Establishing Correlations Between Normal Pancreatic and Submandibular Gland Ducts

BACKGROUND. The objectives of this study were to evaluate the relationship between ductal morphometry and ramification patterns in the submandibular gland and pancreas in order to validate their common fractal dimension. METHODS. X-ray ductography with software-aided morphometry were obtained by injecting barium sulphate in the ducts of post-mortem submandibular gland and pancreas specimens harvested from 42 adult individuals. RESULTS. Three cases were excluded from the study because of underlying pathology. There was a significant correlation between the length of the main pancreatic duct (MPD) and the intraglandular portion of the right submandibular duct (SMD) (r = 0.3616; p=0.028), and left SMD (r = 0.595; p<0.01), respectively, but their maximal diameters did not correlate (r = 0.139 - 0.311; p>0.05). Both dimensions of the SMD showed a significant right-left correlation (p<0.05). The number of MPD side branches (mean=37) correlated with the number of side branches of left SMD, but not with the right one (mean = 9). Tortuosity was observed in 54% of the MPD, 32% of the right SMD, and 24% of the left SMD, with mutual association only between the two salivary glands. CONCLUSIONS. Although the length of intraglandular SMD and MPD correlate, other morphometric ductal features do not, thus suggesting a more complex relationship between the two digestive glands.

Giant torus mandibularis causing submandibular duct obstruction and sialadenitis

Torus mandibularis is a benign osseous overgrowth arising from the lingual surface of the mandible. It is a common, incidental finding on imaging due to its relatively high prevalence. In the majority of cases, mandibular tori are asymptomatic. We report a novel presentation of a giant torus mandibularis causing bilateral obstruction of the submandibular ducts and consequent sialadenitis. Our patient presented with progressive pain centered in the floor of his mouth and had bilateral submandibular glandular enlargement on exam. Computed tomography showed a giant right torus mandibularis, which was causing obstruction and dilation of the bilateral submandibular ducts. Although conservative management was attempted, he ultimately underwent surgical resection of his torus with symptomatic improvement. This patient highlights a novel complication of torus mandibularis and illustrates successful treatment. Though not previously described, this complication may be underreported and should be considered in the appropriate clinical setting.

FEATURES OF FETAL ANATOMY OF THE SUBMANDULAR DUCT

Knowledge of the patterns of the formation of the structure and topography of organs and systems of the human body is important for the interpretation of the true direction of the processes of organogenesis, the mechanisms of normal morphogenesis of organs, the emergence of anatomical variants and congenital defects. The interest in continuing the research was initiated by the buildup of an integrative approach in scientific developments, which, together with the doctrine of the individual anatomical variability of organs, systems and the shape of the human body, is the foundation of medicine. The next movement in this direction is the study of the variability of the shape of the submandibular strait of the human submandibular salivary gland during intrauterine development. Using the methods of macro-copy, microscopy, graphic and plastic reconstruction, fine preparation under the control of a binocular loupe, morphometry on 111 objects (60 before a person's fetus 7-12 weeks of intrauterine development and 51 fetuses of 4-10 months of intrauterine development were studied Variants of the form of the submandibular strait and the frequency of its manifestations in prenatal and human fetuses are from the rudiment of the tongue. At the beginning of the prefetal period of human ontogenesis, the rudiment of the gland increases significantly and takes the form of a continuous epithelial cord, which is represented by a large number of dividing cells. during the prefetal period with the rudiment of the submandibular duct of the submandibular salivary gland, a number of regular sequential changes occur: 1 – the formation of numerous epithelial cords of the II, III, IV order, as dichotomous branches from the main (main) epithelial anlage, 2 – the formation of a cavity (canal ) in the main epithelial bud and its ramifications of the II-IV order; 3 – the concentration of mesenchymal cells surrounding the epithelial cords (the formation of the mesenchymal part of the submandibular strait of the submandibular salivary gland) with its clear separation from adjacent tissues. In the group of objects of study, most often (76 cases, or 68.47%) there is a direct form of the submandibular ducts; the arcuate variant of the form of the submandibular ducts is almost three times less (26 cases, or 23.42%); as a variant of the form – the S-shaped form of the submandibular duct – was observed even less often (9 cases, or 8.11%).