Treatment of Sialolithiasis of Sublingual Gland with Sialolithiasis of the Submandibular Gland: Stone in a Posthilar to Intraparenchymal Location
When the calculus is situated in a posthilar or intraparenchymal position within the submandibular gland, it lies beyond the reach of standard endoscopic or palpation-guided retrieval. This anatomical location — present in only a small minority of salivary stone cases — defines a distinct management scenario.
Clinical scenario: Sialolithiasis of the submandibular gland with the stone in a posthilar to intraparenchymal location. Intraparenchymal stones represent approximately 10% of all salivary calculi, making this a less common presentation that requires a targeted, specialised approach.
Treatment approach
For stones in this location, extracorporeal shock-wave lithotripsy (ESWL) is the primary indicated intervention — with further steps depending on the response and stone mobilisation. The complete protocol with the full sequenced regimen is available below.
References
DOI: 10.3390/jcm11010231
- Posthilar to Intraparenchymal Stones
- Only approximately 10% of all stones are in an intraparenchymal location.
- If stones cannot be visualized endoscopically, are not palpable, and are located too far inside the duct system (>6.5–7.0 cm), ESWL is indicated.
- However, ESWL can be supplemented with or later combined with ISWL or TDS after adequate mobilization.
View source ↗