CLINICAL CASES   

Rivista Italiana di Chirurgia Maxillo-Facciale 2002 December;13(3):179-82

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Bilateral submandibular sialolithiasis. Report of a case

Santamaria S. ¹, Mileto D. ¹, Cristiano G. ¹, Catalfamo L. ¹, De Ponte F. S. ^{1, 2}

¹ Chair of Maxillo-Facial Surgery University of Messina, Italy 2 School of Plastic and Reconstructive Surgery (Head: Prof. Francesco S. De Ponte) University of Messina, Italy

Bilateral sia­lol­i­thi­a­sis of sub­man­dib­u­lar ­glands is ­not com­mon­ly report­ed in ­the lit­er­a­ture. The ­authors ­report a ­case of bilat­er­al sub­man­dib­u­lar sia­lol­i­thi­a­sis in a 28-­y-­old wom­an. A scia­load­e­nit­ic chron­ic symp­tom­a­tol­o­gy start­ed ­about 10-­y ­before. Ultrasono-graphy ­and ­MRI ­were ­used to con­firm ­the diag­no­sis of bilat­er­al sia­lol­i­thi­a­sis of sub­man­dib­u­lar ­glands; cal­cu­li ­were locat­ed in ­the ­glands them­selves. Ultrasonographic exam­ina­tion, accord­ing to ­the lit­er­a­ture, ­showed ­high sen­si­tiv­ity ­for detec­tion of cal­cu­li; there­fore ultra­so­nog­ra­phy ­was car­ried ­out in ­order to ­show ­the paren­chy­mal struc­tu­ral alter­a­tions. ­MRI, usu­al­ly con­sid­ered a 2nd lev­el tech­nique of inves­ti­ga­tion ­for ­this pathol­o­gy, ­was per­formed to dem­on­strate ­the pres­ence of cal­cu­li ­and ­the degen­er­a­tive alter­a­tions of ­the glan­du­lar paren­chy­ma of ­both sub­man­dib­u­lar ­glands. The ­patient ­was treat­ed ­with exci­sion of ­both sub­man­dib­u­lar ­glands by ­means of a trans­cer­vi­cal ­approach ­and ­post oper­a­tive­ly ­had a rou­tine con­va­les­cence. After 1-­y fol­low-up ­there ­was no evi­dence of def­i­cit of mar­gi­nal man­dib­u­lar, lin­gual ­and hypo­glos­sal ­nerves. The cosmetic appearance was satisfactory. The exci­sion of ­the 2 sub­man­dib­u­lar ­glands ­was fol­lowed by com­plete regres­sion of ­the symp­tom­a­tol­o­gy: ­this ­result sup­ports ­the use­ful­ness of a rad­i­cal treat­ment ­for chron­ic symp­to­mat­ic cal­cu­lous sia­lad­e­nitis. Transcervical sia­lad­e­nec­to­my, con­sid­er­ing ­the ­absence in ­this clin­i­cal ­case of func­tion­al ­and cos­met­ic out­comes, ­may be regard­ed as a 1st ­choice sur­gi­cal tech­nique ­for exci­sion of ­the sub­man­dib­u­lar ­glands affect­ed by cal­cu­lous sia­lad­e­nitis.