Excision of Submandibular Gland

Indications

  • Excisional biopsy of submandibular gland neoplasms.
  • Recurrent submandibular gland infection/obstruction.
  • As part of neck dissection in head and neck cancer.

 

Procedure

An incision is made at least two finger-breadths below the mandible. The surgeon dissects through platysma directly to the submandibular gland capsule. The tissues are raised in this plane. The gland is dissected out and the duct is eventually divided.

 

Length of procedure

Approximately 60 minutes, although a gland with recurrent infections can be adherent to surrounding tissues, and take longer to remove.

 

Complications

NB Patients may ask whether excision of a single salivary gland will lead to a dry mouth. They can be reassured that this is very unlikely.

Pain 

Bleeding/haematoma  A drain is sometimes placed. 

Infection 

Need for further treatment  Depending on histology. 

Scar

Marginal mandibular nerve injury  This leads to lip/angle of mouth weakness. Great care is taken to avoid this, and permanent injury is quite rare, but the nerve can be variable in position and very small. Temporary lip droop may result from traction or heating of the nerve, so patients should initially be reassured.

Lingual nerve injury  This leads to tongue anaesthesia (rare).

Hypoglossal nerve injury This leads to tongue weakness (rare).

 

Post-operative management

  • Patients may go home the same day, or stay overnight depending on preference/comorbidities.
  • Suture removal in 1 week.
  • Outpatient follow-up in 2-3 weeks for histology results.

 

TTO

  • Analgesia only

 

 

 

 Page last reviewed: 23 September 2016