Surgery to remove Wharton duct stones under the jaw

Stones from the submandibular salivary glands and wharton ducts account for 80% of all cases of salivary gland stones. The treatment of salivary gland stones has many methods, including surgical removal of stones in the duct to avoid complications caused by the blockage of the salivary glands.

1. Overview of wharton ductal stones

The submandibular salivary gland is a large gland behind the parotid gland, and saliva is secreted into the duct to empty into the oral cavity. Saliva contains enzymes that help digest food and eliminate pathogenic bacteria in the oral cavity.
Submandibular Wharton's duct stone is the most common condition of the salivary glands, accounting for 80%. This condition can cause saliva to stagnate and not be secreted normally, causing inflammation of the submandibular glands.
Inflammation of the submandibular salivary glands, if left untreated for a long time, will easily lead to chronic fibrosis, leading to the risk of surgical removal of the salivary glands. The treatment of submandibular gland inflammation caused by Wharton's duct stones by surgical method helps to remove the stone in the duct while preserving the gland for good treatment results.
Some manifestations of submandibular duct stones:
If small stones do not cause obstruction, there are usually no symptoms and will be eliminated after a while. If the stone causes obstruction of saliva flow leading to pain, the area under the jaw; Pain increases when chewing, feeling of lump under the tongue. In case of infection, it can lead to fever, severe pain, bad breath.

2. Indications and contraindications for surgical removal of Wharton's duct stones

Indication
Stone removal surgery is indicated when the Wharton duct stone of the submandibular salivary gland in the ductal part is located outside the gland.
Contraindications
The patient's health condition does not allow, too weak, body weakness, severe blood clotting disorder that has not been controlled. There is a stable local infection that has not been treated. If surgical intervention can increase the severity and risk of sepsis. Allergic to drugs used during the entire surgical process such as anesthesia, anesthesia... Wharton's duct stones are located in the gland. In this case, surgical removal of the gland is usually indicated. If you are taking anticoagulants, you need to stop at least 24 hours before surgery, to avoid the risk of bleeding during and after surgery.
Phẫu thuật lấy sỏi được chỉ định khi sỏi ống Wharton tuyến nước bọt dưới hàm
Phẫu thuật lấy sỏi được chỉ định khi sỏi ống Wharton tuyến nước bọt dưới hàm

3. Steps to perform the surgery to remove wharton's duct stones

3.1 Preparation Performer: Maxillofacial surgeon and technician.
Patients: The surgical procedure and possible complications are explained during the treatment.
3.2 Procedures Check that the patient is stable and anesthetize, choose an appropriate method of anesthesia such as anesthesia or endotracheal anaesthesia. Perform surgery. Disinfect the surgical area. Locate the stone on the duct and use a suture to tie the back of the stone. Incision of the mucosa and removal of the stone: Use a knife to make an incision in the mucosa of the floor of the mouth along the Wharton tube at a position just above the site of the stone. Then dissect, expose the stone and remove all stones in the submandibular duct. After removing the gravel, proceed to pump and clean the duct. Hemostasis and mucosal closure.
Lấy sỏi ống tuyến wharton tuyến dưới hàm là phẫu thuật tương đối đơn giản
Lấy sỏi ống tuyến wharton tuyến dưới hàm là phẫu thuật tương đối đơn giản

4. Monitoring and handling of incidents occurring

Possible complications such as
In surgery: Bleeding complications during surgery, immediately stop bleeding for the patient, add fluid or give blood transfusion if a lot of blood is lost. Note that before surgery, it is necessary to fully check clotting factors and stop anticoagulants 1 day before surgery. After surgery Bleeding after surgery: Monitor bleeding through outflow, if it is fresh blood, it is necessary to note bleeding after surgery. Use measures to stop bleeding.
Infection : Treat with systemic broad-spectrum antibiotics to prevent infection and take care of the incision site properly.
Surgery to remove the submandibular wharton gland is relatively simple, but like any other surgery, it also carries a risk of complications. To limit the risk of complications, surgery should be performed at a reputable facility, with an experienced doctor. As soon as there are signs of the disease, you should go to the facilities for early examination and treatment to avoid complications.
Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; civilized, polite, safe and sterile medical examination and treatment space.

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Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng.

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