Giant sialoliths of Wharton duct: Report of two rare cases and review of literature

Abstract

Sialolithiasis is a common disease of the major salivary glands, characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions. Sialoliths usually measure from 1 mm to <10 mm. They rarely measure more than 15 mm, and infrequently giant salivary gland calculi >15 mm have been reported in the literature. The submandibular gland and its duct appear to be the most susceptible sites for this disease. In this article, we report two unique cases, including a giant bilateral case, measuring 50 mm in length and 5 mm in width on the right side and one, 30 mm in length, and 5 mm in width on the left side; and another case, measuring 83 mm in length. The diagnostic and therapeutic approaches consisted of transocclusal radiography with the conservative transoral surgical technique in both cases. The follow-up showed the normal function of the relevant salivary glands. To the best of our knowledge and belief, similar cases have not been reported in the literature.

Keywords: Salivary duct; Sialoliths; Submandibular Glands; Wharton duct.

Figure 1

Transocclusal endoral radiography showed two radiopacities within the Wharton duct on the right and left sides.

Figure 2

Huge right submandibular sialolith, exposed in the orifice of Wharton duct.

Figure 3

Transocclusal endoral radiography showed a radiopaque stone within the right Wharton duct.

Figure 4

Giant submandibular sialolith.