Giant Sialoliths Research Articles

Giant Sialoloth -A Rare Case Report

Sialolithiasis is the most common disease of salivary glands. Its estimated frequency is 1.2% in the adult population. Sialoliths most commonly occur in the submandibular glands. A history of pain or/and swelling in the salivary glands, especially during meal suggests this diagnosis. For small and accessible stones conservative therapies like milking of ducts with palliative therapy can produce satisfactory results. Surgical management should be considered when the stone/stones are inaccessible or large in size as conservative therapies turned out to be unsatisfactory. In this paper, we present a case of 55-year-old male patient resenting painful swelling and a giant submandibular gland sialolith. The sialolith usually measures from 1 to <10 mm. Giant Sialoliths are classified as those exceeding 15 mm in any one dimension. This case report describes a patient presenting with an unusually large sialolith (megalith), which was in size 2.5 x 3cm, the subsequent patient management, etiology, diagnosis, and treatment.

Enormous Asymptomatic Intraoral Sialolithiasis: A Case Report.

Sialolithiasis is one of the most common diseases of salivary glands. More than 80% of the sialoliths occur in the submandibular gland. While most of the calculi are less than 10 mm in size, 7.6% are larger than 15 mm and are classified as giant sialoliths. We demonstrate a rare case of asymptomatic giant sialolith in the left Wharton's duct with a total atrophy of the left submandibular salivary gland. A 48-year-old female patient presented with lumping sensation for 1 month. A left mouth floor mass was found accidentally during examination and was later revealed to be a painless sialolithiasis. Image study revealed a giant sialolith in the left Wharton's duct with duct dilatation and left submandibular gland total atrophy. She underwent transoral sialolithotomy with removal of a huge stone, measuring 3.5 × 1.4 cm in size. Sialolithiasis usually presents with typical symptoms of the involved salivary gland, and the size of calculi is usually less than 20 mm. This is a rare case report of an asymptomatic giant sialolith in the Wharton's duct, causing left submandibular salivary gland total atrophy, and its diagnosis and management.

PLUNGING RANULA IN CHILDREN AND THE USEFULNESS OF ULTRASOUND IN THE DIAGNOSIS AND MANAGEMENT: A CASE REPORT

Plunging ranula consists of extravasation of mucin through the mylohyodeum musculature, causing floating cervical volume. Ultrasound is an excellent imaging modality to evaluate obstructive salivary gland diseases. Our study describes a case of an 11-year-old boy presenting a floating cervical volume on the right side, with displacement of the tongue. Ultrasonography showed changes in the mylohyoid muscle, underlying a hypoechoic image in the submandibular region, suggestive of muscle dissection and fluid accumulation, as seen in plunging ranula. Moreover, between submandibular and parotid regions, two rounded hyperechoic images with acoustic shadows, suggestive of giant sialoliths, were observed. The panoramic radiography confirmed two rough radiopaque images of approximately 30 mm, in the posterior region, consistent with giant sialoliths. The cervical swelling was excised, associated with removing the submandibular gland with one of the sialoliths. The histopathological diagnosis confirmed ranula and the patient has undergone 2 months of follow-up with no recurrence. Plunging ranula consists of extravasation of mucin through the mylohyodeum musculature, causing floating cervical volume. Ultrasound is an excellent imaging modality to evaluate obstructive salivary gland diseases. Our study describes a case of an 11-year-old boy presenting a floating cervical volume on the right side, with displacement of the tongue. Ultrasonography showed changes in the mylohyoid muscle, underlying a hypoechoic image in the submandibular region, suggestive of muscle dissection and fluid accumulation, as seen in plunging ranula. Moreover, between submandibular and parotid regions, two rounded hyperechoic images with acoustic shadows, suggestive of giant sialoliths, were observed. The panoramic radiography confirmed two rough radiopaque images of approximately 30 mm, in the posterior region, consistent with giant sialoliths. The cervical swelling was excised, associated with removing the submandibular gland with one of the sialoliths. The histopathological diagnosis confirmed ranula and the patient has undergone 2 months of follow-up with no recurrence.

