Submandibular Gland Duct Research Articles

Sialolithiasis in a 19 year old male: A case report

Sialolithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions, resulting in salivary ectasia and subsequent dilatation of the salivary gland. This disease is mostly seen in adults or young adults, and seldom develops in children with submandibular gland duct being the most common site. This case report describes a 19 year old patient presenting with pain and swelling in right side of floor of mouth. Sialolithiasis of right submandibular gland was diagnosed based on clinical and radiographic examination. The sialolith was removed under local anesthesia. Keywords: Sialolithiasis, Submandibular gland, Intraductal, Intraglandular, Sialo-MRI, Lithotripsy.

Radyolojik bulgularla submandibular bezde dev siyalolit: Olgu sunumu

<p class="ql-align-justify">A sialolith is defined as one or more calcific foci in oval or round form within a parenchyma or duct of a salivary gland. It is most commonly seen in the submandibular salivary gland and in the 30-60 age range. A 46-year-old male patient was admitted to the Department of Oral and Maxillofacial Radiology of Istanbul University Faculty of Dentistry for dental treatment.&nbsp;A panoramic radiography incidentally showed a radiopaque formation in the right mandible angulus. No symptoms were detected in the clinically relevant region. A cone beam computed tomography showed a mixed, hyperdense focus in the lingual area in the right angulus region and a sialolith was detected. On ultrasonography, a sialolith was found in submandibular salivary gland duct. Due to the absence of any symptoms, regular followup was provided. The determination of localization and size of the sialolith with clinical and radiographic findings are important in treatment planning. In this case report, we aimed to present the radiological findings of an asymptomatic case of a large sialolith.

Preliminary application and evaluation of autograft reconstruction of parotid duct defect with submandibular gland duct for buccal cancer

Background: We aimed to preserve parotid function in patients with buccal carcinoma by applying a new surgical protocol based on reconstruction of parotid ductal defect with submandibular gland ductal.Aims/Objectives: The aim of this study is to introduce the method of autologous submandibular gland duct reconstruction for the treatment of parotid duct defect in buccal carcinoma, and to evaluate its clinical application in follow-up.Material and methods: A total of 28 patients with buccal carcinoma who underwent buccal and neck combined with radical surgery and vascularized flap transplantation were enrolled. Function of the reconstructed duct was reviewed in 6 months after surgery.Results: Both groups achieved good short-term results within 1 month after surgery. The 6-month postoperative angiography examination of the submandibular gland duct showed that 6% of patients in the submandibular gland duct graft group had a blockage or was not smooth. At the same time, 45% of the patients in the vein graft group had failure or obstruction, and the VAS score of pain was higher than that of the submandibular gland ductal graft group (p < .05).Conclusion and significance: Compared with vein grafting, the reconstruction of parotid ductal defect with submandibular gland ductal graft has better long-term effects.

Sialodocholithiasis - A case report and review

A majority of sialoliths occur in the submandibular gland or its duct and are a common cause of acute and chronic infections. This report describes the case of a patient who had an unusual submandibular gland duct sialolith (calculus) that was completely obstructing the submandibular gland duct (sialodocholithiasis) and the use of the computed tomography and ultrasonography as a diagnostic aid and a surgical guide. Patients with sialolithiasis require definitive surgical treatment in most cases, which results in an excellent prognosis. Along with presenting the case report, this article also reviews the etiology, diagnosis, and various treatment modalities available for the management of salivary gland calculi depending on their site and size.

Multiple sialolithiasis in submandibular gland duct: a rare case report

ABSTRACT Sialolithiasis is a pathological process that affects the major salivary glands. It consists of calcifications that obstruct the parenchyma of the gland and / or the lumen of the ducts. The 37 years old female patient, VBB, leucoderma, attended the stomatology service with a complaint of swelling in the floor of mouth, which she noticed 10 years ago. The clinical and radiographic exams indicated a diagnosis of multiple sialolithiasis in the left submandibular gland duct. Surgical intervention was indicated in this case. Amongst all sialolithiasis cases, 80% affect the submandibular glands. Of these, 70% are isolated sialoliths. Only 5% of cases present more than 3 calcifications. This study aims to report the diagnosis and treatment of a rare case of multiple sialoliths located in the duct of the submandibular gland, which were surgically removed via intraoral access.

