This protocol covers a specific clinical presentation of submandibular sialolithiasis: a calculus situated in the posterior duct region, 4 mm or larger in diameter, and not accessible by bimanual palpation.
The stone's posterior location and size are the defining features of this presentation. Stones of 4 mm or larger require a different management pathway than smaller anterior stones, which may be amenable to less-invasive retrieval. When the calculus is not bimanually palpable, the posterior position and size together narrow the range of applicable interventions.
Management in this scenario involves a definitive surgical option targeting the gland. The complete protocol — including the full indication criteria and clinical decision points — is available via the link below.
DOI: 10.1051/mbcb/2018039
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.
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