Transoral Approach Used to Remove a Giant Sialolith

Study Design: Case Report.Objective: Sialoliths are a cause of Sialolithiasis affecting an estimated 12 in 1000 adult population. The patient’s presentation vary from being asymptomatic to pain with swelling and purulent discharge if accompanied with a infection. Giant sialoliths greater than 15 mm are rare. The purpose of the article is to document and educate clinicians on the management of giant sialoliths with possible sparing of the salivary gland.Methods: This report documents a patient with a sialolith measuring 45 mm in the widest diameter removed using a trans-oral approach.Results: The patient presented with an intra-oral sialolith which was asymptomatic except for the hard swelling felt cervically. Clinical examination and radiographic imaging was adequate for a diagnosis and the fact that there was no tenderness over the glandular area a decision to spare the gland was made.Conclusion: There are few reports of giant sialoliths and majority present with sialadenitis. In this case it was rare for the stone to have reached this size with hardly any symptoms. In patients where the gland has not been affected clinicians may consider sparing it and remove only the sialolith to reduce the morbidity and risks associated with glandular excision.

GIANT SIALOLITH IN SUBMANDIBULAR DUCT: CLINICAL CASE

Sialolithiasis is a pathology arising from the formation of mineralized material inside the salivary gland or duct, causing obstruction of the salivary flow. The submandibular gland is the most affected, followed by the parotid gland. Clinically presenting pain and edema. Radiography (occlusal), sialography, and computed tomography help the diagnosis. The objective of this study is to report the case of a patient, 46 years old, with a volumetric increase in the region of the right submandibular duct, covered by hyperemic mucosa, with a hard and painful consistency with purulent exudate exit by the sublingual caruncle. In the occlusal radiography revealed a radiopaque image of cylindrical shape compatible with submandibular duct path, with diagnostic hypothesis of sialolithiasis. An incision was made on the submandibular duct, followed by removal of the 3 x 1 cm sialolith. The patient progressed with improvement. Giant sialoliths are rare, so this case contributes as knowledge for conducting new cases. Sialolithiasis is a pathology arising from the formation of mineralized material inside the salivary gland or duct, causing obstruction of the salivary flow. The submandibular gland is the most affected, followed by the parotid gland. Clinically presenting pain and edema. Radiography (occlusal), sialography, and computed tomography help the diagnosis. The objective of this study is to report the case of a patient, 46 years old, with a volumetric increase in the region of the right submandibular duct, covered by hyperemic mucosa, with a hard and painful consistency with purulent exudate exit by the sublingual caruncle. In the occlusal radiography revealed a radiopaque image of cylindrical shape compatible with submandibular duct path, with diagnostic hypothesis of sialolithiasis. An incision was made on the submandibular duct, followed by removal of the 3 x 1 cm sialolith. The patient progressed with improvement. Giant sialoliths are rare, so this case contributes as knowledge for conducting new cases.

Giant submandibular gland stone largest in India: Management and review of literature: A rare case report

Sialoliths are calcerous concretions seen in the salivary gland parenchyma or its duct, accounting more than 50% of salivary gland diseases. Giant sialoliths measuring 35 mm are rare, with only 19 cases published in literature. Ninety‑five percent of the giant sialoliths reported were in the submandibular gland, all occurring in male patients. Preoperative imaging help in defining the size,location of lesion and helps in planning approach. We are reporting a rare case of giant submandibular gland sialolith in a 52 year male patient measuring 40 mm (probably largest in india), which was removed through transcervical approach under general anesthesia.

A Giant Sialolith in the Submandibular Salivary Gland Parechyma - A Rare Entity

Sialolith is a calcified organic matter that is formed within the secretory system of the salivary glands. Sialolithiasis affects around .01-1.0% of the world population. Salivary calculi are usually seen in the ducts of the glands and in the hilus of the gland. Sialoliths on the parenchyma occur in 9-17% of the cases. Giant sialoliths are a rare finding there sizes vary from approximately 1.5 cm to 7 cm and their weight varies in the literature. Here we report an interesting case of a large sized sialolith in the parenchyma of the left submandibular gland.

Caso clínico: Sialolito gigante en el conducto de Wharton.

La sialolitiasis es una afección frecuente de las glándulas salivales mayores, con una frecuencia de aparición del 1.2% en la población mundial, ocurre con mayor frecuencia en la glándula submandibular. Esta se produce debido a la obstrucción de la glándula salival o del conducto de la misma debido a un sialolito. Este cálculo se desarrolla como resultado de un estancamiento de saliva, este proporciona un ambiente idóneo para la deposición de sales y otras sustancias orgánicas formando un cálculo. El tamaño de los sialolitos frecuentemente es de 1 a 10mm y en raras ocasiones se puede apreciar sialolitos gigantes, estos pueden llegan a medir más de 15mm y usualmente se localizan en el conducto de Wharton. En este artículo se reporta un caso de un sialolito de 25mm de diámetro que se localizaba en el conducto de Wharton, el cual no presentaba sintomatología y fue descubierto por un examen de rutina, y el tratamiento que se eligió fue la remoción por vía intraoral.

