This protocol applies to submandibular sialolithiasis where the salivary stone is situated in the anterior region and is confirmed on bimanual palpation. The location and palpability of the calculus are the key factors that define the appropriate management pathway.
It is generally accepted that an anteriorly located, bimanually palpable sialolithiasis of the submandibular gland directs treatment toward an intra-oral approach. This anatomical position allows for intervention under local anesthesia, which shapes the selection of technique and setting.
For a bimanually palpable stone in the anterior region, the evidence-based approach centres on a surgical procedure delivered via an intra-oral (transoral) route. Further options and the complete procedural pathway — including technique selection criteria and anesthesia approach — are set out in the full structured protocol.
DOI: 10.1051/mbcb/2018039
It is generally accepted that the intra-oral approach is selected when the sialolithiasis is located anteriorly.
An anterior and palpable sialolithiasis can be performed under local anesthesia.
The treatment of choice for patients with stones that are bimanually palpable and/or which are located within the prehilar region of the gland is a transoral surgery.
Sialendoscopy is mainly intended for small stones (less than 4 mm diameter) but can remove stones regardless of their position under local or general anesthesia.
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