Congenital Submandibular Salivary Gland Fistula

Abstract

In this study, we present a patient with a congenital cervical submandibular gland fistula who was admitted to the hospital for nodular thyroid hyperplasia. After bilateral subtotal thyroidectomy, the fistula tract and the submandibular salivary gland on the right side of the neck and the obliterated sinus on the left side of the neck were excised. The pathological examination led to the diagnosis of adenomatous hyperplasia of the thyroid gland with focal lymphocytic thyroiditis and mixed-type main salivary gland (submandibular gland) with cystic dilatation in one duct. Congenital salivary gland fistulae are rare and may be associated with abnormalities of the branchial apparatus or arise from aberrant or accessory salivary tissue. Excision of the fistula and the remaining submandibular gland is considered the treatment of choice in congenital fistulae, but traumatic fistulae generally resolve with conservative treatment within 3 weeks.

Early Clinical Mapping of Submandibular Gland Fistula: A Case Report and Systematic Review

“…A total of 18 cases (17 cases from 16 published articles and an illustrative case) were included in the current review (►Tables 1 and 2). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The age ranged from 6 to 72 years. The exact numerical age was not mentioned in two cases Clinical symptoms/signs were present in the following frequencies: Discharge from fistula opening (66.7%), swelling/mass in the submandibular region (55.6%), tender/pain over the submandibular region (44.4%), and throat lump (5.6%).…”

“…It is associated with various acquired etiologies, including calculi, foreign body, trauma, neoplasm, sialadenitis, or a congenital process linked to the branchial apparatus. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] It can be an external sialo-cutaneous fistula or an internal sialo-oral fistula. The external opening is either cutaneous or subcutaneous.…”

“…Similarly, an internal fistula opening is either mucosal or submucosal. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Clinical manifestation varies with the site of fistula opening and associated etiology. An external fistula mostly presents with serous/mucoid/mucopurulent discharge from the opening, which can sometimes be related to food.…”

“…Various authors have advocated different forms of management varying from observation and conservative management to surgical intervention, including either gland-preserving surgery or excision of the gland with fistulae tract. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Final Comments…”

“…Various etiologies have been attributed to SGF, including both congenital and acquired. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The clinical manifestation of SGF varies and is influenced by the etiology of the disease, making it tough for clinicians to diagnose it clini-cally. Furthermore, the site of the fistula opening has been shown to have an effect on the clinical features.…”