This protocol addresses the management of sialolithiasis of the sublingual gland in the specific setting of sialolithiasis of the submandibular gland, where the stone occupies a posthilar to intraparenchymal position — a distinct and less common presentation that calls for a targeted clinical approach.
Clinical scenario: Sialolithiasis of the submandibular gland with the stone in a posthilar to intraparenchymal location. Intraparenchymal stone placement represents only approximately 10% of all cases, making this a clinically significant sub-population requiring specific management considerations.
The protocol for this scenario involves a surgical approach that may include opening of the submandibular gland itself (submandibulotomy). Specific stone characteristics and clinical findings determine which intervention applies — the complete criteria and decision algorithm are available in the full protocol.
DOI: 10.3390/jcm11010231
Posthilar to Intraparenchymal Stones
Only approximately 10% of all stones are in an intraparenchymal location.
Extended TDS with opening of the gland (submandibulotomy) is indicated for large stones (>10 mm) that are palpable from inside the mouth.
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