Intraoral Surgical Management of Submandibular Duct Sialolithiasis: A Case Report

Abstract

Sialolithiasis, the most common disease of the salivary glands, typically affects the submandibular gland due to its anatomical and physiological features. It often presents with pain and swelling, particularly during meals, due to obstruction of salivary flow. Prompt diagnosis and surgical removal are essential to prevent recurrent infections and glandular damage.

Case Presentation: A 42-year-old female presented with a 3-month history of intermittent pain and swelling in the left floor of the mouth, exacerbated during mastication. Clinical and radiographic evaluation revealed a firm swelling along the floor of the mouth and an oval radiopaque mass within the mid-portion of Wharton's duct, suggestive of submandibular sialolithiasis. A differential diagnosis included phlebolith, submandibular gland infection, and calcified hemangioma. An occlusal radiograph confirmed the presence of a 7 mm calcification. The patient underwent successful intraoral surgical excision under local anesthesia. Postoperative recovery was uneventful, and follow-up visits at 1 week, 1 month, and 6 months demonstrated complete symptom resolution and restoration of salivary flow. Histopathological analysis confirmed the composition of the sialolith as primarily calcium phosphate.

Conclusion: This case highlights the clinical presentation, diagnosis, and effective intraoral surgical management of submandibular sialolithiasis.