- Email: [email protected]
Comparison of sialolithiasis in pediatric and adult patients
Oral Science International 14 (2017) 37–39
Contents lists available at ScienceDirect
Oral Science International journal homepage: www.elsevier.com/locate/osi
Original Article
Comparison of sialolithiasis in pediatric and adult patients Akinari Inui ∗ , Ryohei Itou, Toshirou Oyama, Yoshihiro Tamura, Kosei Kubota, Wataru Kobayashi Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki City, Aomori Prefecture, Japan
a r t i c l e
i n f o
Article history: Received 24 October 2016 Received in revised form 31 January 2017 Accepted 13 February 2017 Available online 15 April 2017 Keywords: pediatric sialolithiasis salivary gland symptoms
a b s t r a c t Aims: To compare the clinical characteristics of sialolithiasis between pediatric and adult patients. Settings and Design: Subject characteristics, clinical manifestations, salivary calculi characteristics, and treatment modalities and outcomes from medical records were retrospectively compared between pediatric and adult patients with sialolithiasis visiting the Department of Oral and Maxillofacial Surgery, Hirosaki University Hospital, between 2005 and 2014. Subjects: We included 5 pediatric (all boys) and 45 adult (20 men; 25 women) patients. Results: Most patients had submandibular swelling. The calculi were located on the right in 100.0% of pediatric patients and 57.8% of adult patients. Moreover, 20.0% of pediatric patients and 35.6% of adult patients exhibited sialoliths in the glands. Calculi were <5 mm in size in 100.0% of pediatric patients and 33.3% of adult patients. Pediatric sialolithiasis treatment included intraoral retrieval under local anesthesia in 4 cases (80.0%) and spontaneous expulsion from the duct in 1 case (20.0%). Adult sialolithiasis treatment included gland resection under general anesthesia in 8 cases (17.8%), intraoral retrieval under general anesthesia in 6 cases (13.3%), intraoral retrieval under local anesthesia in 19 cases (42.2%), spontaneous expulsion in 6 cases (13.3%), and follow-up only in 6 cases (13.3%). Conclusions: A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval under local anesthesia. This difference in the choice of treatment between pediatric and adult sialolithiasis may be attributed to the size and palpability of the calculi. © 2017 Published by Elsevier Ltd on behalf of Japanese Stomatological Society.
Key messages To compare clinical characteristics of sialolithiasis between pediatric and adult patients. A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval.
treatment of sialolithiasis in pediatric and adult patients [1,2,5]. Therefore, our study aimed to compare the clinical characteristics of sialolithiasis between pediatric and adult patients. The findings of this study should be useful for the diagnosis and management of pediatric sialolithiasis. 2. Subjects and Methods
1. Introduction Pediatric sialolithiasis accounts for approximately 3%–13.8% of all sialolithiasis cases [1,2]. Some of the most important factors contributing to stone formation are salivary stasis, ductal inflammation, and injury [3,4]. There are some case series on this topic, but few studies have compared the clinical characteristics and
∗ Corresponding author at: Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifutyo, Hirosaki, 036-8562, Aomori Prefecture, Japan. Tel.: +81 0172 39 5127, fax: +81 0172 39 5128. E-mail address: [email protected] (A. Inui).
This study included 50 patients diagnosed with sialolithiasis who visited our department at Hirosaki University Hospital between January 2005 and December 2014. A thorough physical examination including manual palpation of the oral cavity, panoramic X-ray imaging, occlusal radiograph of the mandible, and computed tomography was performed. In cases where the clinical and radiological examinations strongly indicated sialolithiasis, one of the two treatment strategies was applied according to the location and size of the salivary calculi: (1) intraoral salivary stone retrieval or (2) salivary gland excision. The subject characteristics, clinical manifestations, treatment modalities, and outcomes were compared between pediatric and adult sialolithiasis groups. Sub-
http://dx.doi.org/10.1016/S1348-8643(17)30019-8 1348-8643/© 2017 Published by Elsevier Ltd on behalf of Japanese Stomatological Society.
