ArticleInternational journal of surgery case reports2025
Surgical non-aggressive approach for the delivery of 4 cm salivary stone from the submandibular gland duct: Avoiding salivary gland removal - A case report.
Article in International journal of surgery case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introduction and importanceSalivary calculi represent the most common salivary gland disease. It can vary significantly in size, ranging from less than 1 mm to several centimeters. As the size of the stone increases, the surgical approach becomes more complex and the function of the gland may be compromised, potentially necessitating total gland removal. Successful outcomes depend on appropriate indications, precise surgical techniques, and comprehensive postoperative care. CASE PRESENTATION: A 50-year-old male presented with a chief complaint of pain and swelling in the submandibular region. The patient reported persistent discomfort in the submandibular area for several weeks. Over the last three weeks, his symptoms had intensified, accompanied by an unpleasant taste in his mouth with pain and swelling, especially during meat time. Clinical examination had shown no salivary secretion observed with tenderness across the Wharton duct. Radiological assessment revealed a large salivary stone obstructing the duct of the submandibular gland, the patient underwent surgery under general anesthesia, and an incision was made over the bulge corresponding to the stone. Dissection proceeded through the mucosa until the duct was accessed. The function of the salivary gland was observed, and the return of salivary secretion was confirmed, which was observed immediately after the surgery, and the patient was discharged 5 days after the surgery. DISCUSSION: The treatment plans for such cases vary between non-invasive conservative management of sialolithiasis, which includes gland massage (combined with the use of sialogogues and irrigation), and advance aggressive management, which may involve extracorporeal shock-wave lithotripsy, sialoendoscopy, or surgical removal.
conclusionTransoral surgical removal of large stones from the submandibular gland and duct can be an effective and minimally invasive treatment option for sialolithiasis. Proper indications, surgical techniques, and postoperative care are essential for achieving optimal outcomes, minimizing complications, and ensuring successful results.
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