Giant Sialolith of Submandibular Duct

Sialolithiasis is one of the most common diseases of salivary glands and commonly involves submandibular gland and ducts. "Giant sialoliths" typically measure more than 15 mm in any dimension. Here, an unusual case of sialolith in submandibular duct is reported which progressed into a giant sialolith in six months' time is reported. A 42-year-old man presented with complaints of recurrent pain and swelling in the right submandibular area. A large stone was palpable intraorally within the Wharton's duct and intra-operatively, an elongated giant sialolith of 50 mm length was found which is the second largest to be published till date.

Giant Salivary Calculi of the Submandibular Gland Duct : A Case Report

Giant sialoliths are classified as those exceeding 15 mm in any one dimension.Sialolithiasis is the most common disease of salivary glands and approximately 80% of all reported cases of sialoliths occur in the sub mandibular salivary gland and its duct. A case of unusually large sialolith arising in the submandibular salivary gland duct presented which was removed surgically through per-oral approach.It was measured to be 38 mm along with its greatest length and 15 mm wide.
 JCMCTA 2016 ; 27 (2) : 81 - 83

Giant submandibular sialolith in an old female patient: A case report and review of literature

Sialolithiasis or salivary gland duct calculus or salivary stones are the most common pathologies of the salivary gland. Sialolithiasis accounts for more than 50% of the major salivary gland diseases. Sialoliths are deposits obstructing the ducts of major or minor salivary glands or its parenchyma. Salivary stones larger than 15 mm are classified as giant sialoliths. Giant sialoliths measuring 35 mm or more are extremely rare, with approximately 18 cases published in literature all reported in male patients. The aim of this article is to present a case of a giant sialolith occurring in an old female patient and to communicate the results of a literature search on giant sialoliths.

Imaging features of giant sialolith of submandibular gland: A case report

Sialolithiasis is an obstructive salivary disease due to salivary stone formation, also known as meal time syndrome because of its association with meal times, usually measuring less than 1 cm. However, occasionally giant sialoliths as large as 3 cm have been reported. Here, we report an interesting case of large intraductal sialolith of submandibular salivary gland in an old patient, with relevant radiological investigations and review of literature.

Giant sialolith after submandibulectomy.

A 59-year-old Patient presented with cerivical lymphnode and a submandibular swelling on the right side of unknown cause that was not responsive to antibiotic treatment. 16 years ago a submandibulectomy was performed on the right side, nevertheless submandibular swellings had occurred repeatedly. Clinical examination showed a right-sided cervical swelling in the submandibular region. The floor of the mouth was indurated and pus could be squeezed out of the wharton’s duct. A computed tomography of the neck revealed a calcified structure of 3.8 x 1.3 cm located anterior of the former submandibular region (A). Therapeutically the residual Wharton duct containing the sialolith was removed (B). Giant sialoliths after submandibulectomy are extremely rare. If parts of the Wharton duct remain, sialolithiasis may occur spontaneously or become evident after growth due to further calcification. The treatment of choice consists of the excision of the residual duct with the sialolith and any remaining gland tissue.

Surgical Removal of a Giant Sialolith by Diode Laser

Giant sialoliths larger than 20 mm are rare. The surgery has to be performed with the minimally invasive method in order to avoid the morbidity associated with the surgical techniques. In this report the surgical removal of a giant sialolith of 25 mm by using diode laser is described. A 57-year-old female was presented with a firm mass in the anterior part of the left side of the floor of the mouth. Following the clinical and radiological examination, the left submandibular duct sialolith was diagnosed. The diode laser was used with a power setting of 810 nm of wavelength, 4.0 W of power, 0.5 ms continuous wave and 1000 Hz of frequency for the incision. The giant sialolith was adequately removed under local anesthesia. The procedure was well-tolerated. The wound healing was uneventful in the postoperative period. By the 10th day after surgery the patient had no complaints and the salivary flow was normal. It was concluded that the use of 810-nm diode laser application is a safe and useful technique. Due to the excellent cutting and coagulation ability, there is a low complication rate, making it an appropriate alternative for this type of surgical procedure.

