• 대한기관식도과학회지
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• 제14권1호
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• pp.23-28
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• 2008

Background and Objectives : Traditionally, the excision of submandibular gland (SMG) has been commonly used for treatment of calculi in the proximal duct or gland parenchyma. Over the last 10 years several new minimally invasive techniques including lithotripsy, sialendoscope were introduced in the treatment of sialolithiasis. But these have some limitation on large, infected calculi. The aim of this study is to assess the intraoral treatment of submadibular stones. Subjects and Method : The records of one hundred and seventy-three patients who underwent intraoral removal of submadibular sialolithiasis between June 1, 1989 and July 31, 2006 were retrospectively reviewed. Results : Stone location was distal to the edge of the mylohyoid muscle in 127 patients and proximal to gland in 48 patients (mean size of sialoliths, 7.1mm [range 3.0-25mm]). The complete removal of stones was observed in 170 (97.1%) patients regardless of size and location. Recurrence of lithiasis was found in 8 patients (then treated with intraoral removal in 5 patientsand resection of SMG (submandibular glands) in 3 patients). Acalculous sialadenitis in 9 patients (5.1%) and cyst formation in 2 patients (1.1%) was found. But no evidence of postoperative complications including hemorrhage, fistula, damage to lingual nerve were found. Conclusion : The intraoral removal of submandibular stone is useful in preservation of submandiblar function and effective in palpable stones regardless of location, size.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권2호
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• pp.94-102
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• 2024

The exact mechanism of sialolith formation has yet to be determined. Recurrence of sialolithiasis is rare, affecting only 1%-10% of patients. The current study presents a case of recurrent stones that occurred twice on the right submandibular gland 6 months postoperative and 7 months after reoperation in a 48-year-old female patient. The stones were analyzed using histology, scanning electron microscopy, energy dispersive spectroscopy, and transmission electron microscopy (TEM). The first stone showed a three-layered structure with a poorly mineralized peripheral multilayered zone, highly mineralized middle layer, and the central nidus. The stones were composed of Ca, C, O, Cu, F, N, P, Si, Zn, and Zr. In TEM, compact bi-layered bacterial cell membrane was found on the peripheral layer and the central nidus of the stone as well as exosomes in the central nidus. The results demonstrated the essential components of sialolith formation, including bacteria, inflammatory exosomes, and exfoliated salivary epithelial cells that cooperatively underwent the pathogenetic progresses of central nidus formation, induction of compact zone calcification of the middle layer, and repeated subsequent deposition in the peripheral multilayer zone. The rapid recurrence could have resulted from residual pieces of a sialolith acting as the nidus of bacterial infection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권1호
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• pp.93-96
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• 2005

Sialolithiasis is the most common disease caused by calculi in a salivary gland and its duct. The pain and swelling of salivary gland is a chief complaint of patients presenting. Most salivary gland calculi occur in the submandibular gland, but can also occur in the parotid gland and the sublingual gland. One giant sialolith is rarely reported, while the several cases of one or multiple sialolith in the submandibular gland have reported in the literatures. In this case, we have removed the sialolith in which perforated mouth floor along Wharton's duct and report it.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권3호
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• pp.182-185
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• 2017

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.548-552
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• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

• 한국임상수의학회지
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• 제26권4호
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• pp.371-375
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• 2009

3년령의 비글견이 경부 종괴로 내원하였다. 종괴는 하악의 배쪽 부분에 위치하였다. 환자는 심한 유연 증상을 보였다. 신체 검사, 방사선 검사, 초음파 검사와 컴퓨터단층촬영 결과 타액선 결석과 함께 타액선류로 진단되었다. 타액선 제거술이 수행되었다. 조직병리학적 검사로 타액선 염증과 타액선류로 진단되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권4호
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• pp.363-367
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• 2010

Sialolithiasis is the most commom disease of salivary gland. The main symptoms are pain and swelling of the involved gland during eating. It can occur at any age but patients in their third to fifth decade present most cases. Males are more frequently affected than females. Most sialoliths are located within the duct system of the submandibular gland. Submandibular sialoliths close to the hilum of the gland tend to become large and ovoid shape, whereas sialoliths in the duct tend to be elongated. Commonly, sialoliths measure from 1 mm to less than 10 mm, and larger than 15 mm are considered rare. In one case we have removed a giant sialolith which was located in a wharton's duct and in the other case we have removed multiple sialolith including a giant sialolith which were also located in a Wharton's duct. We report these 2 cases with literature reviews.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.169-173
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• 1992

This is a report of two rare cases, that authors have experienced, one being four sialoliths within a wharton's duct, which is a relatively frequent site of sialolith, and the other a multiple occurrance of 16 sialoliths at the orifice of stensen's duct, which has very low frequency of sialolith occurance. Both pathosis were removed using transoral sialolithotomy.

• 대한두경부종양학회지
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• 제32권1호
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• pp.41-44
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• 2016

The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.25.1-25.6
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• 2017

Background: The conventional transcervical resection for submandibular gland disease has some risks and an unsatisfactory cosmetic result. Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome. Case presentation: The authors performed robot-assisted sialadenectomy via modified facelift incision using the da Vinci Xi surgical system (Intuitive Surgical Inc., CA, USA) with two endowrist arms (monopolar curved scissors and Maryland bipolar forceps) successfully in a 44-year-old female patient who suffered from sialolith and severe atrophic submandibular gland. Conclusions: If similar studies are done in the future, this robot-assisted sialadenectomy may become established as an alternative to existing disadvantageous surgical methods.