Acute submaxillitis: Etiological data and etiological management

Abstract Objectives The objective of the present study was to test the hypothesis that acute submaxillitis involves salivary duct obstruction. Obstacle characteristics and treatment were analyzed. Material and methods Patients presenting with an episode of acute submaxillitis between 2009 and 2015 were retrospectively included. All underwent salivary duct imaging and/or sialendoscopy, with pathologic examination if the salivary gland was removed for etiologic diagnosis. For etiological treatment, if the causal lesion could not be treated by isolated sialendoscopy, surgery used a direct approach assisted by sialendoscope. In case of failure of these procedures, submaxillectomy was indicated. Results Twenty-nine patients were included, 28 of whom showed salivary duct abnormality. At least 1 calculus was found in 27 patients; calculi were usually single ( n = 20), situated in the mid-third ( n = 21), and large (mean 7.7 mm). Ten patients showed stenosis, associated with salivary calculus in 9 cases. Twenty-five patients with salivary duct obstruction underwent sialendoscopy. Isolated sialendoscopy was used in 5 cases, and a combined approach in 13 cases. Conclusion An episode of submaxillitis requires salivary duct exploration by sialendoscopy, to enable early treatment given the prevalence of associated calculi and high success rate of conservative management by sialendoscopy.