Acute submandibular sialadentitis

Case contributed by Dr Derek Smith

Presentation

Left submandibular and fluctuant floor of mouth swelling.

Patient Data

Age: 50 years
Gender: Female
X-ray

Ovoid density projecting over the apices of LL3 and LL4.

10 mm calculus in the region of the left sublingual papilla with an obstructed, distended and enhancing submandibular duct. Enhancement in the floor of mouth, likely reactive with no definite mass. The left submandibular gland is also enlarged and enhancing, with local inflammatory stranding.

No other salivary calculi. No focal collection. No pathological nodal enlargement. Normal upper aerodigestive tract.

Zoomed and annotated images of the submandibular gland (blue), duct (green), obstructing calculus (black star) and mylohyoid muscle (red). You can follow the path of the duct around the posterior margin of mylohyoid, then running deep to the muscle to the sublingual papilla.

Case Discussion

Acute left submandibular sialadenitis (with the calculus visible on CT and OPG). A good opportunity to revise duct anatomy!

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Case information

rID: 77212
Published: 7th May 2020
Last edited: 9th May 2020
System: Head & Neck
Inclusion in quiz mode: Included

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