Treatment of Submandibular Sialolithiasis with a Bimanually Palpable Posterior Stone (≥ 4 mm)
This protocol applies to submandibular sialolithiasis in which the salivary calculus is bimanually palpable, located in the posterior region of the submandibular duct, and has a diameter of 4 mm or larger. These specific features — stone location, palpability, and size — directly determine the appropriate management approach.
Clinical scenario: A submandibular salivary stone is confirmed as bimanually palpable and situated posteriorly in the duct. The stone diameter is 4 mm or more. This combination of findings places the case in a specific management category distinct from smaller or anteriorly located calculi.
Approach (partial): Management involves either an external fragmentation technique or a surgical intra-oral intervention performed under general anesthesia. The criteria for selecting between these options, and any additional procedural steps, are described in the full protocol.
References
DOI: 10.1051/mbcb/2018039
- A posterior and palpable stone should be performed under general anesthesia.
- Calculi smaller than 4 mm may be removed using a basket probe, while larger stones will require endocanal fragmentation (endoscopic laser) or external fragmentation (extracorporeal lithotripsy).