PMC6393947_01
(a) Photograph of the sublingual sialocoele. (b) Photograph of the soft palate showing ulceration (arrow) due to friction from the deviated lateral edge of the tongue
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A left-sided tongue deviation caused by a 2 cm fluctuant, non-painful mass was observed (Figure 1a). The mucous membrane over the soft palate was eroded by the deviated lateral edge of the tongue (Figure 1b).
(a) CT image, sagittal view, of the patient's head. Note the dilated cystic lesion (white star). (b) CT image, transverse view, of the patient's head. The sialocoele (white star) displaces the tongue laterally (arrow). Cr = Cranial
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This structure exerted a significant mass effect in the oral cavity and on the right larynx (Figure 2).
Perioperative photograph of the mandibular-sublingual salivary gland complex. Note the mandibular gland (black arrow), the monostomatic portion of the sublingual gland (white arrow) and the polystomatic portion (white disc). Cr = Cranial
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The salivary duct was then ligated and transected, and the gland complex was removed (Figure 3).
Postoperative photograph of the marsupialisation
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Finally, the sialocoele was excised intraorally with Metzenbaum scissors and the oral mucosa was sutured to the edges of the sialocoele by two continuous patterns, with absorbable monofilament suture (PDS 3-0; Figure 4).
(a) Histopathology slide showing parts of the sialocoele (black asterisks) visible in the soft tissues beneath a normal salivary lobule (white asterisk). Haematoxylin and eosin x 20. (b) Histopathology slide from the wall of the sialocoele, comprising well-vascularised mature fibrous connective tissue. Note the lack of a secretory epithelium on its inner surface. Haematoxylin and eosin x 100
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The wall of the sialocoele was slightly inflamed, with lymphocytes and plasma cells being the most numerous leukocytes. (Figure 5).