Role of Ultrasonography Supplemented by Sialendoscopy in Submandibular Steinstrasse Sialolithiasis

The submandibular gland is the most common major salivary gland vulnerable to sialadenitis secondary to sialolithiasis. We report a case of submandibular steinstrasse causing sialadenitis in a 45-year-old male and describe the appearances on high-resolution ultrasonography. Endoscopic-assisted excision of calculi was done. Post-operative recovery was uneventful and the patient was discharged after one week. The patient has been on follow-up for six months with no complaints of recurrence. Multiple stacked calculi within the Wharton’s duct is an exceedingly rare occurrence. Steinstrasse creates a dilemma of choice for the intended surgical approach during calculi extraction from the Wharton’s duct. Endoscopic guided calculi extraction may be ideal for distally placed calculi along the course of the duct. Submandibular steinstrasse can be a possibility when electrohydraulic or pneumatic techniques have been deployed.