Presentation
Chronic left sided facial pain following eating. Recent acute episode.
Patient Data
1 cm stone in the left submandibular duct.
Enlarged left submandibular gland with surrounding inflammatory change.
The left submandibular gland in enlarged, with intraglandular duct dilatation.
The left submandibular duct is dilated, measuring 10 mm due to an obstructive stone in the proximal duct.
The dilated submandibular duct (blue arrow) is due to a intra-ductal stone (red arrow).
Case Discussion
Sialolithiasis ( salivary gland stone disease ) is the single commonest disorder of the salivary glands.
Of this, the vast majority (more than 80%) occurs in the submandibular gland.
Limited CT is excellent at identifying salivary duct stones and in the acute presentation may identify gland enlargement and inflammation in keeping with sialadenitis.
MRI delineates the gland and the ductal architectural even more clearly, especially the intra-glandular duct dilatation as in this case.
Traditional sialography, although the gold standard, is less commonly required.
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