A Rare Case of Recurrent, Giant and Multiple Obstructive Wharton’s Duct Sialolithiasis Treated with Cannula Placement for Ductal Patency Maintenance

Introduction: Sialolithiasis is the most common benign pathology of the major salivary glands, predominantly affecting the submandibular gland and Wharton’s duct. Giant Wharton’s duct sialoliths (>15 mm) are rare, and their association with multiple calculi is exceedingly uncommon. Case Report: We report a rare case of recurrent, giant and multiple obstructive sialoliths of Wharton’s duct managed successfully by transoral sialolithotomy followed by cannula placement for maintaining ductal patency. This minimally invasive approach resulted in complete stone removal, restoration of salivary flow, and preservation of the submandibular gland, thereby avoiding gland excision. Conclusion: This case highlights the importance of ductal patency maintenance techniques in the management of complex obstructive sialadenitis with sialolithiasis and also reviews contemporary treatment strategies for recurrent, large and multiple salivary duct stones. Key words: Sialolithiasis; Wharton’s duct; giant sialolith; submandibular gland; ductal cannulation; transoral sialolithotomy