Submandibular sialolithiasis

Case contributed by Dr Ian Bickle

Presentation

Chronic left sided facial pain following eating. Recent acute episode.

Patient Data

Age: 41
Gender: Female
CT

1cm stone in the left submandibular duct.

Enlarged left submandibular gland with surrounding inflammatory change.

MRI

The left submandibular gland in enlarged with intraglandular duct dilatation.

The left submandibular duct is dilated measuring 10mm due to an obstructive stone in the proximal duct.

Annotated image

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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Case information

rID: 38151
Case created: 8th Jul 2015
Last edited: 15th Oct 2017
System: Head & Neck
Inclusion in quiz mode: Included

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