38
A. Inui et al. / Oral Science International 14 (2017) 37–39
Table 1 Clinical characteristics of pediatric and adult sialolithiasis.
Age (years) Gender (male/female) Symptoms of duration (months) Pain Swelling Feeling of wrongness Pus discharge Right/Left Location Sublingual papilla Sublingual papilla and submandibular duct Sublingual papilla and submandibular gland Submandibular duct Submandibular duct and gland Submandibular gland Treatment of choice Gland resection under general anesthesia Intraoral retrieval under general anesthesia Intraoral retrieval under local anesthesia Natural emission Follow-up onlya Size Under 5 mm From 5 to 10 mm Over 10 mm Number 1 2 4 5 6 15 a
expulsion from duct in 6 cases (13.3%), and follow-up only in 6 cases (13.3%).
Children (N = 5)
Adult (N = 45)
7.4 ± 1.5 5/0 1.0 ± 0.5 1 (20.0%) 3 (60.0%) 1 (20.0%) 0 (0.0%) 5/0
52.1 ± 2.8 20/25 11.5 ± 4.4 6 (13.3%) 29 (64.4%) 8 (17.8%) 2 (4.4%) 26/19
3 (60.0%) 0 (0.0%) 1 (20.0%) 1 (20.0%) 0 (0.0%) 0 (0.0%)
7 (15.6%) 1 (2.2%) 1 (2.2%) 21 (46.7%) 3 (7.0%) 12 (26.7%)
0 (0.0%) 0 (0.0%) 4 (80.0%) 1 (20.0%) 0 (0.0%)
8 (17.8%) 6 (13.3%) 19 (42.2%) 6 (13.3%) 6 (13.3%)
5 (100.0%) 0 (0.0%) 0 (0.0%)
15 (33.3%) 14 (31.1%) 16 (35.6%)
5 (100.0%) 0 (14.3%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%)
30 (66.7%) 11a (24.4%) 1 (2.2%) 1 (2.2%) 1 (2.2%) 1 (2.2%)
Two adults refused gland resection under general anesthesia.
mandibular sialoliths can occur in the following three locations: sublingual papilla, submandibular duct, and submandibular gland. If multiple salivary calculi were found in the affected gland, all calculi were described.
3. Results A total of 5 pediatric (aged ≤14 years) and 45 adult (aged >14 years) patients were included in this study, and the submandibular gland was affected in all patients. Only one patient exhibited choledocholithiasis postoperatively. In our study, 10.0% of all sialolithiasis cases occurred in the pediatric population (age ≤14 years), including 5 boys (0 girls) with a mean age of 7.4 years (range: 3–12 years; Table 1). The duration of symptoms in pediatric patients was shorter than that in adult patients (1.0 months vs. 11.5 months). The most common chief complaints in both groups were swelling, followed by pain. A single calculus was more common in pediatric patients (85.7%) than in adult patients (65.1%; P = 0.817). The calculi were located in the submandibular gland in 20.0% of pediatric patients (exhibited involvement of the sublingual papilla and submandibular gland) and 35.5% of adult patients (1 adult exhibited involvement of the sublingual papilla and submandibular gland, and 3 adults showed involvement of the submandibular duct and gland). The calculi were <5 mm in diameter in 5 pediatric patients (100.0%) and in 15 adult patients (33.3%). The calculi were intraorally retrieved in most cases in both groups. In the pediatric group, sialolithiasis treatment involved intraoral retrieval under local anesthesia in 4 cases (80.0%) and spontaneous expulsion from the duct in 1 case (20.0%). Treatment in adults included gland resection under general anesthesia in 8 cases (17.8%), intraoral retrieval under general anesthesia in 6 cases (13.3%), intraoral retrieval under local anesthesia in 19 cases (42.2%), spontaneous
4. Discussion Although sialolithiasis is a relatively common disease in adults, it is rare in pediatric cases, with <150 cases reported in the literature [1–3,5–14]. This disease mainly occurs in the submandibular gland, and it can be explained by the pH, mucin content, and high Ca2+ concentration of submandibular saliva [1,2,5]. Males are more frequently affected than females [5,9], although one study reported contrasting results [1]. All pediatric patients in our study showed involvement of the right side (100%). However, the reasons for these differences in sex and side distribution are unclear. The exact pathogenesis of sialolithiasis is unknown, and various hypotheses have been proposed [3,5,15]. One hypothesis states that an initial organic nidus may occur that progressively grows