SUBMANDIBULAR GLAND SURGERY
Xavier and friends who are interested in the submandibular gland surgery, I will briefly explain what this surgery is about and why a person should have surgery to remove the gland.
Las glándulas submaxilares están situadas inmediatamente debajo de la mandíbula, mucha gente confunde estas glándulas con ganglios del cuello y vienen a la consulta un poco asustados por tener unos ganglios grandes desde hace mucho tiempo. The submandibular glands are located just below the jaw. Many people get confused and take submandibular glands for swollen lymph nodes in the neck and come a little scared to the consulting room about having a large lymph for a long time. The main cause of the removal of the submandibular gland is due to LITIASIS SUBMANDIBULAR, which is the same as the formation of stones inside the gland. Why these stones are formed is still unclear but it seems possible that the diet and the high in minerals water intake could favor this condition. When a person has a stone in the submandibular gland is not always necessary to operate, sometimes it can be extracted through Wharton's duct, that carries the saliva from the gland to the mouth (under the tongue) or an endoscopy can be made through this conduit. But sometimes, when this is not possible and the person has recurrent infections, surgical removal of the gland is required.
There are other causes that can make the removal of the submandibular gland necessary, such as tumors, the vast majority benign, that can appear in the gland. The most common of these tumors is the mixed tumor or pleomorphic adenoma, but although this tumor is benign, surgery should be performed because it might become malignant overtime.
GLAND'S SURGICAL TECHNIQUE
Removing the submandibular gland must be performed under general anesthesia , with a 4-5 cm incision in the neck, under the jaw. The surgical technique is not complicated but two major complications can occur, but it is unlikely. The first is bleeding. Surrounding the submandibular gland there is the facial artery supplying blood to the face and sometimes this artery or one of its branches may bleed. This complication, usually is not important, but requires a reoperation. The second complication is the injury of one of the branches of the facial nerve that is responsible for moving the lip, therefore its injury would mean lip paralysis in the same side lower lip.
To avoid this complication, it is very helpful to use magnifying loupes to better identify the nerve and the use of a Neurostimulator to stimulate the nerve without any risk.