Giant Sialolith with 20 Years of Evolution in the Submandibular Duct

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.

Expression and localization of endogenous phospholipase Cβ3 confined to basal cells in situ of immature ducts and adult excretory ducts of submandibular gland of mice

Our previous study demonstrated that, different from the parotid and sublingual glands, the submandibular glands of adult mice did not show an immunoblot band for PLCβ3 which is critical in the secretion mechanism by muscarinic cholinergic signaling. Therefore, the submandibular glands of mice at various stages of postnatal development were examined for this enzyme molecule in immunoblot and immunohistochemistry. In immunoblot, a weak band for PLCβ3-expression was detected only at early postnatal stages. In immunohistochemistry, PLCβ3-immunoreactivity was distinctly found in most basally located cells of immature ducts, while the immunoreactivity was weakly seen in terminal tubule cells without significant immunoreactivity in adjacent acinar cells. In contrast, the immunoreactivity was distinctly found in some basal cells of adult excretory ducts, and it was ultrastructurally localized densely in close association with bundles of tonofilaments in the cells. The present finding suggests the possibility that Ca2+ signaling governed by phospholipase Cβ3 is involved in the differentiation of ductal basal cells into apical cells through control of keratin molecule(s) in the cells.

Disruption of tight junction structure contributes to secretory dysfunction in IgG4-related sialadenitis.

IgG4-related sialadenitis (IgG4-RS) is a chronic fibro-inflammatory disease characterized by swelling of salivary glands and varying degrees of xerostomia. Tight junctions (TJs) play an essential role in maintaining secretory function by regulating the paracellular flow of ions and water. However, whether TJs are altered and contribute to the hyposecretion in IgG4-RS is not fully understood. Here, a total of 399 differentially expressed proteins were identified in IgG4-RS submandibular glands (SMGs) and enriched in the regulation of actin cytoskeleton and the salivary secretion. Real-time PCR results showed that the mRNA levels of claudin-3, -4, -6, -7, -8, -10, -12, occludin, and ZO-1 were significantly lower, whereas claudin-1 and -5 were higher in IgG4-RS SMGs. Immunohistochemical and immunofluorescence staining revealed that claudin-1, -3, -4, occludin, and ZO-1 were mainly distributed at apicolateral membranes in acini and ducts of SMGs from controls, whereas claudin-1 protein intensity at apicolateral membrane was elevated, while the staining of claudin-3, -4, and ZO-1 were reduced in IgG4-RS SMGs. Occludin was dispersed into cytoplasm of acini and ducts in SMGs of patients. Among them, claudin-3 and ZO-1 protein levels were positively correlated with saliva flow rate. Furthermore, the decreased fluorescence intensity of F-actin at peri-apicolateral membranes and the loss of ZO-1 staining at the same location were observed in acinar and ductal cells of IgG4-RS SMGs, which might be responsible for disorganization of TJ complex. Taken together, these findings indicate that the integrity of TJ complex of SMGs is impaired and might contribute to hyposalivation of IgG4-RS patients.

SIALOLITHIASIS OF MINOR SALIVARY GLAND IN THE BUCCAL MUCOSA: A CLINICAL FINDING

Sialolithiasis is the most common salivary gland disease, represented by a solid structure composed of calcium phosphate and organic matrix that may cause obstructive sialadenitis of the affected gland. Regularly diagnosed in the submandibular gland duct, it does not exhibit age or sex predilection. A 43-year-old female patient attended for dental evaluation had a small single asymptomatic yellow nodule with fibrous consistency in the buccal mucosa. An excisional biopsy was performed with clinical hypothesis of fibrous hyperplasia and lipoma. The histopathologic analysis showed an acellular mineralized tissue. The final diagnosis was sialolithiasis of the minor salivary gland. Sialolithiasis of the minor salivary gland is a rarely diagnosed disease and more commonly observed in the upper lip and buccal mucosa, suggesting its inclusion in the differential diagnose of minor salivary glands lesions, and this report emphasizes the importance of a complete clinical examination since it was a clinical finding. Sialolithiasis is the most common salivary gland disease, represented by a solid structure composed of calcium phosphate and organic matrix that may cause obstructive sialadenitis of the affected gland. Regularly diagnosed in the submandibular gland duct, it does not exhibit age or sex predilection. A 43-year-old female patient attended for dental evaluation had a small single asymptomatic yellow nodule with fibrous consistency in the buccal mucosa. An excisional biopsy was performed with clinical hypothesis of fibrous hyperplasia and lipoma. The histopathologic analysis showed an acellular mineralized tissue. The final diagnosis was sialolithiasis of the minor salivary gland. Sialolithiasis of the minor salivary gland is a rarely diagnosed disease and more commonly observed in the upper lip and buccal mucosa, suggesting its inclusion in the differential diagnose of minor salivary glands lesions, and this report emphasizes the importance of a complete clinical examination since it was a clinical finding.

