Krishnan B, Gehani Rafa El, Shehumi Mohammed Il
Department of Oral and Maxillofacial Surgery, Al Arab Medical University, Benghazi, Libya.
Indian J Otolaryngol Head Neck Surg. 2009 Jan;61(Suppl 1):55-8. doi: 10.1007/s12070-009-0019-3. Epub 2009 Mar 21.
Sialolithiasis is one of the most common diseases of the salivary gland. The submandibular gland and its duct appear to be the most susceptible. However, giant sialoliths have rarely been reported in the literature. Two case reports of giant sialoliths in the submandibular duct alone are presented. In both patients, a transoral removal of the stone was done under local anesthesia. The stones were 35 mm and 25 mm long, respectively. Follow-up showed asymptomatic and normal functioning glands. The etiology, pathogenesis and management of such giant sialoliths are discussed.It is interesting to note that both patients remained relatively asymptomatic in spite of such long-standing sialoliths. The glands also recovered normal function quickly following removal of stones, which is interesting as such longstanding stones usually produce irrereversible functional damage to the gland. A conservative approach to the gland will spare the patient the morbidity associated with gland removal.
涎石病是唾液腺最常见的疾病之一。下颌下腺及其导管似乎最易受累。然而，巨大涎石在文献中鲜有报道。本文报告两例仅位于下颌下腺导管的巨大涎石病例。两名患者均在局部麻醉下经口取出结石。结石长度分别为35毫米和25毫米。随访显示腺体无症状且功能正常。文中讨论了此类巨大涎石的病因、发病机制及治疗方法。值得注意的是，尽管存在如此长期的涎石，两名患者相对无症状。结石取出后腺体也迅速恢复了正常功能，这很有意思，因为如此长期存在的结石通常会对腺体造成不可逆的功能损害。对腺体采取保守治疗方法可使患者避免与腺体切除相关的并发症。
