Escisión de Glándula Submandibular por Sialoadenitis Crónica Esclerosante Asociada a Sialolito en el Conducto Submandibular / Submandibular Gland Excision Due to Chronic Sclerosing Sialadenitis Associated With Sialolith in Submandibular Duct

La sialoadenitis crónica esclerosante puede extenderse desde una sialoadenitis focal hasta una cirrosis completa de la glándula. Aparece entre los 40 y 70 años de edad y afecta principalmente a la glándula submandibular. Se asocia con sialolitos y agentes infecciosos inespecíficos. La causa más frecuente de sialolitiasis es la formación de cálculos macroscópicamente visibles en una glándula salival o en su conducto excretor, de los cuales el 80 % al 90 % provienen de la glándula submandibular. Esta predilección probablemente se deba a que su conducto excretor es más largo, más ancho y tiene un ángulo casi vertical contra la gravedad, contribuyendo así a la estasis salival. Además, la secreción semimucosa de la misma es más viscosa. El sitio principal de ubicación de los litos en el conducto submandibular es la región hiliar con un 57 %. La sintomatología típica de la sialolitiasis es el cólico con tumefacción de la glándula y los dolores posprandiales. Reportamos el caso de un paciente masculino de 55 años, quien ingresa al servicio de Cirugía Oral y Maxilofacial del Hospital General Balbuena de la Ciudad de México por presentar un aumento de volumen en la región submandibular izquierda de consistencia dura y dolorosa a la palpación de 15 días de evolución, acompañada de aumento de temperatura en la zona compatible con un absceso. Los estudios de imagen reportan un sialolito en la región hiliar del conducto submandibular de 2,0 x 1,7 x 1,0 cm. Debido a su localización y tamaño, el tratamiento ideal en estos casos es la escisión de la glándula junto con el lito previo drenaje del absceso e inicio de terapia antibiótica doble.

Chronic sclerosing sialadenitis can range from focal sialadenitis to complete cirrhosis of the gland. It appears between 40 and 70 years of age and mainly affects the submandibular gland. It is associated with sialoliths and nonspecific infectious agents. The most common cause of sialolithiasis is the formation of macroscopically visible stones in a salivary gland or its excretory duct, of which 80 % to 90 % come from the submandibular gland. This predilection isprobably due to the fact that their excretory duct is longer, wider and has an almost vertical angle against gravity, thus contributing to salivary stasis. In addition, the semimucous secretion of it is more viscous. The main location of the stones in the submandibular duct is the hilar region with 57 %. The typical symptomatology of sialolithiasis is colic with swelling of the gland and postprandial pain. We report the case of a 55-year-old male patient, who was admitted to the Oral and Maxillofacial Surgery Service of the Hospital General Balbuena in Mexico City due to an increase in volumen in the left submandibular region that was hard and painful on palpation of 15 days of evolution, accompanied by increased temperature in the area compatible with an abscess. Imaging studies report a 2.0 x 1.7 x 1.0 cm sialolith in the submandibular duct hilar region. Due to its location and size, the ideal treatment in these cases is excision of the gland together with the stone previous drainage of the abscess and initiation of dual antibiotic therapy.

Sialolitectomía canicular por sialolito de gran tamaño / Canicular sialolithectomy of a giant sialolith

