Dev Wharton kanalý aþýnýn aðýz içi yaklaþýmla tedavisi: Bir olgu sunumu

Sialolitiazis, tükürük bezlerinin parankim ya da kanallarýnda sialolit varlýðý ile karakterize bir hastalýktýr. Tükürük bezlerinin en yaygýn hastalýðý olan sialolitiazis en çok submandibular bezde görülmektedir. Patogenezi tam olarak bilinmemekle birlikte herhangi bir tükürük bezinde ve her yaþta oluþabilmektedir.
Rutin dental muayene için kliniðimize baþvuran 21 yaþýndaki erkek hastadan alýnan panoramik radyografide sol alt çene kanin-premolar bölgede gömülü diþe benzeyen radyoopak oluþum izlendi. Alýnan okluzal radyografide ise, bu oluþumun lingualde yerleþimli ve homojen yapýlý olduðu tespit edildi. Taný, Wharton kanalýnda sialolit olarak yapýldý ve hasta cerrahi kliniðine yönlendirildi. Sialolitin tedavisi için lokal anestezi altýnda intraoral cerrahi eksizyon planlandý. Aðýz tabanýndan, kanal içerisindeki yaklaþýk 26 mm boyutlarýnda dev sialolit çýkartýldý ve sadece mukozal tabaka kapatýlarak cerrahi iþlem tamamlandý. Hastanýn cerrahi operasyondan 6 ay sonraki kontrolünde tükürük akýþýnýn normal olduðu gözlendi ve herhangi bir komplikasyon saptanmadý.
Aðýz tabanýnda kitle etkisi yaparak palpe edilebilen sialolitlerin; submandibuler bezin tamamý alýnmaksýzýn, intraoral yaklaþýmla çýkarýlmasý ve marsupializasyonu iyi bir tedavi seçeneðidir.

Transoral removal of giant Wharton’s duct sialolith: A case report

Sialolithiasis is a disease characterized by the presence of sialolith in the parenchyma or ducts of the salivary glands. Sialolithiasis, the most common disease of salivary glands. It is most commonly seen in the submandibular gland. Pathogenesis is not exactly known, but it can occur in any salivary gland and at any age.
A 21-year-old male patient was applied to our clinic for routine dental examination. Panoramic radiography revealed a radiopaque mass superimposed on the left mandibular canine-premolar region. On the occlusal radiograph, it was determined that this formation was in the lingual region and homogeneous. The diagnosis was made as sialolith of the Wharton duct and the patient was directed to the surgical clinic. Intraoral surgical excision under local anesthesia was planned for sialolith treatment. An elongated giant sialolith of 26 mm length was removed from the floor of the mouth and surgical procedure was completed. At 6 months after surgery, no complication was observed.
When the stone can be palpated intraorally, it is best treatment method to remove it through an intraoral approach.