A Case of Removal of Multiple Submandibular Gland and Duct Stones by Cervical Incision Approach

A calcified structure blocking the flow of saliva into the mouth is a major cause of salivary dysfunction. If a stone is detected, the goal of treatment would be to remove it. Furthermore, the fundamental treatment for preventing recurrence, although depending on the location and size of the stone, is salivary gland resection. The submandibular gland duct and hilum stone is usually removed by transoral approach. If there are multiple stones in the submandibular gland and the duct, it would be necessary to carry out resection of submandibular gland, using the intra-oral approach. We recently experienced a case of multiple stone in the submandibular gland and the duct in a 73-year-old man, who presented with the right submandibular area swelling after meals. We removed the submandibular gland and duct stone without intra-oral approach and present this case with a review of the literature. Key words: Sialolithiasis ㆍ Submandibular gland ㆍ Whartons duct

Spontaneous Discharged Submandibular Gland Duct Sialolith: Α Rare Case Report

Sialolithiasis is the most common pathology of the salivary gland characterized by the development of salivary stones, known as calculi or sialoliths. Sialoliths commonly measure between 5 and 10 mm in size, and all stones over 10 mm can be reported as sialoliths of unusual size. Sialolith of more than 15 mm is defined as giant sialolith and is extremely rare. Most salivary sialolith occurs in the submandibular gland duct, especially located in the distal third of the duct. The main signs and symptoms are local pain and swelling. The treatment option to remove the sialolith is according to its size and location. For giant sialolith, surgical removal with or without the gland excision needs to be considered. Here, we report a case of giant submandibular gland sialolith of 35 mm in greatest dimension. And this is the first reported case of giant salivary gland duct sialolith discharged spontaneously.

Long-Term Outcomes of Sialendoscopy in the Management of Sialolithiasis and Idiopathic Chronic Sialadenitis with Ductal Scars.

We aimed to present the long-term outcomes and sialendoscopic findings in only patients with sialolithiasis and ductal scars in idiopathic chronic recurrent sialadenitis who experienced unsuccessful results with conservative treatment and were treated with sialendoscopy. We retrospectively analyzed the patients with a diagnosis of only sialolithiasis and ductal scars in chronic recurrent sialadenitis who underwent sialendoscopy between January 2011 and June 2016. We collected clinical and intraoperative data including patient age, sex, date of the procedure, the involved gland, operative findings and complications. Follow-up data included whether the symptoms were resolved or recurred and whether any further procedures were performed. Of a total of 38 patients, 16 were excluded from the study due to missing clinical or follow-up data, and analysis was conducted on 22 patients. Twelve were diagnosed with sialolithiasis, while the remaining 10 were diagnosed with idiopathic chronic sialadenitis and had ductal scars. Stone sizes ranged from 2 mm to 10 mm. Mean follow-up time was 39.5 months. The final success rate was 100%. Of the 10 patients with ductal scarring, five had scar in the parotid gland duct, and five in the submandibular gland duct. The mean follow-up time of all ductal scar patients was 47.1 months. The final success rate was 70%. Sialendoscopy is a minimally invasive method for the diagnosis and treatment of sialolithiasis and ductal scars of the salivary glands after failure of conservative treatments in adults.

The apical Na+ -HCO3 - cotransporter Slc4a7 (NBCn1) does not contribute to bicarbonate transport by mouse salivary gland ducts.