because of the deposition of inorganic and organic substances, whereas another hypothesis states that intracellular microcalculi are excreted in the canal and function as a nidus in the ductal system. Furthermore, debris, bacteria, or substances migrating in the salivary ducts may cause sialolithiasis [15]. The low incidence of these diseases in children may be due to the relatively long time required for the formation of a salivary calculus and because sublingual papillae and salivary glands are very small in children, rendering it difficult for foreign matter to enter [5]. Furthermore, a calculus is more easily formed in adults than in children because the concentration of calcium and phosphate ions in the resting saliva increases with age. In our study, the duration of symptoms was significantly shorter in pediatric patients (0–3 months, mean 1.0 month) than in adult patients (0–120 months, mean 11.5 months). This could be attributed to a lower tolerance to uncomfortable symptoms among the patients or the parents [1]. The high salivary flow in pediatric patients may result in more severe symptoms among them [1]. Furthermore, because the sublingual papilla was the most commonly involved in the children in our study, swellings could be actively monitored by the parents and patients themselves. Five cases were treated by gland resection and six cases by intraoral retrieval under general anesthesia in adult patients. However, pediatric sialolithiasis was not treated by either of these procedures, and a large number of relatively small and distal sialoliths were removed by intraoral retrieval under local anesthesia. This difference in the treatment of choice may be due to the size and palpability of the calculi [1] because the sialoliths were mainly located in the sublingual papilla and submandibular duct and were small in size in the pediatric patients in our study. In contrast, some calculi in adult patients were located in the submandibular gland and were larger in size. A large number of relatively small and distal sialoliths in pediatric patients was removed by intraoral retrieval under local anesthesia. Several different treatment methods have been proposed for sialolithiasis. A previous study reported five pediatric patients who underwent intraoral sialolithotomy by an incision in the floor of the mouth. Sialoendoscopy is another successful treatment for submandibular ductal stones [16] because it reduces the risk of missed stones, nerve injury, and the requirement for sialoadenectomy. Although we did not use these methods, future studies should focus on these. Extracorporeal shock wave lithotripsy of salivary calculi entails a risk of damaging the salivary gland, the ear, dental amalgams, or the central nervous system [17]. In conclusion, intraoral removal of sialoliths under local anesthesia is recommended as the treatment of choice in pediatric patients with of the occurrence of a large number of relatively small and distal calculi, as observed in our study. A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval under local anesthesia.
A. Inui et al. / Oral Science International 14 (2017) 37–39
Source(s) of support None. Presentation at a meeting None. References [1] Chung MK, Jeong HS, Ko MH. Pediatric sialolithiasis: What is different from adult sialolithiasis? Int J Pediatr Otorhinolaryngol 2007;71:787–91. [2] Lustmann J, Regev E, Melamed Y. Sialolithiasis a survey on 245 patients and a review of the literature. Int J Oral Maxillofac Surg 1990;19:135–8. [3] Bhavesh D, Trivedi BD. Surgical removal of submandibular gland sialolithiasis in a 9-year-old girl: A case report. Pediatr Dent J 2014;24:111–4. [4] Flint PW, Haughey BH, Robbins KT, et al. Cummings otolaryngology-head and neck surgery. 5th ed. Elsevier Health Sciences; 2014. p. 1151–61. [5] Bodner L, Fliss DM. Parotid and submandibular calculi in children. Int J Pediatr Otorhinolaryngol 1995;31:35–42. [6] Di Felice R, Lombardi T. Submandibular sialolithiasis with concurrent sialoadenitis in a child. J Clin Pediatr Dent 1994;20:57–9.
