Acta Scientific Otolaryngology (ISSN: 2582-5550) Volume 3 Issue 12 December 2021 Multiple Recurrent Obstructive Sialolithiasis of Left Wharton’s Duct - A Case Report Jitender Kumar Aurora 1 , Shamita Tiwari 2 *, Parul Tandon 3 , Himanshu Chauhan 3 , Amartya P Srivastava 2 and Preeti Sharma 4 1 Professor and Head, Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, India 2 Senior Lecturer, Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, India 3 Reader, Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, India 4 Private Practitioner, Lucknow, India *Corresponding Author: Shamita Tiwari, Senior Lecturer, Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, India. Case Report Received: September 30, 2021 Published: November 23, 2021 © All rights are reserved by Shamita Tiwari., et al. Abstract Sialolith of the salivary glands is a common finding. Superadded infections can make the condition painful. Management of sialolithiasis can be done conservatively or by intraoral surgery without recurrence. Though these can be treated successfully with rare chances of recurrence, multiple sialoliths is a rare finding. It becomes difficult for a surgeon to manage it by less invasive sur- gery if there are multiple recurring calculi. This case report presents the case of a 35 year old woman who reported for the management of multiple calculi which was man- aged by intraoral incision and 9 sialoliths were retrieved from the Wharton’s duct. Occlusal radiographs and restoration of salivary flow confirmed that all the sialoliths had been retrieved. Composition analysis was carried out for the calculi. However, recur- rence occurred multiple times eventually leading to the sialadenitis of the gland. Surgical excision of the submandibular gland was performed to prevent further discomfort to the patient. Recurrence of calculi plays a major role in deciding the method of treatment. Studies on composition analysis can help analyse the cause of multiple recurrences in future. Keywords: Sialolith; Salivary Glands; Radiographs Introduction Sialolithiasis is the most common disease of salivary glands. It affects approximately 12 in 1000 of the adult population with 2:1 male predilection [1]. About 80%-95% of salivary calculi occur in the submandibular gland while 5% to 10% are found in the pa- rotid gland. The least involved salivary glands are the sublingual gland and minor salivary glands with about 1%-2% of occurrence. The higher occurrence of sialoliths in submandibular gland may be attributed to its anatomic location, long tortuous duct with a nar- row orifice compared to the main portion of duct in which saliva flows against gravity at a slower rate [2]. Salivary stones are mainly composed of calcium phosphate with smaller amounts of carbon- ates in the form of hydroxyapatite, smaller amounts of magnesium, potassium and traces of ammonium along with organic material mainly composed of carbohydrates and amino acids [3]. The sub- mandibular stones consist of 82% inorganic and 18% organic ma- terial whereas parotid stones consist of 49% inorganic and 51% organic material [4]. More alkaline nature of saliva in the subman- dibular gland as compared to parotid gland may be a contributing factor for formation of sialoliths with high inorganic content but Citation: Shamita Tiwari., et al. “Multiple Recurrent Obstructive Sialolithiasis of Left Wharton’s Duct - A Case Report". Acta Scientific Otolaryngology 3.12 (2021): 26-30.