Author(s)
Andrew R. Fuson, MD
Nahir J. Romero Estremera, MD
Bernard L. Mendis, BS
Arjun S. Joshi, MD
Affiliation(s)
George Washington University
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to describe the ultrasound characteristics of sublingual gland sialolithiasis. Objectives: Sublingual sialolithiasis is a rarely reported entity. In this study, which represents the largest cohort of patients in the medical literature, we will describe the ultrasound characteristics of 5 cases of sublingual gland sialolithiasis to help guide management. Study Design: Retrospective review of patients over a 8 year period, with sublingual calculi. Methods: Using a high frequency transducer, the floor of mouth was imaged and submandibular region was imaged. Ultrasound findings studied included intraglandular and main ductal dilation, presence of echogenic foci, echotexture of the gland, and presence of posterior acoustic shadowing. Representative images were captured and relevant measurements were taken. Results: In all 5 cases, there were either one or multiple stones found in the anterior floor of mouth region. The main submandibular duct was not visualized in all cases. In the majority of cases, the submandibular gland itself was otherwise normal in size, echotexture, and vascularity. There was no evidence of chronic sialadenitis involving the submandibular gland. All patients underwent sublingual gland resection for treatment and the diagnosis was confirmed. Conclusions: This represents the largest cohort of patients with sublingual calculi thus published. These calculi present as hyperechoic foci with posterior acoustic shadowing in the anterior floor of mouth. Along with the absence of a dilated submandibular duct, normal submandibular parenchyma, and normal vascularity, the clinician can discern that the disease process is confined to the sublingual gland and helps make the diagnosis.