A SPECTRUM OF THE SURGICAL MANAGEMENT OF SUBMANDIBULAR SIALOLITHIASIS — A STUDY 1

Sialolithiasis means formation of calcific structures in salivary glands. It is most common in sub-mandibular gland. Various theories have been proposed to explain its etiology. A study was carried out among patients reporting to department of oral and maxillofacial surgery Khyber College of Dentistry, with Sialolithiasis to find out disease characteristics, surgical treatment offered along with post operative complications. A proforma was filled after diagnosis of sialolithiasis by a detailed history, clinical examination and necessary radiographic investigation. Stones in the anterior part of the duct were treated by duct incision and sialodochoplasty intra-orally while gland removal was done for stones in hilum and gland parenchyma. Patients were followed post operatively for a period of one year. Out of 57 patients, 56% were males while rests of 44% were females. The age ranged from 19 to 60 with mean age of 32.63 ± SD 7.8 years. The number of patients from age range of 31-40 were found to be highest i.e., 30 (53%). Single isolated stone was found in 53 (93%) patients, while 4 (7%) patients had multiple stones. Location of isolated stone in present study was, in anterior part of duct (n= 27, 47%), distal part of duct (n= 26, 46%, Duct parenchyma 5% and both anterior and posterior of the duct 2%. Duct incision followed by retrieval of stone and sialoduchoplasty was carried for 27(47%) stones. Rest 30(53%) patients were treated by sub mandibular gland excision. All the stones were unilateral. Immediate Postoperative complications were Hematoma in the floor of the mouth and the submandibular region in one patient each, paresthesia of the lingual nerve (n=4). Weakness of the marginal mandibular branch of the facial nerve (n=2). Nerve paresthesia improved over a period of 4 months in subsequent follow up visits.