A case report on meal time syndrome

Abstract

Sialolithiasis is the formation of calculi within the parenchyma of salivary gland or its duct. These cases present with pain and swelling of salivary gland. The exact aetiology of salivary stones is not completely understood and various hypotheses have been put forward. They include agglomeration of sialomicroliths, anatomical variations of salivary ducts and altered biochemical composition of saliva. Here we are reporting a case of 45 year old gentleman with a giant sialolithiasis in submandibular region. He came with pain and pus discharge from left side of floor of mouth for one week. On inspection a bludge was seen in left side of floor of mouth. On bimanual palpation, a stony hard mass was felt which was tender and not mobile. Under local anaesthesia surgical removal of stone done. Sialoliths are equally distributed between left and right side of the oral cavity. Mean size of sialolith is reported as six to nine mm and they infrequently measure more than 1.5 cm. The majority of salivary calculi is formed from phosphate and oxalate salts. Sialography allows whole duct system to be visualised, demonstrating calculi of all sizes and also the glandular percentage. Sialodochotomy is a well-reported technique for the intra-oral removal of ductal stones, including giant calculi. Giant sialolith is a rare entity worth reporting. Though conventional methods are still useful for diagnosis and therapy many innovative techniques are evolving around it.