Repeated episodes of submandibular gland pain and swelling — typically worse with meals — in the setting of a confirmed salivary stone or duct stricture represent a well-defined clinical presentation that requires a structured management approach.
Patients present with recurrent postprandial pain and swelling of the submandibular gland, often accompanied by recurrent infections. The submandibular gland is the most commonly affected site, accounting for 80–90% of sialolithiasis cases. When a stone or duct stricture is identified on examination or imaging, obstructive sialadenitis is the working diagnosis.
Acute episodes are managed with antibiotics and supportive care — the complete sequenced regimen, including what follows, is detailed in the full protocol.
Repeated episodes of pain and swelling, often with meals; recurrent infections.
Patients with sialolithiasis typically present with postprandial salivary pain and swelling.
The submandibular gland is most often affected (80% to 90% of cases), and nearly all other cases involve the parotid duct.
Initial management consists of treating any acute infection, followed by surgical removal of the stone.
Dilation, sialodochoplasty, gland excision, antibiotics, supportive care (e.g., hydration, analgesics).
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