CT navigation-assisted intraoral extraction of large submandibular gland stones: a minimally invasive approach

Sialolithiasis is a common cause of salivary gland obstruction, leading to symptoms such as pain and swelling. In cases of intraparenchymal submandibular stones and proximal ductal stones larger than 7 mm, interventional sialendoscopy may fail, necessitating sialoadenectomy. As an alternative, intraoral stone extraction can be performed with CT-guided navigation. This case report describes a 52-year-old male with previous sialadenitis complaints. Imaging confirmed a fixed intraparenchymal stone measuring 21 × 18 mm. Using CT navigation, the stone was located and removed intraorally. Salivary flow resumed through Wharton's duct on the same day postoperatively and the patient was discharged without further complaints or new stone formation during a 1-year follow-up. This minimally invasive method, utilizing CT navigation, allows for the preservation and functional recovery of the submandibular gland, avoiding skin scarring and reducing the risk of nerve damage.