Excision of Submandibular Gland

Indications

• Recurrent submandibular gland infection/obstruction.
• Excision of benign submandibular tumours.
• As part of level I neck dissection in head and neck malignancy.

Procedure

An incision is made at least two finger-breadths below the mandible to avoid the marginal mandibular nerve (VII). 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

Page last reviewed: 30 July 2026