Submandibular Gland Duct Strictures

Submandibular Strictures

Obstructive submandibular sialadenitis is characterized by recurrent swelling during meal time, reduced or absent saliva secretion from the affected gland, without a concomitant reduction in saliva production, followed by bacterial infection. The main causes of non-stone-based obstructive diseases are stenosis or strictures. Compared with a stricture, which is a short segment of intraluminal scar, with either a complete blockage or a very narrow lumen, a stenosis is a long segment with a diffuse narrowing of the ductal lumen. In contrast to obstructive stones that usually appear as a unilateral solitary pathology, strictures might occur bilaterally or with the involvement of multiple major salivary glands. Ductal strictures and stenosis in the parotid and submandibular gland (SMG) are the main cause of swellings of an unclear origin.

There is a big difference in their documented frequency between centers, using a variety of instruments for diagnosis of strictures. Medical centers specializing in salivary gland obstructive pathology and sialendoscopy find more stricture pathology in the ductal system compared with nonspecialized facilities. Submandibular strictures are not as frequent a pathology as submandibular stones. Only 25–30% of all stenosis and stricture cases are associated with the Wharton's duct. This is probably due to an initial larger diameter of Wharton's duct (2–3 mm) compared with the Stensen's duct (1.5 mm).