Download PDF
CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(03): e537-e542
DOI: 10.1055/s-0043-1767801
Systematic Review

Early Clinical Mapping of Submandibular Gland Fistula: A Case Report and Systematic Review

Vivek Dokania 
1   Department of Otolaryngology- Head & Neck Surgery, Asian Super Specialty Hospital, Dhanbad, Jharkhand, India
,
Md Ibrar
2   Department of Radiology, Asian Super Specialty Hospital, Dhanbad, Jharkhand, India
,
Mayashankar Vishwakarma
3   Department of Otolaryngology- Head & Neck Surgery, Khan Bahadur Bhabha Hospital, Kurla, Mumbai, Maharashtra, India
› Author Affiliations Funding The author(s) received no financial support for the research.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Introduction Submandibular gland fistula (SGF) is a rare subset of salivary gland fistulas. It is seldom tough to diagnose them prior to surgical exploration, and it is often clinically confused with close differentials. An early diagnosis based on pertinent clinical features and focused radiological findings can be pivotal in optimal management and help prevent recurrence and avoid unnecessary investigations/interventions.

Objective To review articles that discuss SGF and provide vital etiological, clinical, and imaging features of this rare entity that can aid in early clinical diagnosis.

Data Synthesis An extensive review involving PubMed and Google Scholar and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards.

Conclusion Submandibular gland fistula is a rare entity. It can be confused with close differentials, including branchial fistulas, if not thoroughly examined. Discharge from fistulae along with submandibular pain/tenderness and/or swelling are important diagnostic clues. A history of trauma, nodule at the site of discharge, prior submandibular disease/calculi, or discharge aggravated with food further increases a clinical suspicion. Optimal radiological investigation looking for calculi/foreign body and delineating the fistula tract is vital to affirm a diagnosis. Gland with fistula excision is a commonly advocated treatment of choice with no reports of recurrence, although conservative management and gland preserving surgery have also reported a favorable prognosis.

Keywords

salivary gland - fistula - submandibular gland

Ethics Approval

Not necessary for this research.




Publication History

Received: 24 October 2022

Accepted: 20 February 2023

Article published online:
06 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Arslan S, Çobanoğlu B, Ural A. Head and neck fistulas of congenital or infectious etiology: retrospective analysis of 23 cases. ENT Updates 2017; 7 (01) 42-46
    CrossrefGoogle Scholar
  • 2 van der Waal I. Diseases of the salivary glands including dry mouth and Sjögren's syndrome: diagnosis and treatment. Springer Science & Business Media; 2012 Dec 6
  • 3 de Geus JJ, Maisels DO. A traumatic fistula of the submandibular gland. Br J Plast Surg 1976; 29 (02) 196-198
    CrossrefPubMedGoogle Scholar
  • 4 Knezević G. Facial sinus caused by a foreign body in the submandibular salivary duct. Br J Oral Surg 1983; 21 (01) 69-72
    CrossrefPubMedGoogle Scholar
  • 5 McFerran DJ, Phillips RR. Case report: congenital fistula between the submandibular gland and the oropharynx. Br J Radiol 1993; 66 (786) 561-562
    CrossrefPubMedGoogle Scholar
  • 6 Paul D, Chauhan SR. Salivary megalith with a sialo-cutaneous and a sialo-oral fistula: a case report. J Laryngol Otol 1995; 109 (08) 767-769
    CrossrefPubMedGoogle Scholar
  • 7 Singh B, Shaha A. Traumatic submandibular salivary gland fistula. J Oral Maxillofac Surg 1995; 53 (03) 338-339
    CrossrefPubMedGoogle Scholar
  • 8 Obaid H, Sinha R, Robinson L. Submandibular sialogram performed through a Wharton's duct fistula: technical adaptation of conventional technique. Eur J Radiol 2006; 60 (01) 56-57
    CrossrefPubMedGoogle Scholar
  • 9 Durgun V, Kapan M, Kapan S, Onur E. Congenital Submandibular Salivary Gland Fistula. Oto-Rhino-Laryngologia Nova 2002; 12 (03) 159-160
    CrossrefGoogle Scholar
  • 10 Jana AK, Jaswal A, Sikder B, Jana U, Nandi TK. Fistula of submandibular gland-a rare presentation. Indian J Otolaryngol Head Neck Surg 2006; 58 (04) 393-394
    CrossrefPubMedGoogle Scholar
  • 11 Saha S, Jha A, Kaur N. Unusual cause of orocutaneous fistula in the neck. Case Rep Surg 2012; 2012: 658536
    PubMedGoogle Scholar
  • 12 Saluja H, Kasat VO, Mahindra U. Giant Sialolith in the Wharton's duct causing sialo-oral fistula: A case report and review of literature. J Orofac Sci 2012; 4 (02) 137
    CrossrefGoogle Scholar
  • 13 Rangappa V, Soumya M, Sreenivas V. Salivary fistula with a calculus!. Int J Head Neck Surg 2014; 5 (02) 96-98
    CrossrefGoogle Scholar
  • 14 Kieliszak CR, Gill A, Faiz M, Joshi AS. Submandibular ductal fistula: an obstacle to sialendoscopy. JAMA Otolaryngol Head Neck Surg 2015; 141 (04) 373-376
    CrossrefPubMedGoogle Scholar
  • 15 Kulkarni AA, Thakur SS. Primary squamous cell carcinoma of submandibular salivary gland with sialo-cutaneous fistula: a rare case report. J Clin Diagn Res 2015; 9 (08) PD03-PD05
    PubMedGoogle Scholar
  • 16 Kusunoki T, Homma H, Kidokoro Y. et al. Cervical fistula caused by submandibular sialolithiasis. Clin Pract 2017; 7 (04) 985
    CrossrefPubMedGoogle Scholar
  • 17 Stegmann A, Iro H, Koch M. Pediatric submandibular gland sialolithiasis with salivary–cutaneous fistula: case report on gland–preserving treatment with combined endoscopic–transcutaneous surgery. Am J Otolaryngol Head Neck Surg. 2018; 1 (01) 1003
    Google Scholar
  • 18 Ha DL, Ryu HS, Kim GW. et al. Fistula of the submandibular gland presenting as a painful mass in the neck: a rare case. Ann Dermatol 2020; 32 (01) 81-83
    CrossrefPubMedGoogle Scholar