Incidental finding of sialolithiasis in the sublingual gland: a diagnostic dilemma

Abstract

This case describes a 35-year-old female who presented with an incidental finding of sublingual gland sialolithiasis. The clinical presentation, investigations and management as well as the pathology are described. This case highlights the diagnostic dilemma in determining the anatomical position of sialoliths on radiographs.

Sialendoscopy for Sublingual Gland Sialolithiasis

“…The incidence of sublingual gland sialolithiasis varies in the literature from 0% to 6.4%. 1-3 Studies from the 1950s and 1960s report a higher incidence of 6.4%, which may be falsely elevated due to confusion with stones in the anterior portion of Wharton’s duct. 1,3 At our tertiary care academic center, we have a 1% incidence.…”

“…Sialoliths most commonly occur in the submandibular gland, outnumbering the parotid gland by approximately 4:1, while stones occur in the sublingual gland in just 0% to 6.4% of cases. 1-3 Because the sublingual gland is a rare site for sialolithiasis, it may be underdiagnosed and may be mistaken as a Wharton’s duct stone.…”

Giant sialolith of sublingual gland

“…7 Clarence P. et al reported an unusual case of sialolithiasis of the sublingual gland presenting in a 35-year-old female. They removed the right sublingual salivary gland, together with the five stones (the largest measuring 7x6x4 mm) 7 . Liao LJ et al studied a case of a 50-year-old male with left sublingual gland sialolithiasis who was treated with excision of the left sublingual gland and the stone via a transoral approach.…”

Management of anterior submandibular sialolithiasis

“…In the long run, this pressure will lead to the formation of connective tissue and atrophy of acinar cells [12]. Incomplete obstruction will only cause a decrease of the salivary flow, thus explaining why some salivary stones can be symptomless [25]. Giant sialolithiasis refer to calculi whose dimension exceeds 1.5 cm in any direction or when its weight exceeds 1 g [3].…”