39
[7] Karengera D, Yousefpour A, Sadeghi HMM, et al. Sialolithiasis in children as a diagnostic dilemma. Eur Arch Otorhinolaryngol 2000;257:161–3. [8] McCullom C, Lee CY, Blaustein DI. Sialolithiasis in an 8-year-old child: case report. Pediatr Dent 1991;13:231–3. [9] Nahlieli O, Eliav E, Hasson O. Pediatric sialolithiasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:709–12. [10] Raveenthiran V, Hayavadana Rao PV. Giant calculus in the submandibular salivary duct: report of the first prepubertal patient. Pediatr Surg Int 2004;20:163–4. [11] Shinohara Y, Hiromatsu T, Nagata Y, et al. Sialolithiasis in children: report of four cases. Dentomaxillofac Radiol 1996;25:48–50. [12] Steiner M, Gould AR, Kushner GM, et al. Sialolithiasis of the submandibular gland in an 8-year-old child. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:188. [13] Waseem BZ, Forte V. An unusual case of bilateral submandibular sialolithiasis in a young female patient. Int J Pediatr Otorhinolaryngol 2005;69:691–4. [14] Zou ZJ, Wang SL, Zhu JR, et al. Chronic obstructive parotitis: report of ninety-two cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992;73:434–40. [15] Marchal F, Kurt AM, Dulguerov P, et al. Retrograde theory in sialolithiasis formation. Arch Otolaryngol Head Neck Surg 2001;127:66–8. [16] Chu DW, Chow TL, Lim BH, et al. Endoscopic management of submandibular sialolithiasis. Surg Endosc 2003;17:876–9. [17] Iro H, Schneider TH, Fodra C, et al. Shockwave lithotripsy of salivary duct stones. Lancet 1992;339:1333–6.
Contents lists available at ScienceDirect
Oral Science International journal homepage: www.elsevier.com/locate/osi
Original Article
Comparison of sialolithiasis in pediatric and adult patients Akinari Inui ∗ , Ryohei Itou, Toshirou Oyama, Yoshihiro Tamura, Kosei Kubota, Wataru Kobayashi Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki City, Aomori Prefecture, Japan
a r t i c l e
i n f o
Article history: Received 24 October 2016 Received in revised form 31 January 2017 Accepted 13 February 2017 Available online 15 April 2017 Keywords: pediatric sialolithiasis salivary gland symptoms
a b s t r a c t Aims: To compare the clinical characteristics of sialolithiasis between pediatric and adult patients. Settings and Design: Subject characteristics, clinical manifestations, salivary calculi characteristics, and treatment modalities and outcomes from medical records were retrospectively compared between pediatric and adult patients with sialolithiasis visiting the Department of Oral and Maxillofacial Surgery, Hirosaki University Hospital, between 2005 and 2014. Subjects: We included 5 pediatric (all boys) and 45 adult (20 men; 25 women) patients. Results: Most patients had submandibular swelling. The calculi were located on the right in 100.0% of pediatric patients and 57.8% of adult patients. Moreover, 20.0% of pediatric patients and 35.6% of adult patients exhibited sialoliths in the glands. Calculi were <5 mm in size in 100.0% of pediatric patients and 33.3% of adult patients. Pediatric sialolithiasis treatment included intraoral retrieval under local anesthesia in 4 cases (80.0%) and spontaneous expulsion from the duct in 1 case (20.0%). Adult sialolithiasis treatment included gland resection under general anesthesia in 8 cases (17.8%), intraoral retrieval under general anesthesia in 6 cases (13.3%), intraoral retrieval under local anesthesia in 19 cases (42.2%), spontaneous expulsion in 6 cases (13.3%), and follow-up only in 6 cases (13.3%). Conclusions: A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval under local anesthesia. This difference in the choice of treatment between pediatric and adult sialolithiasis may be attributed to the size and palpability of the calculi. © 2017 Published by Elsevier Ltd on behalf of Japanese Stomatological Society.
