Torus mandibularis and its implication as a risk factor for the formation of sialolithiasis

Abstract

Sialolithiasis is the formation of a stone within the salivary gland, and approximately 80% of them occur within the submandibular gland. Sialolithiasis can lead to swelling and pain of the gland in the immediate phase and if left untreated, can lead to sialadenitis and even atrophy of the gland. Certain factors have already been established in the formation of sialolithiasis such as dehydration, tobacco smoke, autoimmune disorders and certain medications. One factor we theorise contributes to the formation of sialolithiasis is bony outgrowths on the tongue surface of the jaw, called mandibular tori. These outgrowths can lead to external compression of the submandibular duct, which leads to impeded salivary flow and the potential for sialolith formation. We present two cases in which individuals had submandibular sialolithiasis in the setting of extensive mandibular tori.

Keywords: Ear, nose and throat/otolaryngology; Mouth; Otolaryngology / ENT.

Figure 1

(A) Oral cavity of case 1 following sialolithotomy and sialodochoplasty. Bilateral mandibular tori are denoted with white arrows. (B) Two-dimensional ultrasound demonstrating a 0.93 cm hyperechoic focus in the left submandibular ductal system.

Figure 2

(A) Oral cavity of case 2 following right-sided sialolithotomy and sialodochoplasty. Bilateral mandibular tori are denoted with white arrows. (B) Two-dimensional ultrasound demonstrating a 1.15 cm hyperechoic focus in the right submandibular ductal system.