From the Research
Yes, unilateral submandibular swelling can occur secondary to tonsil stones, though it's not the most common cause. Tonsil stones (tonsilloliths) form when debris, bacteria, and dead cells become trapped in the crypts of the tonsils and calcify. When tonsil stones become large or infected, they can cause inflammation that spreads to nearby lymphatic tissue, including the submandibular lymph nodes on the affected side. This lymphadenopathy presents as a palpable, sometimes tender swelling beneath the jawline. The connection occurs because the lymphatic drainage from the tonsils flows to the submandibular and upper cervical lymph nodes 1.
Key Considerations
- Patients with this condition typically experience other symptoms including bad breath, sore throat, difficulty swallowing, ear pain on the affected side, and visible white or yellowish deposits on the tonsils.
- Treatment involves removing the tonsil stones (either at home with gentle pressure or professionally), gargling with salt water, maintaining good oral hygiene, and staying hydrated.
- If infection is present, antibiotics may be necessary, as suggested by the need to consider various causes of submandibular swelling, including infections 2, 3.
- Persistent or recurrent issues might require tonsillectomy in severe cases, highlighting the importance of proper diagnosis and management to prevent complications.
Diagnostic Approach
- A careful evaluation of recurrence and characteristics of signs and symptoms associated with the swelling can help in making the correct diagnosis and planning a proper therapeutic strategy 3.
- Ultrasonography, orthopantomography, and CT scans can be useful in identifying the cause of submandibular swelling, including salivary stones or other pathologies 3, 4.
- It is essential to consider various causes of submandibular swelling, including dental issues, salivary gland diseases, and systemic conditions like Wegener's disease 5, to provide appropriate treatment and improve patient outcomes in terms of morbidity, mortality, and quality of life.