title: Deep and unusual sialolithiasis of submandibular duct and gland: a surgical dilemma.
abstract: Giant solitary submandibular duct calculus and multiple calculi of the gland are extremely rare. This occurrence along with more deep and proximally placed common calculi in submandibular gland may occasionally cause a dilemma in selection of the appropriate surgical approach in the present era of sialoendoscopic surgery. There is a high chance of fracture of the stone in a proximally placed stone in the gland followed by likely dissemination of fragments of the stone into the gland parenchyma during the procedure of sialoendoscopy which is a matter of grave concern. We authors believe that excision of the submandibular gland with the stone in such a situation should still be preferred as the gold standard of treatment leaving the ductal stone for endoscopic removal.
authors.affiliation: Department of ENT, NMC Specialty Hospital, P.O. Box 6222, Abu Dhabi, UAE.
authors.forename: Produl
authors.initials: P
authors.lastname: Hazarika
authors.affiliation: Department of ENT, NMC Specialty Hospital, P.O. Box 6222, Abu Dhabi, UAE.
authors.forename: Seema E
authors.initials: SE
authors.lastname: Punnoose
authors.affiliation: Department of ENT and Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of ENT, NMC Specialty Hospital, P.O. Box 6222, Abu Dhabi, UAE.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Arora
keywords: Dissemination of fragmented calculi; Excision of gland; Sialoendoscopy; Sialolithiasis of submandibular gland