Unusually large sialolith of submandibular duct: A case report

Background: Sialolithiasis is a common ailment of major salivary glands. Sialoliths are usually less than 1 cm in diameter and frequently found in the submandibular gland and its duct (Wharton’s duct). A sialolith is considered giant if it is greater than 1.5cm in diameter and almost exclusively develop in the Wharton’s duct.Methods: Literature review was conducted using search engines such as PubMed and Google Web Browser looking for key terms such as “salivary stone”, “sialolith” and “Submandibular duct”. A 17-year-old female with recurrent swelling and xerostomia underwent a diagnostic workup using occlusal radiography to localize a sialolith in the terminal portion of the submandibular duct. The management involved an intraoral surgical excision under local anesthesia to remove the 17 × 10 mm calcification, followed by ductal irrigation to successfully restore salivary function.Results: A total of 12 research articles were found relevant to our topic after analysis of the initial pool of research papers. We report a case of a large sialolith in the course of submandibular gland duct of a 17-year-old female who attended our clinic complaining of recurring swelling and pain in the left Wharton’s duct opening area. The patient also complained of dry mouth. Occlusal radiography confirmed a sialolith in the terminal part of the submandibular duct. Surgical removal of a brownish sialolith measuring 17 × 10 mm in size was undertaken under local anesthesia intraorally.Conclusion: The management of giant sialoliths can be achieved via a minimally invasive surgical procedure and subsequently normal salivary flow was established and pain during meals disappeared.Keywords:Sialolith, Submandibular duct, Salivary stone