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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33922
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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gland..that can occur to the lips and tongue and possible nasty scar

Resolved Question:

Hi I have just had a 3 day hospital stay with 5 stones and infection in my submandibular gland.Two small stones were removed via probing and I'm now on strong antibiotics till my next visit in a week to see the ent doctor. I was advised that the gland will have to be removed but I'm concerned as to the nerve damage that can occur to the lips and tongue and possible nasty scar. Is there any alternative but surgery? Regards Paul
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello Paul,

 

What did your sialogram show?

 

Are you diabetic?

 

Dr. Arun

Customer: replied 8 years ago.
Hello Dr Arun

I had an ultrasound with the following results:
The right salivary gland is enlarged. There is dialation of the intraglandular ducts as well as the main submandibular duct. There is a 4mm calculus within the gland and 4 calculi within the distal duct varying between 2mm and 9mm in diameter.
A few small benign lymph nodes are seen on the right.
I am not diabetic.
Kind Regards
Paul
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello Paul,

 

The surgical scar is a very small scar which is under the chin, so is not readily visible. The incidence of nerve damage is around 1% which is suppose to be very safe and low incidence. Thus surgery after all is quite safe.

 

But there are other methods of the stone removal also;

 

1) Insertion of the small telescope

2) Shock wave: which fragment the stones

 

Read the resource;

 

http://www.privatehealth.co.uk/private-operations/ear-nose-and-throat/submandibular-duct-stone-excision/

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 8 years ago.
Hello Dr Arun,
A 1% risk of nerve damage is quite low indeed..I guess I read to much on the net regarding the instances of damage to these nerves. Will saliva be a problem seeing as I have lost the left submandibular gland many years back..it was never removed but atrophied due to stones (which were removed while having a benign growth removed from my uvula)
In your opinion would you suggest the best remedy would be removal of the gland?
If left alone I presume the chances of infection and further stones could be a future problem?
Kind Regards
Paul
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hi Paul,

 

The best course is to get it excised / removed. Recurrence of the stones is very common and infection is quite a significant risk, with the recurrent stones. The procedure is very safe in good hands. The saliva quantity or dry mouth is never a problem as parotids, submental glands and many minor salivary glands are good enough to produce adequate amount.

 

It is pleasure assisting you.

 

Dr. Arun

Dr. Arun Phophalia and 2 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Hi Dr. Arun,
Thank you for all the answers to my questions, it's been some time now and luckily without surgery I have not had a problem since. I know the remaining stones are still in the gland but no swelling,infection has occurred so I'm feeling quite lucky. I hope i've done the right thing in not having the surgery..Too many other problems atm with my aging parents I'm worried about.
Kind Regards
Paul Shipley
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Paul Shipley,

 

Thanks for updating me. If there is no pain, surgery may not be needed, so right decision.

 

Best wishes and kindest regards,

 

Dr. Arun

Customer: replied 6 years ago.
Hi Again Dr Arun,
Thanks for such a quick reply,may I ask what causes these stones. I know they are usually calcium based as in kidney,gall etc but is there any main factor? Does diet have an effect? I have eliminated salt for many years and base my diet on seafood,mainly oily fish such as salmon,sardines and tuna. I do eat a lot of bread also but I vary the intake between wholemeal,white and grain mix.
I have had a kidney stone but many years ago, I would dearly love to avoid these incidents in the future.
Kind regards
Paul Shipley
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Paul,

 

These stones are due to narrowing of the duct.

 

Dr. Arun