We reviewed the clinical history of 48 consecutive patients who underwent submandibular gland removal for radiologically proven sialolithiasis. The specimens were examined by a pathologist blinded to the clinical data. A histopathologic classification into 1 of 3 grades was established by evaluating the degrees of atrophy, fibrosis, and inflammation. A correlation between the clinical and pathological variables was sought in order to define clinical variables that would predict abnormal submandibular glands that required extirpation. A significant percentage of the submandibular glands exhibited normal histologic findings. The patients with normal submandibular glands had a clinical evolution similar to that of other patients with severely damaged glands. The only clinical variable that correlated with increased histopathologic alteration was the patient's age. In view of the newly available diagnostic and therapeutic techniques for sialolithiasis, a conservative attitude to submandibular gland resection appears justified.
LustmannJRegevEMelamedY. Sialolithiasis. A survey on 245 patients and a review of the literature. Int J Oral Maxillofac Surg1990; 19: 135–8.
2.
CawsonRAGleesonMJEvesonJW. Sialadenitis. In: CawsonRAGleesonMJEvesonJWPathology and surgery of the salivary glands. Oxford, England: Isis Medical Media, 1997: 33–63.
3.
RiceDH. Diseases of the salivary glands — non-neoplastic. In: BaileyBPillsburyHCHead and neck surgery–otolaryngology. Philadelphia, Pa: JB Lippincott, 1993: 475–84.
4.
van den AkkerHPBusemann-SokoleE. Submandibular gland function following transoral sialolithectomy. Oral Surg Oral Med Oral Pathol1983; 56: 351–6.
SmithWPPetersWJMarkusAF. Submandibular gland surgery: An audit of clinical findings, pathology and postoperative morbidity. Ann R Coll Surg Engl1993; 75: 164–7.
9.
Berini-AytesLGay-EscodaC. Morbidity associated with removal of the submandibular gland. J Craniomaxillofac Surg1992; 20: 216–9.
PanzoniEMarchesiALippiL. Sialoadenectomia sottomandibolare: Tecniche chirurgiche, casistica operatoria ed esiti a distanza. Riv Ital Stomatol1984; 53: 121–30.
12.
MiltonCMThomasBMBickertonRC. Morbidity study of submandibular gland excision. Ann R Coll Surg Engl1986; 68: 148–50.
13.
IsacssonGLundquistPG. Salivary calculi as an aetiological factor in chronic sialadenitis of the submandibular gland. Clin Otolaryngol1982; 7: 231–6.
14.
IsacssonGAhlnerBLundquistPG. Chronic sialadenitis of the submandibular gland. A retrospective study of 108 cases. Arch Otorhinolaryngol1981; 232: 91–100.
15.
ShinoharaMOkaMYamadaKHashimuraKYubaKMoriM. Immunohistochemical and electronmicroscopic studies of obstructive lesions in submandibular glands. J Oral Pathol Med1992; 21: 370–5.
16.
SeifertG. Klinische Pathologie der Sialadenitis und Sialadenose. HNO1971; 19: 1–9.
17.
BatsakisJG. Salivary glands. Physiology. In: CummingsCWFredricksonJMHarkerLAKrauseCJSchullerDEOtolaryngology–head and neck surgery. St Louis, Mo: Mosby, 1993: 986–1007.
18.
ScottJ. Degenerative changes in the histology of the human submandibular salivary gland occurring with age. J Biol Buccale1977; 5: 311–9.
19.
BeckerMMarchalFBeckerCD. Sialolithiasis and salivary ductal stenosis: Diagnostic accuracy of MR sialography with a three-dimensional extended-phase conjugate-symmetry rapid spin-echo sequence. Radiology2000; 217: 347–58.
20.
SeifertGDonathK. Zur Pathogenese des Kutter-Tumors der Submandibularis. Analyse von 349 Fallen mit chronischer Sialadenitis der Submandibularis. HNO1977; 25: 81–92.
MarchalFDulguerovPBeckerMLehmannW. Interventional sialendoscopy. In: WackymPARiceDHSchaeferSDMinimally invasive surgery of the head, neck and cranial base. Philadelphia, Pa: Lippincott, Williams & Wilkins (in press).
23.
MarchalFDulguerovPLehmannW. Interventional sialendoscopy. N Engl J Med1999; 341: 1242–3.
24.
KatzP. Thérapeutiques non chirurgicales des lithiases salivaires. Endoscopie et lithotrypsie extra-corporelle. Rev Off Soc Fr ORL1997; 45: 47–52.
25.
IroHSchneiderHTFodraC. Shockwave lithotripsy of salivary duct stones. Lancet1992; 339: 1333–6.
26.
KaterWMeyerWWWehrmannTHurstABuhnePSchlickR. Efficacy, risks, and limits of extracorporeal shock wave lithotripsy for salivary gland stones. J Endourol1994; 8: 21–4.
27.
GundlachPSchererHHopfJ. Die endoskopisch kontrollierte Laserlithotripsie von Speichelsteinen. In-vitro-Untersuchungen und erster klinischer Einsatz. HNO1990,38: 247–50.