Key messages To compare clinical characteristics of sialolithiasis between pediatric and adult patients. A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval.
treatment of sialolithiasis in pediatric and adult patients [1,2,5]. Therefore, our study aimed to compare the clinical characteristics of sialolithiasis between pediatric and adult patients. The findings of this study should be useful for the diagnosis and management of pediatric sialolithiasis. 2. Subjects and Methods
1. Introduction Pediatric sialolithiasis accounts for approximately 3%–13.8% of all sialolithiasis cases [1,2]. Some of the most important factors contributing to stone formation are salivary stasis, ductal inflammation, and injury [3,4]. There are some case series on this topic, but few studies have compared the clinical characteristics and
∗ Corresponding author at: Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifutyo, Hirosaki, 036-8562, Aomori Prefecture, Japan. Tel.: +81 0172 39 5127, fax: +81 0172 39 5128. E-mail address: [email protected] (A. Inui).
This study included 50 patients diagnosed with sialolithiasis who visited our department at Hirosaki University Hospital between January 2005 and December 2014. A thorough physical examination including manual palpation of the oral cavity, panoramic X-ray imaging, occlusal radiograph of the mandible, and computed tomography was performed. In cases where the clinical and radiological examinations strongly indicated sialolithiasis, one of the two treatment strategies was applied according to the location and size of the salivary calculi: (1) intraoral salivary stone retrieval or (2) salivary gland excision. The subject characteristics, clinical manifestations, treatment modalities, and outcomes were compared between pediatric and adult sialolithiasis groups. Sub-
http://dx.doi.org/10.1016/S1348-8643(17)30019-8 1348-8643/© 2017 Published by Elsevier Ltd on behalf of Japanese Stomatological Society.
38
A. Inui et al. / Oral Science International 14 (2017) 37–39
Table 1 Clinical characteristics of pediatric and adult sialolithiasis.
Age (years) Gender (male/female) Symptoms of duration (months) Pain Swelling Feeling of wrongness Pus discharge Right/Left Location Sublingual papilla Sublingual papilla and submandibular duct Sublingual papilla and submandibular gland Submandibular duct Submandibular duct and gland Submandibular gland Treatment of choice Gland resection under general anesthesia Intraoral retrieval under general anesthesia Intraoral retrieval under local anesthesia Natural emission Follow-up onlya Size Under 5 mm From 5 to 10 mm Over 10 mm Number 1 2 4 5 6 15 a
expulsion from duct in 6 cases (13.3%), and follow-up only in 6 cases (13.3%).
Children (N = 5)
Adult (N = 45)
7.4 ± 1.5 5/0 1.0 ± 0.5 1 (20.0%) 3 (60.0%) 1 (20.0%) 0 (0.0%) 5/0
52.1 ± 2.8 20/25 11.5 ± 4.4 6 (13.3%) 29 (64.4%) 8 (17.8%) 2 (4.4%) 26/19
3 (60.0%) 0 (0.0%) 1 (20.0%) 1 (20.0%) 0 (0.0%) 0 (0.0%)
7 (15.6%) 1 (2.2%) 1 (2.2%) 21 (46.7%) 3 (7.0%) 12 (26.7%)
0 (0.0%) 0 (0.0%) 4 (80.0%) 1 (20.0%) 0 (0.0%)
8 (17.8%) 6 (13.3%) 19 (42.2%) 6 (13.3%) 6 (13.3%)
5 (100.0%) 0 (0.0%) 0 (0.0%)
15 (33.3%) 14 (31.1%) 16 (35.6%)
5 (100.0%) 0 (14.3%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%)
30 (66.7%) 11a (24.4%) 1 (2.2%) 1 (2.2%) 1 (2.2%) 1 (2.2%)
Two adults refused gland resection under general anesthesia.
mandibular sialoliths can occur in the following three locations: sublingual papilla, submandibular duct, and submandibular gland. If multiple salivary calculi were found in the affected gland, all calculi were described.
