Deep and Unusual Sialolithiasis of Submandibular Duct and Gland: A Surgical Dilemma
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Giant solitary submandibular duct calculus and multiple calculi of the gland are extremely rare. This occurrence along with more deep and proximally placed common calculi in submandibular gland may occasionally cause a dilemma in selection of the appropriate surgical approach in the present era of sialoendoscopic surgery. There is a high chance of fracture of the stone in a proximally placed stone in the gland followed by likely dissemination of fragments of the stone into the gland parenchyma during the procedure of sialoendoscopy which is a matter of grave concern. We authors believe that excision of the submandibular gland with the stone in such a situation should still be preferred as the gold standard of treatment leaving the ductal stone for endoscopic removal.
KeywordsSialolithiasis of submandibular gland Sialoendoscopy Dissemination of fragmented calculi Excision of gland
We, the authors acknowledge the immense help and support that we received from our NMC group medical director Dr. B. R. Shetty and Medical Director of NMC Specialty Hospital, Abu Dhabi Dr. C. R. Shetty without whom none of this would have been possible.
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