Submandibular Gland Sialolithiasis — MFDS Part 1 MCQ

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EasyAnatomy (Head & Neck)Submandibular Gland SialolithiasisMFDS Part 1

A patient reports recurrent pain and swelling in the floor of the mouth during meals. A hard calculus is palpated within a salivary duct. Which duct is most commonly affected by sialolithiasis?

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Correct answer: B — Submandibular duct (Wharton's)

The correct answer is the submandibular duct (Wharton's duct). Most salivary calculi arise in the submandibular gland, and approximately 90% of submandibular stones are situated within its duct. Obstruction produces the characteristic meal-related pain and swelling, while the duct's course through the floor of the mouth makes a distal stone palpable intraorally. Proposed predisposing factors include the duct's long, partly ascending course and the relatively viscous, mineral-rich nature of submandibular saliva, although the precise pathogenesis is not fully established. Stensen's duct is the next most frequently affected but is substantially less common. Calculi in the major or lesser sublingual ducts and minor salivary gland ducts are uncommon.

Reference: Kraaij S, Karagozoglu KH, Forouzanfar T, Veerman ECI, Brand HS. Salivary stones: symptoms, aetiology, biochemical composition and treatment. British Dental Journal. 2014;217:E23. https://pubmed.ncbi.nlm.nih.gov/25476659/