearances on high-resolution ultrasonography. Endoscopic-assisted excision of calculi was done. Post-operative recovery was uneventful and the patient was discharged after one week. The patient has been on follow-up for six months with no complaints of recurrence. Multiple stacked calculi within the Wharton's duct is an exceedingly rare occurrence. Steinstrasse creates a dilemma of choice for the intended surgical approach during calculi extraction from the Wharton's duct. Endoscopic guided calculi extraction may be ideal for distally placed calculi along the course of the duct. Submandibular steinstrasse can be a possibility when electrohydraulic or pneumatic techniques have been deployed.

Abscess Associated with Sialolith in a Parotid Duct - A Case Report

RATIONALE

The aim of this work is to describe the case of a large abscess associated with a sialolith in the parotid duct.

PATIENT CONCERNS

Patient's concern is evident in this pathology, because infection untreated or rapidly spreading infections can be potentially life-threatening secondary to airway compromise or septicemia.

DIAGNOSIS

Clinical examination, ultrasonography of the region, and cone beam computed tomography were requested to confirm the diagnosis of a sialolith associated with a large abscess.

TREATMENT

Antibiotic therapy with extraoral drainage was performed. After remission of the infection, the stone was located, removed, and the edges sutured.

OUTCOMES

The patient was followed for 6 months. There was a minimal scar without any other noteworthy change.

TAKE-AWAY LESSONS

The pathological changes involving the salivary glands are extremely important for diagnosis and treatment plan.