Lingual-nerve Block for Calculi in Wharton's Duct

Introduction: Salivary stones inside the Wharton’s duct adjacent to the mylohyoid muscle are often removed by a little incision of the mouth floor under local anesthesia. However, in the case of relatively large salivary stones, a large incision is required, which is commonly accompanied by hemorrhage and the need for surgical hemostasis, resulting in prolonged surgery. Furthermore, troublesome sequelae such as ranula and lingual nerve paralysis can occur after surgical procedures. Methods: Two patients who had relatively large salivary stones (>1 cm diameter) in the Wharton’s duct were underwent incision of the mouth floor soft tissues with a CO2 laser. Results: In both patients, the stone was removed in a few minutes without causing abnormal bleeding, nerve injury, or sublingual gland disorders and was completely healed. Conclusion: We report the usefulness and safety of the CO2 laser in two patients with relatively large salivary stones, who underwent successful surgical removal.

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Unusual presentation of submandibular lingual nerve sheath tumour as sublingual stone

BMJ Case Reports ◽

10.1136/bcr-2019-233759 ◽

2020 ◽

Vol 13 (6) ◽

pp. e233759 ◽

Cited By ~ 1

Author(s):

Alexander J Straughan ◽

Christopher Badger ◽

Ramin Javan ◽

Andrew Fuson ◽

Arjun S Joshi

Keyword(s):

Submandibular Gland ◽

Lingual Nerve ◽

Unusual Presentation ◽

En Bloc ◽

Submandibular Region ◽

Surgical Exploration ◽

Nerve Sheath Tumour ◽

Taste Changes ◽

Nerve Sheath ◽

Wharton’S Duct

A 60-year-old woman was referred to the otolaryngologist for 18 months of left-sided tongue pain and taste changes. Surgeon-performed ultrasound of the submandibular region revealed a hyperechoic mass. Wharton’s duct was dilated proximally and the submandibular gland demonstrated normal vascularity. While these findings were highly suspicious for submandibular gland sialolith, an in-office attempt at sialolithotomy suggested an alternate process or mass. After imaging failed to further elucidate an aetiology, surgical exploration revealed a well-circumscribed submandibular mass associated with the lingual nerve. The mass was removed en-bloc and pathology revealed a schwannoma of the lingual nerve.

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Sialolithiasis in the sublingual gland

The Journal of Laryngology & Otology ◽

10.1258/002221503322542971 ◽

2003 ◽

Vol 117 (11) ◽

pp. 905-907 ◽

Cited By ~ 16

Author(s):

Ki Hwan Hong ◽

Yoon Soo Yang

Keyword(s):

Salivary Gland ◽

Parotid Gland ◽

Stone Formation ◽

Lingual Nerve ◽

Sublingual Gland ◽

Common Site ◽

Salivary Gland Dysfunction ◽

Floor Of The Mouth ◽

Wharton’S Duct ◽

The Right

Sialolithiasis is a major cause of salivary gland dysfunction. The submandibular gland is the most common site followed by the parotid gland. The sublingual gland and minor glands are very rare sites for stone formation. This paper describes a case of multiple sialoliths arising in the sublingual gland. They presented on the right floor of the mouth. The sublingual gland and sialoliths were completely removed with careful preservation of the lingual nerve and Wharton’s duct. This was an uncommon sialolithiasis of the sublingual gland in a 14-year-old female.

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Ultrasound-Guided Inferior Alveolar Nerve Block in the Horse: Assessment of the Extraoral Approach in Cadavers

Journal of Veterinary Dentistry ◽

10.1177/0898756419844836 ◽

2019 ◽

Vol 36 (1) ◽

pp. 46-51

Author(s):

Jessica Purefoy Johnson ◽

Robert Karl Peckham ◽

Conor Rowan ◽

Alan Wolfe ◽

John Mark O’Leary

Keyword(s):

Methylene Blue ◽

Nerve Block ◽

Inferior Alveolar Nerve ◽

Lingual Nerve ◽

Blue Dye ◽

Methylene Blue Dye ◽

Inferior Alveolar Nerve Block ◽

Success Rates ◽

Ultrasound Guided ◽

Dye Staining

Blinded techniques to desensitize the inferior alveolar nerve (IAN) include intraoral, angled, and vertical extraoral approaches with reported success rates of 100%, 73%, and 59%, respectively. It has not been determined whether an ultrasound-guided extraoral approach is feasible. Further, the fascicular nature of the inferior alveolar and lingual nerves of the horse has not been described. The objectives of this study were to describe a low-volume ultrasound-guided vertical extraoral inferior alveolar nerve block technique and to describe the fascicular nature of these nerves. An ultrasound-guided approach to the IAN was conducted with a microconvex transducer and an 18-G, 15-cm spinal needle using a solution containing iodinated-contrast and methylene blue dye. Accuracy was assessed by contrast visualized at the mandibular foramen on computed tomography (CT) and methylene blue dye staining of the nerves on gross dissection. Sections of inferior alveolar and lingual nerves were submitted for histological analysis. Assessment by CT and dissection determined success rates of 81.3% and 68.8%, respectively; 68.8% of injections had inadvertent methylene blue dye staining of the lingual nerve. Nerve histology revealed both the inferior alveolar and lingual nerves to be multifascicular in nature. Mean fascicle counts for the inferior alveolar and lingual nerves were 29 and 30.8, respectively. The technique is challenging and no more accurate than previously published blinded techniques. Any extraoral approach to the IAN is likely to also desensitize the lingual nerve.

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