Submandibular Gland Surgery

What are salivary glands?

Salivary glands are glands that secrete saliva and juices to keep the mouth moist and to help with swallowing and digestion. These include the parotid glands, the submandibular glands, the sublingual glands, and minor salivary glands on the soft and palate and oral cavity. Tumours in the larger glands are usually non cancerous (benign), while those in mirror salivary glands have a higher chance of being cancerous (malignant). About 80% of tumours occur in the parotid gland. There are many different types of benign and malignant tumours of the salivary gland, each with their own distinct biology and behaviour.

What is the submandibular gland?

The submandibular glands are paired major salivary glands that sit under the jaw, and secrete saliva into the mouth through a duct that opens in the floor of the mouth.

Submandibular gland problems

One of the common problems of the submandibular gland is inflammation from stones blocking the submandibular duct (called sialolithiasis). The submandibular duct opens in the floor of the mouth. Sometimes these problematic stones can removed by exploring and opening the duct inside the mouth. If you have stones within the gland, then a submandibular gland excision may be recommended to prevent recurrent episodes of inflammation (sialoadenitis). The gland can also become inflamed from autoimmune conditions like Sjögren’s syndrome. Another reason for removing the gland is for a tumour in the submandibular gland (benign or malignant).

Some symptoms of submandibular gland problems include:

  • Blocked saliva flow

  • A swollen, painful, or firm lump in the neck under the jaw

  • Foul tasting discharge of pus from the duct into the mouth

  • Enlarged lymph nodes in the neck from repeated infections in the submandibular gland

  • Tumours of the gland often appear a firm enlarged firm lump in the gland

What is a submandibular gland excision?

A small incision will be placed in the neck on the side with submandibular gland pathology. The key steps are identifying key local anatomical structures such as the facial vein and preserving nerves that provide sensation, taste, and movement of the lower lip, and tongue. The gland is removed in entirety. Frequently a drain will be placed in the wound for a day, and the wound will be closed with dissolving sutures.