Submandibular Gland Resection

Submandibular gland resection is a procedure that involves removing the entire gland to treat cancer in the salivary gland or infection caused by stones. The submandibular glands lie just below each side of the jaw and are responsible for producing and releasing saliva into the mouth.

Individuals with salivary stones experience swelling, pain or both in the affected salivary gland. Symptoms worsen when the individual is eating or anticipating eating. Individuals may have symptoms that come and go over a period of weeks or be persistent. Symptoms typically worsen if the stone moves or grows in a way that blocks the duct of the gland. Individuals experiencing any of these symptoms should schedule a visit to their primary physician.

The exact cause of salivary stones is unknown, but several factors may increase the likelihood of salivary stone formation:

• Dehydration
• Trauma to the inside of the mouth
• Gum disease
• Smoking

The risks of a submandibular gland resection include:

• Bleeding
• Infection
• Hematoma
• Scarring
• Temporary or permanent numbness of the tongue
• Difficulty speaking or swallowing
• Damage to the facial nerve that may lead to permanent weakness of the mouth and lip on that side
• Risks of anesthesia

Before the procedure can begin, the patient is given an intravenous (IV) line that is inserted into a vein in the arm or hand. The patient will then receive general anesthesia.

Once the patient is asleep, the surgeon will make a cut in the upper part of the neck, below the jaw line, under the chin, behind the ear, or in the mouth. The surgeon will move muscles, nerves and blood vessels out of the way to access the gland.

A facial nerve monitor will be used to map the exact location of the facial nerve that lies near the submandibular gland. The surgeon will then remove the gland. Some surrounding tissue and lymph nodes may also be removed if a cancerous tumor is present.

The surgeon will close the cut with surgical glue, sutures or surgical strips and place a tube (or drain) into the surgical area. This is done to remove any fluid that may build up after surgery. Some patients may receive an injection of local anesthesia to alleviate pain after surgery. The entire procedure will take about one hour.

Patients will have soreness in their throat and have difficulty talking and swallowing. Patients may also feel sleepy and nauseated from the anesthesia. Pain medication will be provided, and patients will be monitored for one to two days after the procedure.

At home, patients will need to check their cut daily for symptoms of infection, such as increased pain, swelling, redness, drainage or warmth. Patients should eat soft foods and avoid hot, spicy, acidic, hard or crunchy foods. Walking will help improve blood flow and breathing and promote healing. Patients should avoid engaging in exercise or strenuous activities for seven days after surgery.