Supporting the Iowa Head and Neck Protocols - 2024 - Donations Needed!Click Here
Make a Donation

Sublingual gland salivary stones (sialolithiasis) transoral resection technique

Submitted by hoffmanh on Wed, 11/01/2023 - 16:31
8 month postop sublingual resection US
8 month postop sublingual resection US
8 month postop sublingual resection US

see: Plunging Ranula Transoral Resection (Sublingual Gland) Aided With Sialendoscopy with Histopathology

Background

Sublingual sialolithiasis (salivary stones originating in the sublingual glands) are rare.  Lustmann et al in 1990 reported on 245 patients treated with sialolithiasis over a 20 year period with the submandibular gland most frequently involved (231 patients) the parotid less frequently (11  patients) and only one patient with sublingual sialolithiasis (Lustmann 1990). 

Modified Op Note

Preop Dx: Left sublingual sialadenitis with sialolithiasis

Postop Dx: Same

Procedure:

1. Left submandibular sialendoscopy (0.8 mm Zenk scope) before SL gland resection with placement of a 4Fr and then 5Fr COOK salivary access dliator to hilum (5 cm)

2. Left sublingual gland resection with lingual nerve dissection and preservation

3. Left submandibular sialendoscopy following SL gland resection with intact non-disrupted Wharton's duct to hilum

4. Infusion of 1 cc of kenalog 10 to left submandibular duct

Anesthesia: General OETT 

Findings: as per above and photos

Additionally: 'accessory' sublingual gland identified separate from the primary gland left attached to Wharton's duct as per the photos

P: f/u in 4 weeks, medrol dose pak, augmentin 875 mg po bid for 7 days, peridex oral rinse qid for 2-3 weeks (until healed) to see in 2nd stage before discharge today

References

Grewal JS, Bordoni B, Shah J, Ryan J. Anatomy, Head and Neck, Sublingual Gland. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30571047.

Goodstein L, Galinat L, Curry J, Luginbuhl A, Cognetti D. Sialendoscopy for Sublingual Gland Sialolithiasis. Ann Otol Rhinol Laryngol. 2017 Mar;126(3):216-218. doi: 10.1177/0003489416684846. Epub 2017 Jan 5. PMID: 28056531.

Lustmann J, Regev E, Melamed Y. Sialolithiasis. A survey on 245 patients and a review of the literature. Int J Oral Maxillofac Surg. 1990 Jun;19(3):135-8. doi: 10.1016/s0901-5027(05)80127-4. PMID: 2114453.

Jain P, Jain R. Types of sublingual gland herniation observed during sonography of plunging ranulas. J Ultrasound Med. 2014 Aug;33(8):1491-7. doi: 10.7863/ultra.33.8.1491. PMID: 25063415.