Removing a submandibular salivary gland is called sialoadenectomy. It’s a surgery to take out the gland under the jaw. The submandibular glands make saliva that helps with chewing and keeps the mouth moist.
But, if this gland gets stuck with infections, stones, or tumors, it might need to be removed. This helps stop pain, swelling, or dry mouth. At Liv Hospital, our team offers caring, science-backed care for those getting saliva gland removal.
Key Takeaways
- Submandibular gland removal is a surgical procedure for addressing gland-related issues.
- The submandibular gland plays a critical role in saliva production.
- Sialoadenectomy can solve chronic infections and blockages.
- Advanced surgical methods lead to better results and fewer problems.
- Patients get full support from skilled head and neck surgeons.
Understanding the Submandibular Salivary Gland and Indications for Removal
The submandibular gland is under the jaw and is key for saliva production. It’s removed for several health issues. We’ll explore its anatomy, function, and what happens when it’s removed.
Anatomy and Function of the Submandibular Gland
The submandibular gland is in the submandibular triangle. It’s surrounded by the jaw’s lower edge, the digastric’s posterior belly, and the anterior belly. This gland is a major player in saliva production, vital for oral health and digestion.
The gland makes a lot of saliva, with the submandibular gland producing both serous and mucinous types. This saliva helps with food lubrication, swallowing, and digestion. It drains through the Wharton’s duct into the mouth’s floor.
Common Indications for Surgical Removal
Removing the submandibular gland, or submandibular gland excision, is needed for several reasons. These include:
- Salivary stones (sialolithiasis) causing obstructive symptoms
- Chronic sialadenitis, which is inflammation of the salivary gland
- Benign or malignant tumors of the submandibular gland
For more details on the surgery, check medical resources. The decision to remove the gland is based on thorough tests and the patient’s health.
| Indication | Description |
| Salivary Stones | Causing obstructive symptoms and recurrent infections |
| Chronic Sialadenitis | Inflammation of the salivary gland leading to chronic pain and swelling |
| Tumors | Benign or malignant growths within the submandibular gland |
Preoperative Assessment and Patient Preparation
Getting ready for submandibular gland removal means a detailed check-up. This helps spot any risks and plan the surgery well. It’s key for the best results for patients.
Diagnostic Evaluation and Imaging Studies
Checking the submandibular gland and nearby areas is a must. Ultrasound or CT scans are used to see tumors and stones. They help us know the gland’s size and where it is.
Imaging studies help us:
- Look at the gland’s shape and any issues
- Find possible problems during surgery
- Choose the best way to operate
Patient Selection and Contraindications
Picking the right patients is key for a successful salivary gland removal procedure. We check for things like bleeding problems or serious health issues. This lowers the risk of problems.
Important things to think about are:
- Looking at the patient’s health history
- Checking the patient’s overall health
- Thinking about the chance of problems during and after surgery
Preoperative Patient Education and Informed Consent
Telling patients about the surgery is very important. We make sure they know about the risks and benefits. This is to get informed consent.
Good patient education means:
- Explaining the surgery and what to expect
- Talking about possible problems and risks
- Answering any questions or worries
By doing a thorough pre-op check and preparing patients well, we can make sure they do well after submandibular gland removal.
Surgical Techniques for Submandibular Salivary Gland Removal
Surgeons have many techniques to remove the submandibular salivary gland. Each method has its own benefits and risks. The choice depends on the patient’s body, the problem, and the surgeon’s skill.
Traditional Transcervical Approach
The traditional method involves a 2- to 3-cm transverse neck incision. It’s made about 1 to 2 cm below the jawline. The incision is planned to hide the scar well.
After the incision, the surgeon works through the platysma muscle to reach the gland. They then move the gland and keep the facial artery and vein safe. The submandibular duct is tied off, and the gland is taken out.
Advanced Surgical Approaches
New techniques aim to make surgery better and safer. Endoscopic-assisted surgery is one, using an endoscope for a smaller incision. This method is less invasive.
Another new way is the transoral removal of the gland. It goes through the mouth, avoiding a neck cut. This can lead to less visible scarring, but it needs special skills and tools.
