Removal of a Giant Sialolith Located in Right Submandibular Gland Duct: A Case Report

Abstract

The percentage of the population suffering from sialolithiasis of the salivary glands was reported as %1, which predominantly occurs in the submandibular glands in about 80% of cases. Notably, the sialolithiasis found in these submandibular cases usually present as a single solid piece. This paper aims to present a clinical case with two pieces of sialolithiasis and to review the updates on sialolithiasis treatment. A 53-year-old female patient was referred to Istanbul University-Cerrahpaşa Faculty of Dentistry for evaluation due to swelling in the floor of the mouth on the right side. There was no significant relevant medical or dental history. The physical status was defined as ASA-I as the patient was considered to be healthy, non-smoking, with no alcohol consumption, and with the correct BMI for age. A cone beam computed tomography was requested to confirm the presumptive diagnosis after the evaluation of orthopantomography and physical examinations intraorally and extraorally. The sialolithiasis, which was determined to be in two pieces through the tomography, was removed with a surgical procedure under local anesthesia with an intraorally approach. There is no functional sequelae observed during the six-month postoperative follow-up period.

Keywords

• salivary gland
• sialolith
• surgical
• submandibular
• excision

References

1. Oliveira Tde P, Oliveira IN, Pinheiro EC, Gomes RC, Mainenti P. Giant sialolith of submandibular gland duct treated by exci- sion and ductal repair: a case report. Braz J Otorhinolaryngol. 2016;82(1):112–115. doi:10.1016/j.bjorl.2015.03.013.
2. 2. Hammett JT, Walker C. In: Sialolithiasis. Treasure Island (FL): StatPearls Publishing Copyright © 2025, StatPearls Publishing LLC.; 2025. .
3. 3. Huoh KC, Eisele DW. Etiologic factors in sialolithia- sis. Otolaryngol Head Neck Surg. 2011;145(6):935–939. doi:10.1177/0194599811415489.
4. 4. Rosales Diaz Miron D, Castillo B, Rodriguez-Pulido J. Gland ex- cision in submandibular sialolithiasis: A case report. Journal of Oral Research. 2015;4:270–274. doi:10.17126/joralres.2015.052.
5. 5. Marchal F, Kurt AM, Dulguerov P, Lehmann W. Retrograde theory in sialolithiasis formation. Arch Otolaryngol Head Neck Surg. 2001;127(1):66–68. doi:10.1001/archotol.127.1.66.
6. 6. Harrison JD. Causes, natural history, and incidence of salivary stones and obstructions. Otolaryngol Clin North Am. 2009;42(6):927–947, Table of Contents. doi:10.1016/j.otc.2009.08.012.
7. 7. Rzymska-Grala I, Stopa Z, Grala B, Gołębiowski M, Wanyura H, Zuchowska A, et al. Salivary gland calculi - contemporary methods of imaging. Pol J Radiol. 2010;75(3):25–37.
8. 8. Mao JS, Lee YC, Chi JC, Yi WL, Tsou YA, Lin CD, et al. Long- term rare giant sialolithiasis for 30 years: A case report and review of literature. World J Clin Cases. 2023;11(22):5382–5390. doi:10.12998/wjcc.v11.i22.5382.

