What Is the Treatment for a Bimanually Palpable Posterior Submandibular Salivary Stone ≥4 mm?
This protocol applies to a specific, well-defined clinical presentation of submandibular sialolithiasis in which the stone is accessible to bimanual palpation, situated in the posterior region of the submandibular duct, and measures 4 mm or more in diameter.
Clinical Scenario
The patient presents with a submandibular salivary stone that is bimanually palpable on examination. The stone is located posteriorly and its diameter reaches 4 mm or larger — characteristics that place it in a distinct management category compared to smaller or anteriorly situated calculi.
Treatment Approach
In this presentation, management may involve a definitive surgical procedure addressing the gland — the specific indications, criteria, and procedural details are outlined in the complete 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);
- 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.
View source ↗