Vincent Cumberworth BSc FRCS Consultant Ear, Nose and Throat Surgeon

Clementine Churchill Hospital Sudbury Hill Harrow Middlesex HA1 3RX
Private Secretary: Tel: 020 8872 3866 Fax: 0208872 3861

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Submandibular gland surgery

Problems which require surgical intervention on the submandibular gland can be due principally either to calculi (stones) or narrowing and blockage of the duct system. The condition of recurrent pain, swelling and inflammation of a salivary gland is called sialadenitis. If the calculus is very close to the end of the duct, which opens just under the tongue at the side of the frenulum in the midline of the flood of the mouth, then occasionally debris can be removed under local anaesthesia which allows the gland to drain. Ultrasound examination can be useful to evaluate the problem and occasionally a sialogram, in which a small amount of radio opaque dye is introduced into the duct of the gland to outline the ductal system, can be required.

If the submandibular gland needs to be removed, this is performed by a skin crease incision on the neck, around 3 – 4 fingers breadth below the level of the mandible. This is done to minimise the risk of damage to the marginal mandibular nerve, which can otherwise produce a slight weakness of the angle of the mouth on that side. The glands sit next to the important structures and complications also include bruising or damage to these adjacent nerves such as the lingual nerve, which can produce numbness of the tongue if damaged, and the hypoglossal nerve, which can produce weakness of movement of the tongue should that nerve be damaged.

Sutures will be required and there will be a scar on the neck after the procedure and typically an inpatient stay of 1 – 2 nights after the operation is required and generally there is a drain which is removed 24 hours post-operatively. 7 – 10 days would be recommended off work.

© Vincent Cumberworth 2005