Recurrent left submandibular sialolithiasis managed by gland excision: A case report

Sialolithiasis of the submandibular gland is the most common salivary stone disease and may present with recurrent swelling, pain, and infection. Management is guided by stone size, number, location, symptom severity, and residual gland function. We report a case of 46-year-old man with diabetes and history of prior sialolith removal of left submandibular duct who presented with recurrent left submandibular swelling. Non-contrast CT demonstrated an intraparenchymal calcified sialolith measuring approximately 8 mm at greatest dimension. Given the recurrent symptoms and the intraglandular location, which reduced the likelihood of successful endoscopic retrieval or lithotripsy, the patient underwent external excision of the left submandibular gland via a transverse neck incision. Postoperative recovery was uneventful, with complete resolution of symptoms at 1-month follow-up.