Giant Submandibular Sialolith (Megalith): A Rare Case Report

Abstract

Background: Submandibular sialolithiasis is the most common salivary gland disorder. Giant sialoliths, also termed megaliths, are rare and pose diagnostic and surgical challenges, particularly in elderly or medically compromised patients.

Case Presentation: A 76-year-old male presented with a massive right submandibular duct sialolith measuring 5.5 × 3 × 2.5 cm and weighing 32 g. The patient had multiple comorbidities including atrial fibrillation, pulmonary hypertension, chronic obstructive pulmonary disease, and dementia. Due to high anaesthetic risk, the stone was successfully removed through an intraoral approach under local anaesthesia.

Conclusion:  This case highlights that even very large submandibular megaliths can be safely and effectively managed via an intraoral approach under local anaesthesia in carefully selected high-risk patients.