Right sub-mandibular region swelling for two years.
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Non-enhanced CT images demonstrate a large, oval-shaped hyper-dense stone in the right sub-mandibular gland duct (Warthon's duct) measuring 1.6 cm x 1 cm x 0.8 cm in size. It is also associated with proximal intra-mandibular duct dilatation. There is no abnormal collection in its vicinity.
The right submandibular gland is abnormally enlarged due to inflammatory process.
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Sialolithiasis is the most common disease of salivary glands with more than 80% occurring in submandibular gland and its duct, 6% in parotid gland and 2% in lingual and other minor salivary glands.
Its incidence is reported as 1 per 300,000 people per year. Relatively, males are being affected twice as much as females.
Submandibular stones are composed of 82 % inorganic and 18% organic components. The precise aetiology and pathogenesis of silaolithiasis is unknown.
Due to mechanical obstruction, Sialolithiasis can cause repetitive swelling and pain resulting in acute or chronic infections.
Plain radiography, ultrasonography, sialography and computed tomography are the imaging modalities which can detect this entity.
Case contributed by: Marzia Muhammadi and Hidayatullah Hamidi
- 1. Cawson R A, Odell E W. Essentials of oral pathology and oral medicine. 6th ed. pp 239-240. Edinburgh:Churchill Livingstone, 1998
- 2. Zenk J, Benzel W, Iro H. New modalities in the management of human sialolithiasis. Minimally invasive therapy 1994; 3: 275-284.