Excision Submandibular Gland
Obstruction to the flow of saliva most commonly occurs in the parotid and submandibular glands, usually because stones have formed. Symptoms typically occur when eating. Saliva production starts to flow, but cannot exit the ductal system, leading to swelling of the involved gland and significant pain, sometimes with an infection. Unless stones totally obstruct saliva flow, the major glands will swell during eating and then gradually subside after eating, only to enlarge again at the next meal. Infection can develop in the pool of blocked saliva, leading to more severe pain and swelling in the glands. If untreated for a long time, the glands may become abscessed.
Typically, the blocked submandibular glands are removed through a 5cm incision in the submandibular crease (neck). This procedure is done under general anesthesia. You will have an incision and a drain in place after surgery. The nurses at the hospital will assist you with drain care. The drain will be kept in place until there is minimal drainage.
Risks
As with any surgical procedure, there are some risks involved in the excision of a submandibular gland. The risks and complications include:
- Bleeding
- Infection
- Hematoma
- Fistula (a leak from the oral cavity through the skin of the neck)
- Neuroma or Seroma
- Numbness or Weakness
- Complications due to anesthesia (The anesthesiologist will discuss this with you prior to your surgery).
Before the Procedure
- Nothing to eat or drink after midnight the evening before the procedure. This includes all food, liquids, water, candy, mints or chewing gum. You may brush your teeth. You will not be able to undergo the surgery if you do not follow these instructions.
- Please notify us of any medications and dosage (including insulin) or allergies you may have. You will be informed of which medications you can take on the day of surgery with a sip of water.
- A week before the surgery, please avoid aspirin, aspirin-containing products, ibuprofen (Advil, Motrin, Aleve) or Vitamin E. Please notify our office if you are on any medications that affect bleeding, such as coumadin or warfarin. Please call our office if you have any concerns about any medications. (585-342-2080)
- Remove all make-up, jewelry, nail polish, and artificial nails before surgery.
- Do not bring valuables to the hospital (cash, credit cards, watches, jewelry, etc.).
After the Procedure
You will be in the hospital for at least one day after your surgery. The hospital may give you additional post-operative instructions upon discharge.
Activity: Avoid any strenuous activity for two weeks following surgery (NO lifting, bending, or straining). You may shower as long as you keep the steri-strips over your incision dry.
Diet: Advance your diet as tolerated from clear liquids to a full diet. Drink as much fluid as you can to prevent dehydration. Avoid hot liquids and foods.
Wound Care: Keep your incision clean and dry. Instructions on drain care will be provided by the hospital if you are to go home with a drain.
Medications: For pain relief, use your pain medication as directed and as needed. Please notify our office if the pain medicine does not relieve your pain. You may also be given a prescription for antibiotics upon discharge from the hospital.
Follow-Up: Our office will notify you of the date and time of your follow-up appointment.
Please call our office at 585-342-2080 for any of the following:
- Trouble breathing or swallowing
- Coughing up blood or persistent bleeding (you may notice some slight blood tinged sputum, which is not uncommon)
- Fever above 101°F
- Pain that is not relieved by medicine.
- Redness, swelling, or drainage at your incision site
- Any other question or concern
If it is a medical emergency, please call 911.