The HCO3 - secretion mechanism in salivary glands is unclear but is thought to rely on the co-ordinated activity of multiple ion transport proteins including members of the Slc4 family of bicarbonate transporters. Slc4a7 was immunolocalized to the apical membrane of mouse submandibular duct cells. In contrast, Slc4a7 was not detected in acinar cells, and correspondingly, Slc4a7 disruption did not affect fluid secretion in response to cholinergic or β-adrenergic stimulation in the submandibular gland (SMG). Much of the Na + -dependent intracellular pH (pH i ) regulation in SMG duct cells was insensitive to 4,4'-diisothiocyano-2,2'-stilbenedisulfonic acid, S0859, and to the removal of extracellular HCO 3 - . Consistent with these latter observations, the Slc4a7 null mutation had no impact on HCO 3 - secretion nor on pH i regulation in duct cells. Taken together, our results revealed that Slc4a7 targets to the apical membrane of mouse SMG duct cells where it contributes little if any to pH i regulation or stimulated HCO 3 - secretion.

Unusual Variations in Path of Accessory Submandibular Salivary Gland Duct in Comparison with Main Submandibular Salivary Gland Duct

Introduction: The submandibular gland is located bilaterally in the submandibular triangle. The main submandibular duct or Wharton’s duct, runs with lingual nerve to open in the sublingual papilla at the side of frenulum of the tongue. The aim of this study was to demonstrate the unusual variations of accessory submandibular duct in comparison with main submandibular salivary gland duct. Material &amp; Methods: Nineteen cadavers were dissected to study the submandibular salivary duct. Results: 15.7% incidence of variations were observed. We found that one submandibular region was having unusual path of accessory duct, it emerged from superficial part of the gland and crossed the superficial surface of mylohyoid muscle and bifurcated into two branches. These bifurcated branches of duct pierced the mylohyoid muscle to pass between mylohyoid and hyoglossus muscle. One branch of bifurcated accessory duct opened through papilla in the floor of the mouth behind the lower incisor tooth and second branch of the bifurcated duct anastomosed with the main duct (Wharton’s duct) to open in sublingual papilla. Wharton’s duct of this side followed its normal path to open in the sublingual papilla. Two specimens of submandibular region was observed with duplication of submandibular duct in each submandibular gland. One was main duct and second was accessory duct. Both ducts emerged separately from the deep part of submandibular gland and ended independently into sublingual papilla. Conclusion: Reporting of these variations are important for diagnostic imaging, anatomical teaching and to help surgeons while operating in this region.

Adenoid cystic carcinoma of the sublingual salivary gland obstructing the submandibular salivary gland duct

We present the case of a 65-year-old woman with sublingual adenoid cystic carcinoma (ACC). Computed tomography (CT) sialography revealed an expansive process in the left sublingual gland accompanied with ipsilateral submandibular salivary duct obstruction. The head and neck tumor board recommended surgical and radiotherapy treatment. Presently, the patient is disease-free with no visible complications or signs of recurrence.

Morphological and functional state of the epithelial cells in submandibular salivary glands after repeated amputations of the incisor teeth in adult rats

Purpose. To evaluate a morphofunctional state of the epithelial cells of the acini and ducts of submandibular glands of mature rats after repeated incisors amputation. Materials and methods. The experiment was performed on mature (2 months) white male rats, divided into groups: intact, control group and a group of rats subjected to repeated incisors amputation. Applying histological, histochemical and morphometric methods, we evaluated the morphological and functional state of the epithelial cells in submandibular glands of adult rats at 2, 3, 4, 6, 8, 10 and 12 weeks after repeated amputation of the incisor teeth. Results. There is an increase of submandibular gland acini area at the 3–10 week after repeated incisors amputation. The functional activity of the submandibular glands ducts and acini cells decreases at the 2–4 week of the experiment. Conclusion. As a result of repeated incisors amputation in rat submandibular glands acini and ducts epithelial cells develop reversible structural and functional changes, which are leveled by the 12th and 6th week of the experiment, respectively.

