Grabovska Dagnija, Li Junsiyuan, Radziņa Maija, Balodis Arturs
Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia.
Faculty of Residency, Latvian University, LV-1586 Riga, Latvia.
Diagnostics (Basel). 2024 Dec 16;14(24):2833. doi: 10.3390/diagnostics14242833.
BACKGROUND/OBJECTIVES: The muscular base of the oral cavity is formed of the mylohyoid muscle, which forms a sling inferior to the tongue. The muscle is often discontinuous, and defects may include salivary tissues, fat, and/or blood vessels. Hypertrophic sublingual glands located in mylohyoid defects can be herniated into bilateral submandibular spaces and present as palpable masses. The etiology of this condition may be congenital or acquired, and although such anatomical variations are common, they often go unrecognized in clinical practice. Sialoceles are cyst-like structures that result from chronic inflammation or ductal injury, indicating underlying problems with drainage efficiency.
In this case series, we present two patients.
The first patient is a 44-year-old female who presented with a slowly enlarging right submandibular mass for two years, while the second is a 70-year-old female who presented with nonspecific neck discomfort, lacking palpable masses. In both, initial imaging (ultrasound and CT) was inconclusive. MRI revealed right sublingual gland herniation through a mylohyoid defect (mylohyoid boutonniere) in both cases.
This highlights the importance of comprehensive imaging in the diagnosis of submandibular masses and emphasizes the need for considering mylohyoid boutonniere in cases of bilateral submandibular masses. Further research is warranted into the sialoceles associated with salivary gland abnormalities.
背景/目的：口腔的肌肉基底由下颌舌骨肌构成，该肌肉在舌下方形成一个吊带。该肌肉常不连续，缺损可能包括唾液组织、脂肪和/或血管。位于下颌舌骨肌缺损处的舌下腺肥大可疝入双侧颌下间隙并表现为可触及的肿块。这种情况的病因可能是先天性或后天性的，尽管这种解剖变异很常见，但在临床实践中往往未被识别。涎囊肿是由慢性炎症或导管损伤导致的囊肿样结构，表明存在引流效率方面的潜在问题。
在本病例系列中，我们展示了两名患者。
第一名患者是一名44岁女性，右颌下肿块缓慢增大两年；第二名患者是一名70岁女性，表现为非特异性颈部不适，未触及肿块。在这两名患者中，初始影像学检查（超声和CT）均无定论。MRI显示在这两个病例中均有舌下腺通过下颌舌骨肌缺损（下颌舌骨肌纽扣孔）疝出。
这突出了全面影像学检查在颌下肿块诊断中的重要性，并强调在双侧颌下肿块病例中考虑下颌舌骨肌纽扣孔的必要性。有必要对与唾液腺异常相关的涎囊肿进行进一步研究。