RESUMEN Introducción: La sialolitiasis es una afección frecuente de las glándulas salivales mayores que se manifiesta con mayor frecuencia en pacientes de sexo masculino. Objetivo: Presentar un caso clínico de una sialoadenitis por sialolitiasis de glándula submandibular, tratado exitosamente mediante sialolitectomía canicular intraoral. Caso clínico: Paciente de 45 años de edad atendido en el Departamento de Cirugía Maxilofacial de la Clínica de Especialidades "Manuel de Jesús Cedeño", Granma, Cuba, por presentar molestias en el suelo de la boca con aumento de volumen de consistencia dura, móvil y fácilmente desplazable. Radiográficamente, se observó una imagen radiopaca de bordes definidos, ovoide de aproximadamente 4 cm de largo y 2 cm de ancho. Se comprobó que se trataba de una sialoadenitis por sialolitiasis de la glándula submandibular derecha. Se trató la sintomatología mediante analgésicos-antiinflamatorios y antibióticos. Se realizó sialolitectomía canicular intraoral. Posteriormente se efectuó una recanalización del conducto lo que permitió la permeabilización de este. Conclusiones: La sialoadenitis por sialolitiasis es una afección con pronóstico favorable, pues cuando se realiza el tratamiento adecuado se logra que la glándula vuelva a su fisiología normal, lo que mejora la calidad de vida del paciente. En nuestro caso se realizó la remoción quirúrgica a través de sialolitectomía canicular intraoral, sin complicaciones. El paciente mostró excelente recuperación tras un mes de evolución, constituyendo un tratamiento satisfactorio a corto y largo plazo(AU)

ABSTRACT Introduction: Sialolithiasis is a common disorder of the major salivary glands which presents more frequently in male patients. Objective: Present a clinical case of sialadenitis due to sialolithiasis of the submandibular gland successfully treated by intraoral canicular sialolithectomy. Case report: A male 45-year-old patient attending the Maxillofacial Surgery Department at Manuel de Jesús Cedeño Specialty Clinic in Granma, Cuba, presents with discomfort on the floor of the mouth and a hard, mobile and easily movable mass of increased volume. Radiographic examination revealed a radiopaque oval-shaped image of well-defined edges, approximately 4 cm long x 2 cm wide. A diagnosis was made of sialadenitis due to sialolithiasis of the right submandibular gland. Symptoms were treated with analgesics / anti-inflammatories and antibiotics. Intraoral canicular sialolithectomy was performed. Rechanneling of the duct was then conducted to allow permeabilization. Conclusions: Sialadenitis due to sialolithiasis is a condition of a favorable prognosis. Appropriate treatment will have the gland return to its normal physiology, improving the patient's quality of life. In our case, surgical removal was conducted by intraoral canicular sialolithectomy without any complications. The patient had completely recovered after one month's evolution, the treatment being satisfactory both short- and long-term(AU)

Ultrasonography Echotexture as a surrogate for Sialadenitis secondary to 131I Radioiodine Therapy for differentiated Thyroid Cancer: a review and metaanalysis

To systematically review and analyze the medical literature to assess ultrasonography echotexture changes in thyroid cancer patients for the detection of chronic sialadenitis caused by radioiodine therapy. Methods: Sources were retrieved from PubMed, Scopus, EMBASE and LILACS through November 2018. All studies that assessed ultrasonographic features before 131I administration and at 12 months after 131I administration were selected. After data extraction, statistical analysis was performed by using Stata software. Results: From a total of 435 studies, 4 studies involving 665 patients were considered eligible, and echotexture heterogeneity was found with a significant difference. Conclusions: Ultrasound echotexture may detect chronic sialadenitis secondary to salivary radioiodine therapy.

Sonographic and CT Findings of Sialadenosis in a Child with Leukemia

Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings.

Sialography: Report of 3 cases.

Salivary gland examination is an important part of oral examination, especially because of it's involvement in most of the systemic diseases. Patients most commonly seek medical attention when the major salivary glands like parotid and submandibular gland become enlarged or painful. The various imaging modalities practiced to check the salivary gland disorders include conventional radiography, sialography, ultrasonography, computerized tomography, radionuclide imaging and magnetic resonance imaging. Sialography is one of the oldest imaging procedures and still most commonly practiced, as it is a chair side procedure, simple to perform, and cost effective. We report the role of sialography as an adjuvant in the diagnosis of bacterial sialadenitis and sialadenosis and as a diagnostic and therapeutic aid in a case of juvenile recurrent parotitis.