Transoral Approach Used to Remove a Giant Sialolith

Study Design: Case Report.Objective: Sialoliths are a cause of Sialolithiasis affecting an estimated 12 in 1000 adult population. The patient’s presentation vary from being asymptomatic to pain with swelling and purulent discharge if accompanied with a infection. Giant sialoliths greater than 15 mm are rare. The purpose of the article is to document and educate clinicians on the management of giant sialoliths with possible sparing of the salivary gland.Methods: This report documents a patient with a sialolith measuring 45 mm in the widest diameter removed using a trans-oral approach.Results: The patient presented with an intra-oral sialolith which was asymptomatic except for the hard swelling felt cervically. Clinical examination and radiographic imaging was adequate for a diagnosis and the fact that there was no tenderness over the glandular area a decision to spare the gland was made.Conclusion: There are few reports of giant sialoliths and majority present with sialadenitis. In this case it was rare for the stone to have reached this size with hardly any symptoms. In patients where the gland has not been affected clinicians may consider sparing it and remove only the sialolith to reduce the morbidity and risks associated with glandular excision.