Giant Sialolith with 20 Years of Evolution in the Submandibular Duct

Victor Tieghi Neto,Eduardo Stedile Fiamoncini,Caio Peres Bellato,Andrea Guedes Barreto Gonçales,Rosana Mara Adami Tucunduva,Eduardo Sanches Gonçales,Izabel Regina Fischer Rubira-Bullen

doi:10.4236/ojst.2020.106013

Abstract

Sialolithiasis is a common disease that affects the major salivary glands, which is characterized by obstruction of the gland itself or its excretory duct due to the formation of a sialolith, resulting in decreased salivary flow. It mainly affects the submandibular glands (80% - 90%), probably because it has a long duct that surrounds the mylohyoid muscle and emerges against gravity through the Wharton’s duct. The size of the salivary calculus can vary from below 1 millimeter (mm) to a few centimeters in diameter, where most stay below 10 mm. Only 7% are greater than 15 mm and these are classified as giant calculi. This report presents a case of asymptomatic giant sialolith (approximately 60 mm in diameter) located in the duct of the right submandibular gland, with 20 years of evolution. The treatment of choice was the surgical removal of the sialolith (calculus) through the salivary duct with maintenance of the gland. Although the individual did not present complaints related to the presence of the giant calculi, its removal had a great impact on their quality of life, since a significant respiratory improvement was reported by the individual. The major difference reported was better sleep quality.

Highlights

Sialolithiasis is a common disease that affects the major salivary glands, which is characterized by obstruction of the gland itself or its excretory duct due to the formation of a sialolith, resulting in decreased salivary flow
Sialolithiasis is a common disease of the major salivary glands
Sialolithiasis can present 3 different manifestations: firstly with total absence of symptomatology, where a sialolith is accidentally found in routine radiographic examinations; it presents as intermittent edema and pain preceding meals around the area involving the affected gland

Summary

Introduction

Sialolithiasis is a common disease of the major salivary glands It is characterized by mechanical obstruction of the gland or its excretory duct due to the deposition of minerals around an organic matrix giving rise to a salivary calculi (sialolith) resulting in a decrease in salivary flow. There are reports of dysphagia and dysarthria in cases of giant sialoliths, but these are extremely rare [2] [7]

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