Treatment of Submandibular Sialolithiasis with a Bimanually Palpable Posterior Stone Less Than 4 mm

This protocol applies to patients with submandibular sialolithiasis in whom the salivary stone is bimanually palpable, located in the posterior region of the duct, and measures less than 4 mm in diameter.

Clinical Scenario

The calculus is confirmed in the submandibular gland and is accessible on bimanual palpation. Its posterior location and palpable nature are directly relevant to management planning — a posterior, palpable stone is a specific presentation that informs both the approach and the anesthetic requirements.

Treatment Approach

The structured protocol for this presentation includes a surgical intervention. The specific clinical criteria, procedural details, and the complete decision algorithm are available in the full evidence-based regimen.

Instant Access to Structured Evidence-Based Regimens

References

A posterior and palpable stone should be performed under general anesthesia.
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.
In case of multiple recurrence, failure of non-invasive and invasive treatments or complete loss of salivary gland function, submandibulectomy can be discussed with the patient.

DOI: 10.1051/mbcb/2018039 View source ↗