Anterolateral Sialolithiasis in Wharton's Canal

Abstract

Salivary glands are exocrine glands whose functions include the production of saliva to moisten the mouth and thus help and facilitate the digestive process. Sialolithiasis is an entity that can commonly present in these glands and is mainly due to the presence of intraglandular stones or within the salivary duct system. These sialoliths can grow abruptly and cause major obstructions and associated secondary complications. This study presents the case of a 48-year-old female patient who was referred to the Maxillofacial Surgery Department of Kitui Hospital in Kenya due to increased volume in the left anterolateral region of the floor of the mouth, which was associated with pain when consuming acidic, salty, or even very sweet foods, with a reported evolution time of 1 year. She also reported that sometimes the pain was so severe that she could observe a slight increase in volume in the submandibular region on that side, which gradually disappeared as the pain subsided. An occlusal X-ray was indicated, which confirmed the presence of a sialolith in Wharton's duct. Some laboratory studies were performed, and then the excision was carried out through an intraoral canalicular sialolectomy. The presentation of our case is part of a paradigm shift documented in recent literature, where the management of sialolithiasis has evolved from glandulectomy as the standard toward minimally invasive and organ-preserving strategies. This transformation, initiated in the 1990s, has reduced the rate of glandular resections from 40-50% to less than 5% in specialized centers.