Navigating Submandibular Gland Surgery: What to Expect

The submandibular gland, located beneath the jaw, plays a vital role as one of the body’s main salivary glands, responsible for producing saliva that aids in digestion and oral health. It’s relatively common for lumps to develop in this gland; approximately 60% of these lumps are benign, while the remaining may be cancerous. These lumps often arise due to an overgrowth of cells within the gland, leading to noticeable swelling. Other times, a blockage from stones obstructing the gland’s ducts can cause painful swelling, infection, and impaired functionality in routine activities.

Diagnosis and Assessment of Submandibular Lumps

During the initial consultation, a comprehensive evaluation is performed, beginning with a detailed history and physical examination. In many cases, a fine needle aspiration (FNA) may be utilized, where a small needle is inserted into the gland to obtain a sample of cells from the lump. This sample is then analyzed under a microscope to assess whether the swelling is benign or malignant. If stones are suspected, an X-ray is commonly performed first to detect these obstructions. Additionally, more advanced imaging techniques, such as CT scans, MRI scans, or sialograms, may be required to gain a clearer understanding of the lump or blockage.

Treatment and Management

The course of treatment depends largely on the characteristics and diagnostic findings related to the lump. Removal of the lump is often recommended since the full nature of the swelling is best determined after the lump has been surgically removed and analyzed. Moreover, untreated lumps can continue to grow, becoming a cosmetic concern and potentially turning malignant over time. Larger, cancerous lumps present more complex surgical challenges and can complicate recovery.

Surgical Procedure for Submandibular Gland Removal

The standard surgical approach for submandibular gland removal involves excising the entire gland. This procedure is conducted under general anesthesia, ensuring that the patient is comfortable and unconscious throughout. An incision is made along a natural crease in the neck, situated well below the jawline to make any resulting scar minimally noticeable over time. At the conclusion of the surgery, a small drain is placed under the skin to prevent fluid accumulation, which is  Usually removed the following day, allowing the patient to return home.

Potential Complications of Submandibular gland surgery

While generally safe, the surgery does carry a few risks, primarily due to the proximity of sensitive nerves.

• Weakness of the Corner of the Mouth: The nerve responsible for movement at the corner of the mouth runs close to the gland and is at risk during the surgery. Damage to this nerve can lead to temporary or, rarely, permanent weakness, causing drooping at the mouth’s corner, which can be more noticeable when smiling. In most cases, this effect is temporary, with full recovery within a few weeks.
• Numbness and Stiffness of the Neck: Numbness and a stiff sensation around the neck are common postoperative symptoms that generally resolve on their own over a few months. Regular use of moisturizers or creams can help ease discomfort and improve skin suppleness around the scar.
• Blood or Saliva Accumulation: Postoperative blood or saliva may occasionally collect under the skin, leading to a hematoma. Although this is typically mild and absorbed by the body, in rare cases, a return to the operating room may be necessary to drain the collection.
• Altered Taste: The lingual nerve, essential for taste sensation, lies close to the submandibular duct and can be bruised during surgery, temporarily altering taste perception. Generally, this effect is temporary, with taste returning to normal in a few weeks.
• Tongue Weakness: Though very rare, damage to the nerve controlling tongue movement can occur, leading to weakness in the affected side of the tongue. As with other nerve-related symptoms, this typically recovers within a few weeks.

Post-Surgical Recovery and Self-Care

Recovery from submandibular gland surgery generally takes a few weeks, during which patients are encouraged to focus on gentle neck movements to avoid stiffness and maintain good circulation. Hydration is also key, as it supports the body’s natural healing process and prevents dryness in the area. While rare, any signs of infection—such as increasing pain, redness, or swelling—should be reported to a healthcare provider promptly.