A patient presents with recurrent painful swelling of the submandibular gland on eating, especially during gustatory stimulation. Ultrasound shows an echogenic shadow with posterior acoustic shadowing in Wharton's duct. The most likely diagnosis and its commonest stone composition are:
- A Submandibular sialolithiasis — calcium phosphate (hydroxyapatite) ✓
- B Parotid sialolithiasis — calcium phosphate
- C Submandibular sialolithiasis — calcium oxalate
- D Submandibular sialolithiasis — uric acid
Correct answer: A. Submandibular sialolithiasis — calcium phosphate (hydroxyapatite)
Explanation
Submandibular gland accounts for 80–90% of all salivary calculi because its saliva is more viscous, alkaline and mucoid, and Wharton's duct has a long, tortuous course against gravity. Submandibular calculi are predominantly composed of calcium phosphate (hydroxyapatite) making them radio-opaque and visible on plain X-ray or ultrasound. Treatment for accessible anterior duct stones is intraoral lithotomy; posterior stones may require gland excision or sialendoscopy.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.