3. Results A total of 5 pediatric (aged ≤14 years) and 45 adult (aged >14 years) patients were included in this study, and the submandibular gland was affected in all patients. Only one patient exhibited choledocholithiasis postoperatively. In our study, 10.0% of all sialolithiasis cases occurred in the pediatric population (age ≤14 years), including 5 boys (0 girls) with a mean age of 7.4 years (range: 3–12 years; Table 1). The duration of symptoms in pediatric patients was shorter than that in adult patients (1.0 months vs. 11.5 months). The most common chief complaints in both groups were swelling, followed by pain. A single calculus was more common in pediatric patients (85.7%) than in adult patients (65.1%; P = 0.817). The calculi were located in the submandibular gland in 20.0% of pediatric patients (exhibited involvement of the sublingual papilla and submandibular gland) and 35.5% of adult patients (1 adult exhibited involvement of the sublingual papilla and submandibular gland, and 3 adults showed involvement of the submandibular duct and gland). The calculi were <5 mm in diameter in 5 pediatric patients (100.0%) and in 15 adult patients (33.3%). The calculi were intraorally retrieved in most cases in both groups. In the pediatric group, sialolithiasis treatment involved intraoral retrieval under local anesthesia in 4 cases (80.0%) and spontaneous expulsion from the duct in 1 case (20.0%). Treatment in adults included gland resection under general anesthesia in 8 cases (17.8%), intraoral retrieval under general anesthesia in 6 cases (13.3%), intraoral retrieval under local anesthesia in 19 cases (42.2%), spontaneous
4. Discussion Although sialolithiasis is a relatively common disease in adults, it is rare in pediatric cases, with <150 cases reported in the literature [1–3,5–14]. This disease mainly occurs in the submandibular gland, and it can be explained by the pH, mucin content, and high Ca2+ concentration of submandibular saliva [1,2,5]. Males are more frequently affected than females [5,9], although one study reported contrasting results [1]. All pediatric patients in our study showed involvement of the right side (100%). However, the reasons for these differences in sex and side distribution are unclear. The exact pathogenesis of sialolithiasis is unknown, and various hypotheses have been proposed [3,5,15]. One hypothesis states that an initial organic nidus may occur that progressively grows because of the deposition of inorganic and organic substances, whereas another hypothesis states that intracellular microcalculi are excreted in the canal and function as a nidus in the ductal system. Furthermore, debris, bacteria, or substances migrating in the salivary ducts may cause sialolithiasis [15]. The low incidence of these diseases in children may be due to the relatively long time required for the formation of a salivary calculus and because sublingual papillae and salivary glands are very small in children, rendering it difficult for foreign matter to enter [5]. Furthermore, a calculus is more easily formed in adults than in children because the concentration of calcium and phosphate ions in the resting saliva increases with age. In our study, the duration of symptoms was significantly shorter in pediatric patients (0–3 months, mean 1.0 month) than in adult patients (0–120 months, mean 11.5 months). This could be attributed to a lower tolerance to uncomfortable symptoms among the patients or the parents [1]. The high salivary flow in pediatric patients may result in more severe symptoms among them [1]. Furthermore, because the sublingual papilla was the most commonly involved in the children in our study, swellings could be actively monitored by the parents and patients themselves. Five cases were treated by gland resection and six cases by intraoral retrieval under general anesthesia in adult patients. However, pediatric sialolithiasis was not treated by either of these procedures, and a large number of relatively small and distal sialoliths were removed by intraoral retrieval under local anesthesia. This difference in the treatment of choice may be due to the size and palpability of the calculi [1] because the sialoliths were mainly located in the sublingual papilla and submandibular duct and were small in size in the pediatric patients in our study. In contrast, some calculi in adult patients were located in the submandibular gland and were larger in size. A large number of relatively small and distal sialoliths in pediatric patients was removed by intraoral retrieval under local anesthesia. Several different treatment methods have been proposed for sialolithiasis. A previous study reported five pediatric patients who underwent intraoral sialolithotomy by an incision in the floor of the mouth. Sialoendoscopy is another successful treatment for submandibular ductal stones [16] because it reduces the risk of missed stones, nerve injury, and the requirement for sialoadenectomy. Although we did not use these methods, future studies should focus on these. Extracorporeal shock wave lithotripsy of salivary calculi entails a risk of damaging the salivary gland, the ear, dental amalgams, or the central nervous system [17]. In conclusion, intraoral removal of sialoliths under local anesthesia is recommended as the treatment of choice in pediatric patients with of the occurrence of a large number of relatively small and distal calculi, as observed in our study. A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval under local anesthesia.
