Obstructive Submandibular Sialadenitis Complicated with Severe Neck Phlegmon: Transcutaneous Removal of Sialolith with a Flow of Pus: Literature Review of Extraoral Complications

Lilia A. Savchuka, Ievgen I. Fesenkob more
a Lilia A. Savchuk

Doctor of Ultrasound Diagnostics (DUD), PolycDoctor of Ultrasound Diagnostics (DUD), Polyclinic, Kyiv Regional Clinical Hospital, Kyiv Regional Clinical Hospital, Kyiv, Ukraine

b Ievgen I. Fesenko

PhD, Associate Professor, Department of Oral and Maxillofacial Surgery, Private Higher Educational Establishment “Kyiv Medical University.” Doctor-Stomatologist-Surgeon (DSS), Doctor of Ultrasound Diagnostics (DUD), Center of Maxillofacial Surgery, Kyiv Regional Clinical Hospital (place of work at moment of material collection). Corresponding author’s address: Department of Oral and Maxillofacial Surgery, Private Higher Educational Establishment “Kyiv Medical University.” 7 Antona Tsedika Street, Kyiv 02000, Ukraine. E-mail: eugenfesenko@gmail.com (Ievgen Fesenko) ORCID: https://orcid.org/0000-0002-8901-1632 Instagram: @dr_eugenfesenko Facebook: Eugene Fesenko

November 30, 2021


J Diagn Treat Oral Maxillofac Pathol 2021;125–134.

Under a Creative Commons license


Savchuk LA, Fesenko II. Obstructive submandibular sialadenitis complicated with severe neck phlegmon: transcutaneous removal of sialolith with a flow of pus: literature review of extraoral complications. J Diagn Treat Oral Maxillofac Pathol 2021;5(11):125–34.


Sialolithiasis, as the most common reason (60–85 percent) of obstructive salivary gland disease, in the rare cases, may be complicated by soft tissues abscess or/and fistula. The purpose of this report is to present a rare case of submandibular gland sialolithiasis complicated with severe neck phlegmon in a 47-year-old Caucasian male. Ultrasonography and transcutaneous removal of sialolith upon the purulent locus lancing are highlighted. Our literature review based on the existed ones with a total 24 complication cases is presented. Wakoh et al`s classification of submandibular gland sialolith-associated fistulas types is analyzed. The ultrasound imaging is still underestimated and not adequately popularized among head and neck and oral and maxillofacial surgeons. Presented case and published reports show the usefulness of this constantly developing diagnostic technique in a combination with knowledge of possible extraoral purulent complications’ and its management.