Sialolitotomía submandibular / Submandibular Sialolithotomy

Los sialolitos son masas calcificadas que se encuentran dentro de los conductos salivales, siendo más frecuente su localización en el conducto de la glándula submandibular, asociado a su configuración anatómica, así como a la alta concentración de fosfatos de calcio y mucina en la saliva. Su patogenia no está bien identificada ni establecida. La sintomatología está asociada a dolores prandiales, así como inflamación de la glándula afectada y en ocasiones se presenta sintomatología de índole infecciosa. El diagnóstico es realizado mediante una palpación bimanual extraoral e intraoral de la glándula, así como el apoyo de estudios imagenológicos. El tratamiento depende de la localización y del tamaño del sialolito, con base en estos criterios se opta por una intervención conservadora o bien su remoción quirúrgica. El presente artículo describe una sialolitotomía submandibular con abordaje intraoral (AU)

Sialoliths are calcified masses found within the salivary ducts, most frequently located in the submandibular gland duct, associated with their anatomical configuration as well as the high concentration of calcium phosphates and mucin in saliva. Its pathogenesis is not well identified or established. The symptoms are associated with prandial pain, as well as inflammation of the affected gland and occasionally symptoms of an infectious nature are present. Diagnosis is made by extraoral and intraoral bimanual palpation of the glands, as well as the support of imaging studies. Treatment depends on the location and size of the sialolith. Based on these criteria, a conservative intervention or surgical removal is chosen. This paper describes a submandibular sialolithotomy with an intraoral approach (AU)

Sialolitiasis, sialoadenitis y sialoadenosis. Revisión de literatura y reporte de un caso clínico / Sialolithiasis, sialadenitis and sialadenosis. Review of literature and report of a clinical case

Introducción: la formación de sialolitos se considera la alteración más común en las glándulas salivales. Su origen aún no es claro en cuanto a qué provoca la obstrucción parcial o total del sistema de conductos salivales, con una predilección significativa en las glán - dulas submandibulares, lo que permite un desplazamiento retrógrado de bacterias a través del conducto salival hacia la glándula afectada, el cual se traducirá clínicamente como inflamación unilateral o bila - teral. El tratamiento para la sialolitiasis y sialoadenitis puede variar desde un manejo conservador hasta tratamientos que implican la remoción de la glándula salival afectada. La sialoadenosis difiere de las anteriores en su origen, ya que ésta no se considera inflamatoria ni neoplásica y no afecta la función glandular de excretar saliva. Presentación de caso clínico: se trata de paciente masculino con diagnósticos presuntivos de sialoadenitis y sialolitiasis, al cual se le realizó biopsia escisional de la glándula afectada, su estudio histo- patológico corroboró los diagnósticos mencionados anteriormente que además confirmó un diagnóstico de sialoadenosis. Conclusio- nes: la escisión de la glándula salival involucrada se realizará en casos diagnosticados de sialoadenitis y sialolitiasis con sialolitos de gran tamaño y procesos supurativos crónicos que no resuelven con antibioticoterapia (AU)

Malformation of Wharton′s duct with multiple sialoliths: a case report and literature review / 口腔疾病防治

Objective@#To explore the diagnosis and treatment of ductal malformations of the submandibular gland with multiple stones.@*Methods@# A case of a malformation of Wharton′s duct with multiple sialoliths according to the clinical data, diagnosis and treatment of the patient was analyzed retrospectively.@*Results@#The patient′s physical examination and CBCT showed a tumor on the left floor of the mouth. In this case, it was found that the mass was a malformation of Wharton′s duct with multiple sialoliths according to operative exploration. The postoperative pathological examination showed (left submaxillary) salivation gland tissue, duct dilation and duct epithelia hyperplasia, duct calculus, and a large number of lymphocytes proliferating around the duct; 1 month after the follow-up, the patient had healed well. Through literature review and analysis, it was found that cases of submandibular ductal malformation with multiple stones were rare and should be carefully differentiated from arteriovenous malformation at the base of the mouth. Calculi of the submandibular gland can be removed by incision through the oral submandibular duct or by combined resection of the submandibular gland and ductal calculi, and some smaller calculi can also be treated by endoscopy of the salivary gland. @* Conclusion@# In cases of submandibular ductal malformation with multiple stones, intraoral and extraoral incisions should be performed simultaneously to remove the associated ductal stones.

The influence of salivary pH and calcium/phosphate ions concentration on salivary gland stones' formation

Sialolithiasis is a multi-factorial pathology that accounts for more than 50% of salivary gland disease. However,the exact impact of salivary pH and calcium (Ca2+) and phosphate (PO43−) on the sialoliths' formation stillremains unknown. Materials and Methods: Seven removed sialoliths were put into flasks with artificial salivasolution that differed in concentrations of Ca2+ and PO43−. The changes in weights of sialoliths and alterations inpH had been measured for 13 weeks. Concentrations of Ca2+ and PO43− in the artificial saliva solution wereestimated at the beginning and at the end of the experiment. Results: Sialoliths' weight decrease was observedfrom the 2nd to 7th week. It occurred parallel with natural pH decrease (from 7 to 6.5 pH). Sialoliths’ weightsstarted increasing after pH was adjusted with NaOH. Analyzing the concentration changes of Ca2+ in everyflask, it was determined that from natural or double Ca2+ concentration, it decreased till similar amount (7–14times). Analyzing the concentration changes of PO43−, it was determined that from natural or doublePO43− concentration it decreased 24 times. Conclusions: Sialoliths' weights decreased parallel with natural pHdecrease and sialoliths grew when pH was adjusted. PO43− ions concentration decreased relatively more thanCa2+ ions concentration.

Removal of submandibular calculi by surgical method and hydraulic power with curved needle: a case report

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.

Removal of a submandibular duct calculus with 'SNU Sialoop': Technical report / 대한구강악안면방사선학회지

Manufacturing method and technical procedure of 'SNU Sialoop', which was a new device designed for removal of sialolith, were introduced. Two cases about removal of Wharton' duct sialolith using SNU Sialoop were presented.