Abstract
Sialolithiasis is a commonly encountered disease of the salivary glands, reported to represent up to 30% of all salivary gland diseases. However, the condition is rarely encountered in the pediatric population. The formation of a salivary stone is believed to be secondary to the deposition of calcium salts around a nidus. The formation of a nidus is commonly associated with desquamated epithelial or sloughing from a recent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. Neglected and poorly treated acute infection may progress to life-threatening abscess formation. Here we are describing our encounter with a 10-year-old boy with recurrent submandibular sialolithiasis. He was initially treated with conservative measures and antibiotics regimen. Failure of medical treatment and recurring symptoms led to submandibular gland excision followed by a full recovery.
Highlights
The formation of a salivary calculus is believed to be secondary to the deposition of calcium salts around a nidus which can be caused by desquamated epithelial or sloughing from a recent bacterial infection [3]
We present a rare case of pediatric recurrent sialolithiasis that required submandibular gland excision in a 10-year-old boy
Marchal et al proposed a retrograde theory for sialolithiasis formation which involves retrograde migration of food particles, foreign bodies or pathogens ascending from the oral cavity into the salivary ductal system, which subsequently act as a nidus for further calcification resulting in salivary stone formation [4]
Summary
Sialolithiasis is commonly seen in the adult population, representing up to 30% of all salivary gland diseases [1]. Sialolithiasis is a condition that involves the formation of calcareous deposits within a salivary gland or its excretory duct causing obstruction to normal salivary flow. We present a rare case of pediatric recurrent sialolithiasis that required submandibular gland excision in a 10-year-old boy. The patient was seen during follow-up at our ENT outpatient clinic for two more visits over a six-month period in which he reportedly had another episode of submandibular swelling, with passing of sialolith after being treated with oral antibiotics at a. The patient was scheduled for a submandibular gland excision with an indication of recurrent right submandibular duct sialolithiasis. The patient was seen during follow up at our outpatient clinic for six months after surgery and there was no recurrence of neck swelling or sialolith formation
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