Managing Intraoperative Complications
Even with careful planning, problems can happen during surgery. One big risk is injury to the marginal mandibular branch of the facial nerve. This can cause weakness or paralysis of the lower lip.
To fix this, surgeons must be ready to find and fix the nerve damage. Other possible issues include bleeding, infection, and harm to nearby nerves. Knowing these risks helps surgeons perform a safe and effective surgery.
Conclusion: Postoperative Management and Clinical Outcomes
After submandibular gland removal, postoperative care is key for the best results. Complications can include nerve damage, swelling, infection, fistulas, and scarring. We will cover the main points from the article and talk about how to manage these issues.
Good postoperative care is vital for patients having salivary gland surgery. Infections can happen, with a 7.7% rate. Parotid surgeries have a 5.2% rate, while submandibular surgeries have a 14.3% rate. Some patients may also face salivary fistula and nerve palsy, with 12 cases reported.
For those with cancer, adjuvant radiotherapy is sometimes used, affecting 21 patients. Neck dissection is done when nodes are significant. Unexpected malignancies are found in some cases, showing the need for detailed pathology checks.
Knowing the possible complications and using effective postoperative care can greatly improve patient outcomes. This is true for submandibular gland removal and other salivary gland surgeries.
FAQ
What is the submandibular gland, and what is its function?
The submandibular gland is a major salivary gland located beneath the floor of the mouth. Its primary function is to produce roughly 60% to 70% of your resting saliva, which is vital for lubricating the mouth, aiding in the initial stages of digestion, and protecting dental health.
Why is the submandibular gland removed?
Removal is typically necessary due to chronic, painful infections (sialadenitis), recurrent salivary stones that cannot be cleared, or the presence of benign or malignant tumors. In some cases, it is removed if a stone is lodged so deeply within the gland tissue that it cannot be reached via the duct.
What diagnostic evaluations are necessary before submandibular gland removal?
Doctors usually require imaging such as an ultrasound, CT scan, or MRI to map the gland’s anatomy and the extent of any growth. A fine-needle aspiration (FNA) biopsy is frequently performed to check for cancerous cells, helping the surgeon determine the scale of the operation.
What are the surgical approaches for submandibular gland removal?
The standard approach involves an external incision made in a natural skin crease about two centimeters below the jawline to minimize visible scarring. Occasionally, minimally invasive robotic or endoscopic techniques may be used to access the gland through the mouth.
What are the possible complications during submandibular gland removal surgery?
The primary risk involves potential damage to three nearby nerves: the marginal mandibular nerve (controls the lower lip), the lingual nerve (tongue sensation), and the hypoglossal nerve (tongue movement). Other risks include bleeding, infection, or a temporary collection of fluid called a seroma.
How is postoperative care managed after submandibular gland removal?
Post-op care includes monitoring the incision for redness or swelling and often involves a small surgical drain to remove excess fluid for the first 24 to 48 hours. Patients are typically advised to stick to a soft diet and avoid heavy lifting for at least one to two weeks.
What is the significance of follow-up care after submandibular gland removal?
Follow-up visits allow the surgeon to remove sutures and assess nerve function to ensure no permanent damage occurred. If the gland was removed due to a tumor, these visits are critical for reviewing pathology results and monitoring for any recurrence.
What is sialoadenectomy surgery?
Sialoadenectomy is the formal medical term for the surgical removal of any salivary gland. When only the submandibular gland is removed, the procedure is specifically called a submandibular sialoadenectomy.
How does the removal of the submandibular gland affect saliva production?
While this gland produces a significant amount of saliva, the remaining parotid and sublingual glands—along with hundreds of microscopic minor glands—usually compensate quite well. Most patients do not suffer from chronic dry mouth after losing just one of their submandibular glands.
What is the role of imaging studies in submandibular gland removal?
Imaging is essential for identifying the exact location of stones or the relationship between a tumor and the surrounding blood vessels and nerves. This “road map” allows the surgeon to navigate the complex anatomy of the neck with higher precision and safety.
References
National Center for Biotechnology Information. Evidence-Based Medical Insight. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK568740/[3
