Sialolithiasis of Right Submandibular Duct of Unusual Size

Abstract

We present a case of a 35-year-old gentleman with a submandibular duct stone measuring 12 × 6 mm. Considering the literature, most stones are less than 5 mm, and stones more than 10 mm are quite unusual. This gentleman had typical symptoms of chronic sialadenitis, who was clinically diagnosed to have sialolithiasis, which was later confirmed by imaging studies. He was operated upon to remove the stone along with the submandibular gland. The term sialolithiasis is derived from the Greek words sialon (saliva) and lithos (stone), and the Latin -iasis meaning "process" or "morbid condition". Sialolithiasis affects the submandibular gland in 80-90% of cases because of the curved course of submandibular duct and the secretions being more mucous. Pain is the most common presenting feature during mastication and surgical removal of the sialolithiasis is the treatment of choice. The incision depends on the location of the stone in the duct.

Keywords: Obstructive salivary disease; Sialolithiasis; Submandibular duct; USG sialolith.

Fig. 1

X-ray of head showing a radiopaque shadow in right submandibular region. The stone after removal is shown

Fig. 2

USG of right submandibular gland showing hyperechoic lesion with posterior acoustic shadow and proximal dilated duct