Surgical management of submandibular gland sialolith through submandibular incision: a case report

Salivary gland calculi account for the most common disease of the salivary glands, and may range from tiny particles to several centimeters in length. Sialolithiasis (also termed salivary calculi, or salivary stones), is a condition where a calcified mass forms within a salivary gland1. The term is derived from the Greek words sialon (saliva) and lithos (stone), and the Latin -iasis meaning "process" or "morbid condition". Sialoliths are calcified organic matter that forms within the secretory system of the major salivary glands. The incidence of sailolith is 80% in sub mandibular gland, 4-10% in the parotid gland and 1-7% in the sublingual gland. Submandibular gland is the second largest salivary gland in human body2. Each submandibular gland weighs approximately 10-15.Submandibular gland excision is recommended in cases of substantial intra-glandular caliculli, which are inaccessible via a trans-oral approach and also, when multiple small calcified masses are present in the vertical and comma portions of Wharton’s duct. The present case report describes a safe and easy surgical technique in a patient, who had a painful swelling in the right submandibular region, giving a clinical evidence of submandibular gland stone. MRI examinations were done where the gland and sialolith dimensions were approximately 4 x 3.5cm and 0.8 x 0.6mmrespectively. As the sailolith was present in the center of gland,causing inflammatory changes so that the gland had to be removed in toto.