Sialolithiasis is one of the most common diseases of the salivary gland, but giant sialoliths have been reported in the literature infrequently. The submandibular gland and its duct appear to be the sites most susceptible to this disease. We report 2 cases of giant sialoliths occurring solely in the submandibular duct. In both cases, transoral removal of the stone was performed under local anesthesia; one of the stones was 35 mm long and the other was 25 mm long. The patients' glands were managed conservatively with sialagogues and analgesics. The glands recovered normal function quickly after removal of the stones, which is noteworthy because such long-standing stones usually produce irreversible functional damage. Follow-up showed asymptomatic and normally functioning glands. The authors conclude that a conservative approach will spare the patient the morbidity associated with gland removal.
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