Giant sialoliths of submandibular gland duct: Report of two cases with unusual shape

Giant sialoliths are classified as those exceeding 15 mm in any one dimension. Although, large sialoliths have been described in the body of salivary glands, they are rarely found in the salivary ducts, particularly when the patients have no painful symptoms. Sialolithiasis is one of the most common diseases of the salivary glands in middle-aged patients and approximately 80% of all reported cases of sialoliths occur in the submandibular gland. Here, we report two cases of giant sialolith of submandibular gland duct. Interestingly, sialolith found in one of our cases had an unusual similarity with the canine tooth and mimicking it in both size and shape. In both cases the calculus was removed surgically via intraoral approach. No recurrence was seen in any of the cases on follow-up.

Sialolito gigante no ducto da glândula submandibular

Sialolithiasis is the most common salivary disorder, predominantly affecting both the submandibular gland and the Wharton's duct. Most of the salivary calculi are small in size but can reach large proportions, called giant sialoliths. This paper aims to describe a case of giant sialolith located in the submandibular gland duct, which was treated by surgical removal using an intraoral approach.

Giant Sialolith in the Wharton′s duct causing sialo-oral fistula: A case report and review of literature

Sialolithiasis is the most common salivary gland disease accounting for more than 50% of the cases. Majority of salivary calculi occur in the submandibular gland and its duct. It has male predilection and is often seen in adults. Majority of the calculi are less than 10 mm in size. Calculi > 15 mm in size are considered giant. Giant sialoliths within the parenchyma of the salivary glands are frequently reported in the literature, but they are uncommon in the salivary ducts. The purpose of this article is to report a case of giant sialolith in the Wharton's duct of a 65-year-old male, which had caused sialo-oral fistula. Literature in English language on giant sialolith in Wharton's duct is reviewed since 1990. Also etiology, pathogenesis, clinical features, diagnosis and management aspects are discussed.

Giant Submandibular Sialolith: A Case Report and Review of Literature

ABSTRACTSialolithiasis is the most common disease of salivary glands. Commonly, sialoliths measure from 5 to 10 mm in size and stones over 10 mm can be reported as sialoliths of unusual size. Giant sialoliths measuring more than 35 mm are extremely rare, with only around 17 cases published in the literature. We report an asymptomatic case of a sialolith in the submandibular duct measuring 62 × 20 mm and weighing 40 gm, highlighting the management aspects and also review the literature.

Trattamento chirurgico della scialolitiasi gigante intraduttale: casi clinici

Objectives Very few cases of giant sialoliths have been reported in literature. The purpose of this article is to provide a literature review and assess the effectiveness of two different surgical treatments for this condition: one involving marsupialization of Wharton's duct on the floor of the mouth, the other involving the use of a Teflon cannula to maintain the patency of the duct. Materials and methods The two patients included were a 67-year-old woman who presented with fever and pain and swelling in the right submandibular region and a 51-year-old man, whose only symptom was the sensation of a foreign body in the floor of the mouth. Radiological examinations confirmed the presence of giant salivary gland stones, which were removed. The operations were completed by duct marsupialization in the first case and by placement of a Teflon tube in the second. Results and conclusions Both treatments proved effective and decisive.

Management of giant sialoliths: Review of the literature and preliminary experience with interventional sialendoscopy

To report our experience with management of giant salivary stones via a combined approach technique using salivary endoscopy (CA) and results of a review of current literature related to giant salivary stones. Retrospective case series. An institutional review board-approved chart review was performed on patients managed with a CA to treat giant salivary stones (≥15 mm). In addition, we reviewed the English literature from 1942 to 2009. Table 1 consists of 54 stones; 47 of which were identified during the review of literature and 7 from our case series. Of those 47 stones, 23 were hilar in location, 23 were glandular in location, and 1 stone was missing data. The gland preservation rate in the 47 reported stones was 57% (17/30). Among patients where gland resection was reported, the majority of the patients (12/13) had hilar glandular stones. Only one patient with a ductal stone had a gland resection. In our series, CA enabled a gland preservation rate of 86% (6/7). Among these patients, stone location was hilar glandular in six (86%) and ductal in one (14%). The mean size of stones from the literature review was 35 mm and from our series was 19 mm. Our review reflects current treatment recommendations for giant stones, i.e., transoral sialolithotomy for ductal stones and gland resection for hilar glandular stones. Our preliminary experience with CA for giant stones suggests improved gland preservation rates (86% vs. 57%) independent of stone location and with preservation of salivary function.