An otherwise healthy 42-year-old female presented to her primary care physician with acute onset left submandibular fullness with ear pain of 3-day duration. She denied any postprandial symptoms or external neck swelling. She denied any prior episodes. She was placed on antibiotics, and after several days the fullness subsided, but she continued to have ear discomfort. She was then referred and evaluated by an outside otolaryngologist who ordered a CT neck with contrast which failed to demonstrate any obstructive pathology involving the parotid or submandibular glands (Fig. 20.1). Conservative management was recommended.
Robot assisted left submandibular sialolithotomy and combined approach technique for stone removal demonstrating the posterior floor of mouth anatomy with the lingual nerve laterally and the hilar portion of the submandibular duct containing the sialolith (WMV 3419 kb)
Endoscopic removal of 2 mm stone using stone basket (M4V 1340 kb)