Sialolithotomy and sialodochoplasty of giant sialolith in the submandibular duct: a case report

Abstract

Objective: To report a case of giant sialolith in the submandibularduct in which sialolithotomy and sialodochoplasty procedures wereperformed with an intraoral and extraoral approach.Method: A 47 years old male patient reported a complaint of swellingin the left lower jaw which triggered discomfort, particularly wheneating. The extraoral examination found 50 mm sized swelling thatwas firm in consistency, not painful and showed the same colour asthe tissue in the left submandibular region. Meanwhile, the intraoralexamination indicated a 5 mm sized whitish firm mass on the mucosalfloor of the mouth. The panoramic radiograph examination showeda multiple radiopaque mass in the left mandible with a well-definedborder. A multiple mass was found by the CT-scan examination inthe left submandibular region and floor of the mouth. Sialographicexamination described a total obstruction in the left submandibularduct and allegedly chronic inflammation-induced sialolith.Results: Sialolithotomy was done with an intraoral and extraoralapproach after which sialodochoplasty was also performed to insertthe pediatric feeding tube no. 8 aiming to retain the shape andfunction of the submandibular duct.Conclusion: Treating giant sialolith with sialolithotomy followedby sialodochoplasty has given a satisfactory result without anycomplication and recurrence.