Functional Wharton’s Duct Remnant Post-Submandibular Gland Resection with Sialadenitis

Abstract

Wharton’s duct remnant post-submandibulectomy is generally assumed functionless as the duct was ligated intraoperatively. There are well-documented surgical complications related to submandibular gland excision for non-neoplastic diseases, particularly sialadenitis, mucocele and sialolithiasis formation. However, little is known of the risk factors for developing these complications despite the absence of gland. Herein, we present the case of a 57-year-old woman who presented with a chronic, painless viscous mucopurulent secretion from a ‘left-behind’ patent Wharton’s duct on the left floor of her mouth, one year after excision of the left submandibular gland. Based on the clinical assessment, a diagnosis of sialadenitis of the left Wharton’s duct remnant was made. She was treated successfully with a two-week course of oral antibiotics. A likely mechanism for the disorder and associated risk factors are hereby discussed.