Nadir Bir Parotis Bezi Sialolitinin Tanısı ve Minimal İnvaziv Tedavisi: Olgu Sunumu

Abstract

Sialolit, tükürük bezlerinin en sık görülen patolojilerinden biridir. Tüm sialolitlerin yaklaşık %5-20'si parotis bezinde görülür. Bu olgu sunumunda nadir görülen bir parotis sialolitinin tanı ve tedavi süreci sunulmaktadır. 71 yaşında erkek hasta kliniğimize sol yanak bölgesinde 6 aydır devam eden ağrı ve şişlik şikayetiyle başvurdu. İntraoral muayenede Stensen kanalı seviyesinde hassasiyet ve irin akıntısı görüldü. Panoramik radyografide Stensen kanalı bölgesinde radyoopak kitle görüldü. Sialolitin boyutunu, yerini ve çevre dokularla ilişkisini değerlendirmek için konik ışınlı bilgisayarlı tomografi (CBCT) kullanıldı. Sialolit, lokal anestezi altında transoral yaklaşımla cerrahi olarak çıkarıldı. Tükürük akışının devamını sağlamak için bir dren yerleştirildi. Hasta komplikasyonsuz bir şekilde iyileşti. Bu olgu, parotis siyalolitinin doğru tanısal görüntüleme ve uygun cerrahi planlama ile başarılı bir şekilde tedavi edilebileceğini göstermektedir.

Keywords

• Parotis sialoliti
• transoral sialolitotomi
• tükrük bezi hastalıkları

Diagnosis and Minimally Invasive Management of a Rare Parotid Gland Sialolith: A Case Report

Abstract

Sialolith is one of the most common pathologies of the salivary glands. Approximately 5–20% of all sialoliths occur in the parotid gland. This case report presents the diagnosis and treatment process of a rare parotid sialolith. A 71-year-old male patient presented to our clinic with a 6-month history of pain and swelling in the left cheek region. Intraoral examination revealed tenderness and pus drainage at the level of the Stensen’s duct. Panoramic radiograph showed a radiopaque mass corresponding to the duct’s course. Cone-beam computed tomography (CBCT) was used to evaluate the size, location, and relationship of the sialolith to surrounding tissues. The sialolith was surgically removed via a transoral approach under local anesthesia. A drain was placed to maintain salivary flow. The patient made a full recovery without complications. This case demonstrates that parotid sialolith can be successfully managed with accurate diagnostic imaging and appropriate surgical planning.

Keywords

• Parotid sialolith
• transoral sialolithotomy
• salivary gland disease

References

1. 1. Bhovi, T.V., et al., Giant submandibular sialolith in an old female patient: A case report and review of literature. J Indian Acad Oral Med Radiol, 2016. 28(4): 437-440.
2. 2. Arslan S., et al., Giant sialolith of submandibular gland: report of a case. J Surg Case Rep, 2015, 4:43-43
3. 3. Manuaba, I.A.K.W., I.M.D. Ayusta, and P. Patriawan, Overview of findings on radiographic examination of sialography in patients with sialolithiasis: case serial. lnaBJ, 2022. 16(2): 120-123.
4. 4. Ungari, C., et al., Giant submandibular sialolith: a case report. Clin Ter, 2022. 173(3): 217-221.
5. 5. Chen, Y.C., et al., Impaired spontaneous secretion as a potential factor in the development of sialolithiasis in the submandibular gland: A preliminary sialoscintigraphic study. Laryngoscope Investig Otolaryngol, 2022. 7(5): 1329-1336.
6. 6. Kondo, N., et al., The landmark for removal of sialoliths using sialendoscopy alone in parotid gland sialolithiasis. Auris Nasus Larynx, 2018. 45(2): 306-310.
7. 7. Neto, V.T., et al., Giant Sialolith with 20 Years of Evolution in the Submandibular Duct. Open J Stomatol, 2020. 10.6.: 115-120.
8. 8. Kajal, S., et al., Submandibular ‘Megalith’ Compromising Airway: A Case Report of Giant Sialolith and an Update of Literature. J Maxillofac Oral Surg, 2025, 1-7

9. 9. Gadipelly, S., et al., Parotid sialolith-a case report and review of literature. IJCMR, 2016. 3(4): 1211-1213.
10. 10. Shah, J., M. Rathod, and J. Dubey, An angulated parotid duct sialolith: Radioimaging in diagnosis. J Oral Maxillofac Radiol, 2021. 9(2): 52-55.
11. 11. Younus, N., et al., Radiologic imaging features of major salivary glands: a review. Pak. j. med. dent., 2016. 5(2).
12. 12. Roland, L.T., S.A. Skillington, and M.A. Ogden, Sialendoscopyassisted transfacial removal of parotid sialoliths: A systematic review and meta-analysis. Laryngoscope, 2017. 127(11): 2510-2516.
13. 13. Lystad, H., E. Yu, and R. Subramony, Parotid Sialolithiasis Diagnosed on Point of Care Ultrasound (POCUS). POCUS journal, 2025. 10(1): 104.
14. 14. Althobaiti, M., et al., A Rare Case of Parotid Stone Adherence to the Facial Nerve. Cureus, 2024. 16(4): e57614.
15. 15. John, C.S., et al., A Rare Case of Parotid Gland Sialolith. Saudi J. Oral. Dent., 2020(5): 587-589.
16. 16. Soumithran, C., M. Mathew, and A.D. DP, Parotid Sialolithiasis: A Case Report. IOSR J Dent Med Sci, 2016. 15(07): 96-100.
17. 17. Kraaij, S., et al., Relationship between volume of submandibular salivary stones in vivo determined with Cone-Beam Computer Tomography and in vitro with micro-Computer Tomography. Med Oral Patol Oral Cir Bucal, 2021. 26(5): e598.
18. 18. Erdem, S., et al., An unusual parotid sialolith diagnosis and treatment: A. J Dent Res, 2018. 1(1): 1-4.
19. 19. Kılınc, A., et al., A Major Salivary Gland Calculi in Stenon Duct: Case Report. Turkiye Klinikleri J Dental Sci Cases, 2015. 1(4):272-275.
20. 20. Tanenbaum, Z., et al., Parotid sialolithiasis–Long term followup analyzing surgical approaches. Laryngoscope Investig Otolaryngol, 2024. 9(6): e70030.
21. 21. Berini-Aytes, L. and C. Gay-Escoda, Morbidity associated with removal of the submandibular gland. J Craniomaxillofac Surg, 1992. 20(5): 216-219.
22. 22. Iro, H., et al., Shockwave lithotripsy of salivary duct stones. Lancet, 1992. 339(8805): 1333-1336.
23. 23. Romdhane, N., et al., A Misleading Stone: Case Report of a Giant Sialolithiasis and Review of Literature. Indian J Otolaryngol Head Neck Surg, 2025. 77(7): 2704–2710.
24. 24. Sodnom-Ish, B., et al., Elemental characteristics of sialoliths extracted from a patient with recurrent sialolithiasis. J Korean Assoc Oral Maxillofac Surg, 2024. 50(2): 94-102.