Dealing with a 6 mm Stone in My Submandibular Salivary Gland: Seeking Guidance
Hello everyone, I am hoping to get some insights from the medical professionals here regarding a health concern of mine. I have had a stone measuring approximately 5-6 mm situated in my left submandibular salivary gland for over 33 years now (it may have been smaller during my teenage years). At the age of 16, I experienced symptoms such as swelling, difficulty opening my jaw, and pain. A visit to the doctor led to an X-ray that confirmed the presence of the stone. The recommendation was to remove my entire salivary gland, but as a young teenager in Belgium, this daunting procedure—with its risks including facial nerve damage and a significant 5 cm neck scar—terrified me. Consequently, I chose to leave the stone untreated and, over time, the discomfort significantly decreased, allowing me to live with it for over three decades without issue. However, I am now experiencing a range of health problems related to (peri)menopause at 49 years old. Just last year, I had to have my gallbladder removed, which was particularly troublesome after years of dealing with sludge. Following the onset of perimenopause at 45, previous health issues resurfaced with severe pain. Additionally, for nearly two years, I’ve been struggling with dry mouth, a white-coated tongue, swollen mucous membranes, and pain in the area beneath my jaw where the stone resides. I recently consulted with a doctor at a university hospital but was once again told that removal of the gland was the best course of action. I have come across information suggesting that a less invasive procedure called sialendoscopy could be an alternative for removing the stone. However, one doctor I consulted believes that no saliva is excreted from my gland when pressure is applied, claiming it is deeply embedded, essentially rendering the gland "dead" and a potential breeding ground for bacteria, thus necessitating removal. Is this perspective accurate? It seems there are no facilities in Belgium equipped with the necessary sialendoscopy tools and specialists, which means they still resort to complete gland removal. If I manage to locate a center that performs this procedure, whether in Germany, France, or potentially in Belgium, would they first attempt sialendoscopy to assess the situation? Considering that my stone is only 6 mm, I wonder if they might be able to break it into smaller pieces and remove it endoscopically, thereby allowing me to retain my gland. I am quite apprehensive about undergoing yet another surgery that involves a 5 cm scar, the risk of facial nerve damage (even if temporary), a hospital stay of two nights, difficulties with tongue mobility, challenges in eating for several days, and the resulting scar. I truly appreciate any advice or knowledge you can provide! Thank you very much for your help!!!
Answers (1)
9/11/2025, 7:31:04 PM
OpenHealth AI
You're facing a challenging situation with a long-standing stone in your submandibular salivary gland, and it's natural to feel apprehensive about the treatment options. Let's summarize the key points and provide actionable advice.
Main Points:
- Persistent Salivary Stone: You have a 5-6 mm stone that has been present for over 33 years, with intermittent symptoms.
- Concerns Regarding Surgery: You are worried about the risks associated with gland removal and are curious about less invasive options like sialendoscopy.
Explanation:
Salivary stones can cause pain, swelling, and other symptoms, especially if they block saliva flow. Although it's true that stones can sometimes lead to gland dysfunction or infection, your stone's history suggests that while it has caused issues in the past, you've managed to live with it without significant problems for a long time.
Sialendoscopy is indeed a minimally invasive procedure that has been effective for many patients. It involves using a tiny camera to visualize the duct and potentially remove or fragment the stone without the need for full gland removal. However, the success often depends on the gland's condition and the stone's positioning.
Next Steps:
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Seek Out Specialized Care: Actively search for medical centers in nearby countries (like Germany or France) that perform sialendoscopy. They may have the advanced techniques and equipment necessary for evaluation and treatment.
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Consult a Specialist: When you find a center, request an appointment with an ENT surgeon who specializes in salivary gland conditions. They will typically perform imaging studies (like an ultrasound or a CT scan) before deciding on treatment. Discuss your concerns openly during this appointment.
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Assess Options: Confirm whether they can evaluate your gland's function (sialoendoscopy can sometimes assess salivary production) and clarify their protocol should they find the stone is removable endoscopically.
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Consider a Second Opinion: If you receive recommendations for gland removal, consider obtaining a second opinion from a different specialist. This can give you more options and clarity on whether surgery is truly necessary.
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Self-Care for Current Symptoms: In the meantime, stay hydrated and practice good oral hygiene. Using a saliva substitute can help alleviate your dry mouth symptoms. Avoiding sour candies or citrus can also stimulate saliva production and help with dryness.
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Monitor Symptoms: Keep track of any changes in symptoms you experience, especially in relation to your dry mouth and swelling. This information may be helpful for specialists you consult.
Your concerns are valid, and thorough evaluation of your options can empower you to make an informed decision that aligns with your comfort level. If you need further assistance, feel free to reach out.
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