A. Inui et al. / Oral Science International 14 (2017) 37–39
Source(s) of support None. Presentation at a meeting None. References [1] Chung MK, Jeong HS, Ko MH. Pediatric sialolithiasis: What is different from adult sialolithiasis? Int J Pediatr Otorhinolaryngol 2007;71:787–91. [2] Lustmann J, Regev E, Melamed Y. Sialolithiasis a survey on 245 patients and a review of the literature. Int J Oral Maxillofac Surg 1990;19:135–8. [3] Bhavesh D, Trivedi BD. Surgical removal of submandibular gland sialolithiasis in a 9-year-old girl: A case report. Pediatr Dent J 2014;24:111–4. [4] Flint PW, Haughey BH, Robbins KT, et al. Cummings otolaryngology-head and neck surgery. 5th ed. Elsevier Health Sciences; 2014. p. 1151–61. [5] Bodner L, Fliss DM. Parotid and submandibular calculi in children. Int J Pediatr Otorhinolaryngol 1995;31:35–42. [6] Di Felice R, Lombardi T. Submandibular sialolithiasis with concurrent sialoadenitis in a child. J Clin Pediatr Dent 1994;20:57–9.
39
[7] Karengera D, Yousefpour A, Sadeghi HMM, et al. Sialolithiasis in children as a diagnostic dilemma. Eur Arch Otorhinolaryngol 2000;257:161–3. [8] McCullom C, Lee CY, Blaustein DI. Sialolithiasis in an 8-year-old child: case report. Pediatr Dent 1991;13:231–3. [9] Nahlieli O, Eliav E, Hasson O. Pediatric sialolithiasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:709–12. [10] Raveenthiran V, Hayavadana Rao PV. Giant calculus in the submandibular salivary duct: report of the first prepubertal patient. Pediatr Surg Int 2004;20:163–4. [11] Shinohara Y, Hiromatsu T, Nagata Y, et al. Sialolithiasis in children: report of four cases. Dentomaxillofac Radiol 1996;25:48–50. [12] Steiner M, Gould AR, Kushner GM, et al. Sialolithiasis of the submandibular gland in an 8-year-old child. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:188. [13] Waseem BZ, Forte V. An unusual case of bilateral submandibular sialolithiasis in a young female patient. Int J Pediatr Otorhinolaryngol 2005;69:691–4. [14] Zou ZJ, Wang SL, Zhu JR, et al. Chronic obstructive parotitis: report of ninety-two cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992;73:434–40. [15] Marchal F, Kurt AM, Dulguerov P, et al. Retrograde theory in sialolithiasis formation. Arch Otolaryngol Head Neck Surg 2001;127:66–8. [16] Chu DW, Chow TL, Lim BH, et al. Endoscopic management of submandibular sialolithiasis. Surg Endosc 2003;17:876–9. [17] Iro H, Schneider TH, Fodra C, et al. Shockwave lithotripsy of salivary duct stones. Lancet 1992;339:1333–6.