Submandibular gland disease

Question 1

A 56-year-old man presents with episodic facial pain and discomfort whilst eating. He has suffered from halitosis recently and he frequently complains of a dry mouth. He has a smooth swelling underneath his right mandible. What is the most likely underlying diagnosis?

a) . Stone impacted in Wharton duct
b) . Stone impacted Stensens duct
c) . Benign adenoma of the submandibular gland
d) . Adenocarcinoma of the submandibular gland
e) . SCC of submandibular gland

Answer 1

The answer is A - stone impacted in Wharton duct!

Colicky pain + post prandial swelling of the gland + dry mouth + halitosis (bad breath)

Wharton’s duct drains saliva from the submandibular gland to the mouth

Ix: Sialography (X-rays + contrast) to show the site of obstruction

Mx: Gentle probing, Therapeutic sialendoscopy

Question 2

What’s the name of the duct that drains the parotid gland?

Answer 2

Stensens duct!