(A241) Sialadocholithiasis and Sialadenitis Secondary to Large Mandibular Tori: A Case Report

Introduction: Mandibular tori (MT), or torus mandibularis, are bony outgrowths of the lingual surface of the mandible with an unknown etiology affecting 10-30% of adults. They are generally asymptomatic; however, recent reports suggest that large MT may play a role in the development of sialadenitis and sialolithiasis due to obstruction of Wharton's duct.

Methods: This case report presents a patient with significant mandibular tori (MT) who developed sialodocholithiasis and sialadenitis.

Results: A 58-year-old woman presented with complaints of bilateral submandibular neck swelling and dysgeusia. Physical examination and computed tomography revealed sialadenitis of the right submandibular gland with sialodocholithiasis in the presence of large MT obstructing Wharton’s ducts bilaterally. The patient reported the MT had been present for approximately 20 years without complication. Bedside sialodocholithotomy was performed, but was more difficult due to the presence of MT. The patient's symptoms subsequently resolved with antibiotic therapy.

Conclusions: This case highlights the potential impact of large mandibular tori (MT), particularly their role in obstructing Wharton’s ducts and contributing to salivary gland disorders. While MT are typically asymptomatic and go unnoticed, their presence can complicate the diagnosis and management of sialadenitis and sialodocholithiasis.