9. 9. Yiu AJ, Kalejaiye A, Amdur RL, Todd Hesham HN, Bandyopad- hyay BC. Association of serum electrolytes and smoking with salivary gland stone formation. Int J Oral Maxillofac Surg. 2016;45(6):764–768. doi:10.1016/j.ijom.2016.02.007.
10. 10. Sonar PR, Panchbhai A, Dhole P. Sialolithiasis in the Left Submandibular Gland: A Case. Cureus. 2023;15(11):e48999. doi:10.7759/cureus.48999.
11. 11. Jáuregui E, Kiringoda R, Ryan WR, Eisele DW, Chang JL. Chronic parotitis with multiple calcifications: Clinical and sial- endoscopic findings. Laryngoscope. 2017;127(7):1565–1570. doi:10.1002/lary.26386.
12. 12. Silveira Junior JBd, Matias Neto JB, Andrade Junior I, Capis- trano HM. Multiple sialolithiasis in submandibular gland duct: a rare case report. RGO - Rev Gaúcha Odontol. 2020;68. doi:10.1590/1981-863720200002920180103.
13. 13. Foletti JM, Graillon N, Avignon S, Guyot L, Chossegros C. Salivary Calculi Removal by Minimally Invasive Techniques: A Decision Tree Based on the Diameter of the Calculi and Their Position in the Excretory Duct. J Oral Maxillofac Surg. 2018;76(1):112–118. doi:10.1016/j.joms.2017.06.009.
14. 14. Marchal F, Dulguerov P. Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg. 2003;129(9):951– 956. doi:10.1001/archotol.129.9.951.
15. 15. Aoun G, Maksoud C. Sialolith of Unusual Size and Shape in the Anterior Segment of the Submandibular Duct. Cureus. 2022;14(4):e24114. doi:10.7759/cureus.24114.
16. 16. Sigismund PE, Zenk J, Koch M, Schapher M, Rudes M, Iro H. Nearly 3,000 salivary stones: some clinical and epi- demiologic aspects. Laryngoscope. 2015;125(8):1879–1882. doi:10.1002/lary.25377.
17. 17. Krishnappa BD. Multiple submandibular duct (Wharton’s duct) calculi of unusual size and shape. Indian J Otolaryngol Head Neck Surg. 2010;62(1):88–89. doi:10.1007/s12070-010-0018- 4.
18. 18. Uğur TA, Yılmaz S. Üç Varyasyonuyla Submandibular Tükürük Bezi Taşları: Olgu Serisi. Akd Dent J. 2023;2(2):110–114.
19. 19. Melo GM, Neves MC, Rosano M, Vanni C, Abrahao M, Cer- vantes O. Quality of life after sialendoscopy: prospec- tive non-randomized study. BMC Surg. 2022;22(1):11. doi:10.1186/s12893-021-01462-2.
20. 20. Buyruk A, Bozkuş F. Submandibular Bez Cerrahi Sonuçlarımız. Harran univtıp fak derg. 2020;17(1):45–49. doi:10.35440/hutfd.651611.
21. 21. Leung AK, Choi MC, Wagner GA. Multiple sialoliths and a sialolith of unusual size in the submandibular duct: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(3):331–333. doi:10.1016/s1079-2104(99)70218-0.
22. 22. Moon PP, Bankar M, Kalambe S, Badge A, Kukde MM, Bankar NJ. An Unusually Large Submandibular Sialolith: A Case Report. Cureus. 2024;16(9):e70356. doi:10.7759/cureus.70356.
23. 23. Huang TC, Dalton JB, Monsour FN, Savage NW. Multiple, large sialoliths of the submandibular gland duct: a case report. Aust Dent J. 2009;54(1):61–65. doi:10.1111/j.1834-7819.2008.01091.x.
24. 24. Brusati R, Fiamminghi L. Large calculus of the submandibular gland: report of case. J Oral Surg. 1973;31(9):710–1.
25. 25. Xiao JQ, Sun HJ, Qiao QH, Bao X, Wu CB, Zhou Q. Evalu- ation of Sialendoscopy-Assisted Treatment of Submandibu- lar Gland Stones. J Oral Maxillofac Surg. 2017;75(2):309–316. doi:10.1016/j.joms.2016.08.023.
26. 26. Cumpston E, Chen P. In: Submandibular Excision. Treasure Island (FL): StatPearls Publishing Copyright © 2025, StatPearls Publishing LLC.; 2025. .
27. 27. Bozkurt P, Kolsuz M, Erdem E. Large Sialolith of the Submandibular Gland: Report of a Case and Comparison of Sialolithotomy VS Sialoadenectomy. SDU J Health Sci. 2016;7(1):41–43. doi:10.22312/sbed.28024.
28. 28. Singh PP, Goyal M. Our Experience with Intraoral Submandibu- lar Gland Excision. Indian J Otolaryngol Head Neck Surg. 2020;72(3):297–301. doi:10.1007/s12070-019-01784-x.
29. 29. Kahveci K, Ayrancı F. Retrospective Evaluation of the Treatment of Wharton’s Duct Stones with Transoral Ap- proach. Middle Black Sea J Health Sci. 2019;5(2):74–78. doi:10.19127/mbsjohs.555748.
30. 30. Özen AB, Kırkpunar A, Karaca IR. Siyalolitiyazis Vakalarında Cerrahi Yaklaşımlar ve Klinik Çalışmalar. ADO J Clin Sci. 2024;13(2):388–394. doi:10.54617/adoklinikbilimler.1379003.