A case of sialolith in the submandibular gland duct considered to be caused by a fish bone

Although rare, several cases of sialolith formation around a foreign body have been reported. We report a case of sialolith in the submandibular gland duct, which was suspected to be formed around the nucleus of a fish bone. The patient was a 56-year-old man. His chief complaints were swelling of the right submandibular region and pain while eating. Computed tomography revealed a calculi-like radiopaque substance in the right oral floor region, and sialolithiasis of the right submandibular gland was diagnosed. The sialolith was surgically removed by intraoral incision. Examination of the removed specimen revealed a transparent stick-like material wrapped in the sialolith. The foreign body was histopathologically diagnosed to be bone tissue. On discussion with the patient, he was found to be eating fish every day. Therefore, the foreign body was considered to be a fish bone. However, it was unclear how the fish bone entered Wharton’s duct.

Salivary gland duct obstruction after radioiodine therapy: a case report

Background: Radioiodine therapy has long been used in the treatment of hyperthyroid patients. Salivary complications secondary to radioactive iodine (RAI) treatment are well documented, there is little in the literature addressing salivary gland duct obstruction. We present a rare case of salivary gland duct obstruction developed 2 months after RAI treatment. Case Presentation: We describe a 50-year-old male, treated with RAI for hyperthyroidism. He developed pain and swelling in the left submandibular region, 2 months after receiving RAI treatment (25 mCi). His salivary gland scintigraphy was done after injecting 370 MBq (15 mCi) of Tc99m pertechnetate in supine position. It revealed retention of radiotracer in the left submandibular gland with no drainage through the duct system, even on giving lemon stimulus, favoring submandibular gland duct obstruction. Conclusion: We report this rare complication of submandibular gland duct injury occurring after RAI therapy. The occurrence of this complication even after low dose of radioiodine administration may be listed in gamut. All necessary measures must be taken to reduce such potential complications.

Salivary gland duct obstruction after radioiodine therapy: a case report

Background: Radioiodine therapy has long been used in the treatment of hyperthyroid patients. Salivary complications secondary to radioactive iodine (RAI) treatment are well documented, there is little in the literature addressing salivary gland duct obstruction. We present a rare case of salivary gland duct obstruction developed 2 months after RAI treatment. Case Presentation: We describe a 50-year-old male, treated with RAI for hyperthyroidism. He developed pain and swelling in the left submandibular region, 2 months after receiving RAI treatment (25 mCi). His salivary gland scintigraphy was done after injecting 370 MBq (15 mCi) of Tc99m pertechnetate in supine position. It revealed retention of radiotracer in the left submandibular gland with no drainage through the duct system, even on giving lemon stimulus, favoring submandibular gland duct obstruction. Conclusion: We report this rare complication of submandibular gland duct injury occurring after RAI therapy. The occurrence of this complication even after low dose of radioiodine administration may be listed in gamut. All necessary measures must be taken to reduce such potential complications.

Distribution of aquaporin-5, transforming growth factor-β1 and laminin during regeneration of atrophic rat submandibular glands after duct ligation.

The aim of this study was to determine the localization of aquaporin-5 (AQP5), transforming growth factor-β1 (TGF-β1) and laminin during regeneration of the rat submandibular gland. After duct ligation for 7 days, the regenerating glands were collected on days 0, 1, 3, 7, and 14 after ligation release to study the process of regeneration. Immunohistochemical staining revealed apical expression of AQP5 in many acinar cells, strong expression in intercalated ducts (ICDs) of the normal submandibular gland at Day 14, and strong expression in duct-like structures (DLSs) during regeneration from Day 0 to 7. However, a few AQP5-negative acinar cells were detected during regeneration. At Day 0, immunopositivity for TGF-β1 was detected in connective tissue. At Days 3 and 7 during regeneration, TGF-β1 immunostaining was observed in DLSs, which were surrounded by α-smooth muscle actin-positive thickened myoepithelial cells. Laminin staining was strong in the thickened basement membrane of DLSs at Day 3 during regeneration, but weak around acinar cells at Day 14. These findings suggest that TGF-β1 is involved in the environment around DLSs, myoepithelial cells and laminin, that DLSs have the same functional properties as ICDs, and that AQP5-negative acinar cells may be mucous cells.