Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA.
University of Maryland School of Dentistry, Baltimore, MD, USA.
Gerodontology. 2021 Dec;38(4):437-440. doi: 10.1111/ger.12544. Epub 2021 Feb 15.
This article discusses the clinical significance of an unusual case of the simultaneous occurrence of 2 giant sialoliths within the ipsilateral submandibular gland and distal aspect of Wharton's duct in a 63-year-old patient.
The majority of submandibular gland sialoliths are found in Wharton's duct, with fewer within the gland parenchyma. Giant sialoliths (exceeding 15 mm in size) are rare.
An asymptomatic, otherwise healthy older patient sought dental care and underwent a comprehensive oral and radiographic examination.
A panoramic radiograph revealed 2 incidental radiopaque structures, representing giant sialoliths within the submandibular gland and along the distal segment of Wharton's duct. This synchronous finding apparently represents the first case reported in the geriatric literature.
The detection of 1 salivary stone should heighten the scrutiny for additional stones. Practitioners should carefully weigh the risk of sialolith removal versus deferment of treatment in older medically compromised patients.
本文讨论了一例罕见的双侧下颌下腺和沃顿管远端同时发生 2 个巨大涎石的临床意义,患者为 63 岁。
大多数下颌下腺涎石位于沃顿管内,而位于腺实质内的则较少。巨大涎石(超过 15mm 大小)较为罕见。
一位无症状的、其他方面健康的老年患者寻求牙科护理,并进行了全面的口腔和影像学检查。
全景片显示 2 个偶然发现的不透射线结构,代表下颌下腺内和沃顿管远端的巨大涎石。这种同步发现显然代表了老年医学文献中的首例报告。
检测到 1 个唾液结石应提高对其他结石的警惕性。对于有医学并发症的老年患者,医生应仔细权衡结石切除的风险与延迟治疗的风险。