» Submandibular Gland
Fig. 1 Submandibular Gland
The submandibular gland is located underneath and just deep to the jaw on both sides (Fig. 1 Submandibular Gland). These two glands produce a large portion of the saliva glands, and the consistency of the saliva in these glands is thinner then what is produced by the parotid glands. A duct, called the Warthin’s duct, caries the saliva from the gland and empties it into the mouth, just behind the lower front teeth. These glands are highly active and can develop numerous problems if the environment of the mouth and the gland is not optimal, such as infections and stones in the gland.
The incidence of cancer is roughly 50%, by that we mean 50% of tumors in the submandibular glands are cancerous and the other half are benign. Table 1 shows the frequency of each type of tumor.
The diagnosis is made primarily by needle biopsy, a simple procedure done in the office. At the CENTER we perform this procedure under ultrasound guidance to improve accuracy.
The treatment of all types submandibular tumors is surgery, in case of the benign tumors and the smaller low grade cancers simply removing the submandibular gland is adequate. In more extensive cases the surrounding lymph nodes may have to be removed as well.
Fig. 2 Submandibular Incision
Removal of the submandibular gland involves making a small incision, usually less then an inch, in the upper neck an inch below the jawline (Fig. 2 Submandibular Incision). The gland is carefully seperated from the surrounding muscles and nerves (Marginal Mandibular Nerve, Hypoglossal Nerve & Lingual Nerve). These are all very important nerves and the surgeons experience is of utmost importance in protecting them. Removal of the gland through a transoral (mouth) incision is done in certain cases as well.
Recovery from this surgery is very quick, and usually patients go home the same day and return to work in 5-7 days.
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