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122:Giant Asymptomatic Sialolith in the Submandibular Duct: A Case Report[AAOM2021]
EP36074
Poster Title: 122:Giant Asymptomatic Sialolith in the Submandibular Duct: A Case Report[AAOM2021]
Submitted on 29 Mar 2021
Author(s): Vandana Singh1, Pallavi Parashar1, Noura Alsufyani1,2
Affiliations: 1: University of Alberta, Canada; 2: King Saud University, Riyadh, Kingdom of Saudi Arabia
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
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Poster Information
Abstract: Background: Sialolithiasis is a common condition where a calcified mass forms within a salivary gland or in the salivary ductal system. Sialoliths most commonly occur in the major salivary glands: submandibular gland and parotid gland. These usually occur between the 3rd to 6th decades. The clinical presentation usually involves episodes of pain and local swelling due to the obstruction of salivary flow in the affected gland, and infection. Majority of salivary stones measure between 2.1mm to 10mm in diameter. Sialoliths measuring over 15 mm in diameter in any dimension are classified as giant salivary stones. Giant sialolith have infrequently been described in the salivary ducts, especially in the absence of symptoms.

Case Summary: A 35-year-old male was referred to the Oral Medicine graduate clinic for evaluation of occasional discomfort of the left facial region. On palpation, the left floor of the mouth was tense, extending from the mandibular left premolars to the third molar. We were unable to express saliva from the left submandibular gland. There was no obvious mass in the floor of the mouth. An occlusal radiograph, panoramic radiograph and Cone Beam CT scan were obtained. The occlusal radiograph partially revealed a large linear calcified mass in the left submandibular region. Cone beam CT scan revealed a large sialolith in the left submandibular gland duct that measured 46mm (L) x 7mm (W) x 12mm (H), which likely involved the primary-secondary duct system within the gland parenchyma. Based on the clinical and radiological examination, a diagnosis of giant sialolith of left submandibular duct and gland was rendered. The patient was referred to the ENT clinic and a left submandibular gland resection and transcervical stone removal has been planned.

Conclusion: The review of literature reveals that 60% of the salivary sialoliths are less than 10mm in size and very rarely larger than 15mm in size. A rare case of a giant sialolith in the submandibular duct and gland parenchyma, identified incidentally, is presented in this report.
Summary: The review of literature reveals that 60% of the salivary sialoliths are less than 10mm in size and very rarely larger than 15mm in size. A rare case of a giant sialolith in the submandibular duct and gland parenchyma, identified incidentally, is presented in this report.

Ask the author questions about this poster:vandana1@ualberta.ca
References: 1. Oliveira TP, Oliveira INF, Pinheiro ECP, Gomes RCF, Mainenti P. Giant sialolith of submandibular gland duct treated by excision and ductal repair: case report. Braz J Otorhinolaryngol. 2016;82:112-5.
2. Gupta A, Rattan D, Gupta R. Giant sialoliths of submandibular gland duct: report of two cases with unusual shape. Contemp Clin Dent. 2013;4:78-80.
3. Fowell C, MacBean A. Giant salivary calculi of the submandibular gland. J Surg Case Rep. 2012; 2012: 6. Ref.: https://goo.gl/VBB4GF
4. Siddiqui SJ, Sialolithiasis: An unusually large submandibular salivary stone. 2002 British Dental Journal 193(2):89-9110.1038/sj.bdj.4801491a
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