• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.114-118
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• 2009

Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.548-552
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• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.205-208
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• 1999

Sialolithiasis is relatively common disease of the salivary gland in the field of Oral & Maxillofacial surgery. Obstruction of salivary secretion by a sialolith can result in swelling and pain, as well as infection of the gland. The swelling is usually correlated to meals, when salivary secretion is enhanced. Sialolithiasis occurs mainly in the submandibular gland(92%) and to a lesser degree in the parotid gland(6%). The sublingual gland and the minor salivary gland are rarely affected(2%). This is a report of rare case, the authors have experienced, within the left sublingual gland and the minor salivary glands. It is multiple sialolithiasis(about 22 silaoliths) in the sublingual and the minor salivary glands which has very low incidence of sialolithiasis. The pathosis were removed using transoral sialolithotomy with sublingual sialadenectomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.93-96
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• 2005

Sialolithiasis is the most common disease caused by calculi in a salivary gland and its duct. The pain and swelling of salivary gland is a chief complaint of patients presenting. Most salivary gland calculi occur in the submandibular gland, but can also occur in the parotid gland and the sublingual gland. One giant sialolith is rarely reported, while the several cases of one or multiple sialolith in the submandibular gland have reported in the literatures. In this case, we have removed the sialolith in which perforated mouth floor along Wharton's duct and report it.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.3
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• pp.182-185
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• 2017

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.41-44
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• 2016

The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.44-49
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• 2012

Introduction: Sialolithes are initiated by localized deposition of calcified material in the salivary glands. And that may even cause various symptom especially swelling and pain. This study purposes to collect statistical data of sialolithiasis for clinical analysis. Materials and Methods: Among forty seven patients who have visited Seoul National University Dental Hospital during 2004-2009, patients' age, sex, location and size of stone, radiodensity of stone, symptom, surgical procedure were investigated. Statistical correlation between size, location, symptom was evaluated. Chemical composition was analyzed for 3 sialolithes. Results: The average age was 41.4 years. Sialolithiasis had slight female predilection (57.4%). Most cases occurred in the submandibular glands (91.5%). And most cases had radiopaque features (95.8%). The average size was 7.17 mm. The most frequent location of the stones were the duct orifice and the submandibular gland hilum (16 cases in each), followed by the middle part of the duct (n=8), the intraglandular area (n=4), and the proximal part of the duct (n=3). Eleven cases were asymptomatic. Thirty six cases had complaints of pain, swelling, hardness, and decrease in saliva flow (multiple symptoms). Various methods of surgery was performed. Two cases were self-removed. Thirty seven cases underwent procedure involving stone removal alone. Six cases underwent gland extirpation, and two cases underwent ductoplasty. Conclusion: There was no statistical correlation between size, location, and symptoms. Sialolith was composed of Ca (58.5-69.3%), P (30.7-35.7%), organic material, and trace inorganic material.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.363-367
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• 2010

Sialolithiasis is the most commom disease of salivary gland. The main symptoms are pain and swelling of the involved gland during eating. It can occur at any age but patients in their third to fifth decade present most cases. Males are more frequently affected than females. Most sialoliths are located within the duct system of the submandibular gland. Submandibular sialoliths close to the hilum of the gland tend to become large and ovoid shape, whereas sialoliths in the duct tend to be elongated. Commonly, sialoliths measure from 1 mm to less than 10 mm, and larger than 15 mm are considered rare. In one case we have removed a giant sialolith which was located in a wharton's duct and in the other case we have removed multiple sialolith including a giant sialolith which were also located in a Wharton's duct. We report these 2 cases with literature reviews.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.25.1-25.6
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• 2017

Background: The conventional transcervical resection for submandibular gland disease has some risks and an unsatisfactory cosmetic result. Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome. Case presentation: The authors performed robot-assisted sialadenectomy via modified facelift incision using the da Vinci Xi surgical system (Intuitive Surgical Inc., CA, USA) with two endowrist arms (monopolar curved scissors and Maryland bipolar forceps) successfully in a 44-year-old female patient who suffered from sialolith and severe atrophic submandibular gland. Conclusions: If similar studies are done in the future, this robot-assisted sialadenectomy may become established as an alternative to existing disadvantageous surgical methods.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.94-102
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• 2024

The exact mechanism of sialolith formation has yet to be determined. Recurrence of sialolithiasis is rare, affecting only 1%-10% of patients. The current study presents a case of recurrent stones that occurred twice on the right submandibular gland 6 months postoperative and 7 months after reoperation in a 48-year-old female patient. The stones were analyzed using histology, scanning electron microscopy, energy dispersive spectroscopy, and transmission electron microscopy (TEM). The first stone showed a three-layered structure with a poorly mineralized peripheral multilayered zone, highly mineralized middle layer, and the central nidus. The stones were composed of Ca, C, O, Cu, F, N, P, Si, Zn, and Zr. In TEM, compact bi-layered bacterial cell membrane was found on the peripheral layer and the central nidus of the stone as well as exosomes in the central nidus. The results demonstrated the essential components of sialolith formation, including bacteria, inflammatory exosomes, and exfoliated salivary epithelial cells that cooperatively underwent the pathogenetic progresses of central nidus formation, induction of compact zone calcification of the middle layer, and repeated subsequent deposition in the peripheral multilayer zone. The rapid recurrence could have resulted from residual pieces of a sialolith acting as the nidus of bacterial infection.