Sialendoscopy for Sublingual Gland Sialolithiasis

Abstract

Objectives: To present a unique series of sublingual gland sialolithiasis treated with sialendoscopy. Methods: A retrospective chart review of patients at a single tertiary care academic center undergoing sialendoscopy. Results: We present a series of 4 patients who presented with 1 episode each of sialadenitis without preceding postprandial symptoms. In each case, sialendoscopy identified the calculi embedded within the sublingual duct of Bartholin at its emptying point into Wharton’s duct. The large size of the stones did not permit endoscopic removal, and transoral excision was performed via a floor of mouth incision. All patients recovered well with resolution of preoperative symptoms. Conclusions: Sublingual gland sialolithiasis has a distinct presentation that is not associated with obstructive symptoms and may be successfully treated with a combined endoscopic and transoral approach. Sialendoscopy allows identification of the location of the sialolith to guide removal and helps identify stone fragments and additional stones remaining after sialolithotomy. Transoral resection of the sublingual gland in this scenario facilitates stone removal and may minimize long-term chance of ranula formation.