A RARE OCCURRENCE OF UNILATERAL DUPLICATION OF WHARTON’S DUCT WITH THEIR INTRA-SUBLINGUAL GLANDULAR COURSE: A CADAVERIC REPORT
Duplicated submandibular duct
Abstract
Anatomical variations regarding the salivary glands and their ducts have been observed in previous studies. But the occurrence of accessory submandibular gland duct is less common. In this study, we report a male cadaver with duplicated submandibular duct on the right side. The right upper submandibular duct (main duct) emerged from the anterior aspect of the deep part of the gland, ran its course forward, then pierced the posterior aspect of the sublingual gland and within the gland it ran forward and opened on the posterior aspect of sublingual papilla on the floor of mouth. The lower submandibular duct (accessory duct) also commenced from the anterior aspect of the deep part of the submandibular gland, ran forward just below and superficial to the upper duct and entered the anterior aspect of the sublingual gland and finally opened on the anterior aspect of sublingual papilla separately. Here, the embryological basis for the development of duplicated ducts and its clinical relevance is discussed.
Key words: accessory submandibular duct, duplicated salivary duct, sialography, sialolith, Wharton’s duct
References
1.Tucker AS. Salivary gland development. Seminars in Cell & Developmental Biology 2007;18:237–244.
2. Standring S. Grays Anatomy: The anatomical basis of clinical practice. 40th ed. Philadelphia, Pennsylvania, USA: Churchill Livingstone; 2008. pp. 499–526.
3.Tubbs RS, Shoja MM, Loukas M. Bergman’s comprehensive encyclopaedia of human anatomic variation ,Hoboken, N. J : John Wiley & Sons; Inc.chapter .2016;1184-1185.
4. Som PM, Miletich I. The Embryology of the Salivary Glands:An Update. Neurographics 2015; 5(4):167–177.
5. Manzur-Villalobos I, Pérez-Bula L, Fang L. Anatomical variation of submandibular gland duct.
Sch. J. Dent. Sci 2016;3(1):12-14.
6.Gadodia A, Neyaz Z, Sharma R. Magnetic resonance identification of an accessory submandibular duct and gland: an unusual variant. J Laryngol Otol 2007;121(9).
7. Erdogan NK, Altay C, Özenler N, Bozkurt T, Uluç E, Mete BD et al. Magnetic Resonance Sialography Findings of Submandibular Ducts Imaging. BioMed Research International. 2013;6.
8. Billakanti PB. Accessory Duct of the Submandibular Gland. Sultan Qaboos Univ Med J 2017; 17(1):e119–e120.
9.Gaur U, Choudhry RM, Anand C, Choudhry S. Submandibular gland with multiple ducts.
Surgical and Radiologic anatomy 1994;16(4):439-40.
10. Kuroyanagi N, Kinoshita H, Machida J, Suzuki S, Yamada. Accessory Duct in the Submandibular Gland. Asian Journal of Oral and Maxillofacial Surgery 2007;19(2)110-112.
11. Pai A, Patil BAB, Hegde S, Sodhi A. Interventional radiology and minimally invasive techniques for the management of obstructive salivary gland disorders: A brief overview.
Journal of Medicine, Radiology, Pathology & Surgery 2015;1:31–34.
12. Krishnappa BD. Multiple submandibular duct (wharton’s duct) calculi of unusual size and shape.
Indian J. Otolaryngol. Head Neck Surg 2008;60:287–288.
13. Andretta M, Tregnaghi A, Prosenikliev V, Staffieri A. Current opinions in sialolithiasis diagnosis and treatment. Acta Otorhinolaryngol Ital 2005; 25:145-149.
14.Rzymska-Rzymska-Grala I, Stopa Z, Rzymska-Grala B, Gołębiowski M, Wanyura H, Anna Zuchowska A et al. Salivary gland calculi – contemporary methods of imaging.
Pol J Radiol 2010;75(3): 25-37.
15. Hadi Sharouny H, Omar RB. Iatrogenic Submandibular Duct Rupture Complicating Sialography: A Case Report. Iran Red Crescent Med J 2014;6(9): e7882.
16. Pirkl I, Filipovi´c B, Goranovi´c T, Simunjak B. Large tonsillolith associated with the accessory duct of the ipsilateral submandibular gland: support for saliva stasis hypothesis.
Dentomaxillofac Radiol 2015;44:20150090.
17. Buckenham T. Salivary Duct Intervention. Seminars In Interventional Radiology 2004; 21:3.
18. Nahlieli O, Shacham R, Yoffe B, Eliav E. Diagnosis and treatment of strictures and kinks in salivary gland ducts. J Oral Maxillofac Surg 2001; 59(5):48490.
19. Pal K, Abdulla AM. Congenital imperforate submandibular duct in a newborn.Indian Journal of Pediatrics. 2007;74.
20. Sagar P, Handa KK, Gulati S, Kumar R. Submandibular Duct Re-routing for Drooling in Neurologically Impaired Children. Indian J Otolaryngol Head Neck Surg 2016; 68(1):75–79.