Salivary Gland Cases

Case 1:  This is a case of a 51 year old otherwise healthy male who was incidentally found to have a large stone lodged in his submandibular gland on dental X-rays.  He requested an opinion about minimally-invasive options for removal.  A CT scan was performed which revealed a 1.1 cm stone lodged in the hilum of his submandibular gland.  The stone was first identified with a small scope inserted through the duct.  The stone was then removed through a small incision in the mouth and the incision was closed.  He has had no complications and quickly returned to work and a regular diet. 


CT Scan

Endoscopic view of stone



Small incision for stone removal



Stone removed

 

Case 2:  This is a case of a 57 year old female with a 7 year history of recurrent right submandibular gland swelling and discomfort.  This would occur about once monthly and typically was associated with eating.  A CT scan of the neck revealed mild ductal dilation without stones.  She elected to undergo sialoendoscopy which exhibited near complete stenosis of the primary duct 3 cm proximal to the papilla.   The stenotic region was dilated with a guide wire under endoscopic visualization.  A stent was placed intraoperatively and subsequently removed 3 weeks later.  Three months postoperatively the patient has not experienced any additional swelling or pain and is pleased with her results.


CT scan with dilated duct demonstrated

Stenotic primary duct



Guidewire placed through stenotic region



Dilation partially completed