Submandibular gland excision

The Submandibular gland is a gland that produces saliva. It's located under the jaw line. The gland sometimes needs to be removed, due to an obstruction, repeated infections, or a growth in it.

There are risks and complications with this procedure. They include but are not limited to the following.

General risks

• Infection can occur, requiring antibiotics and further treatment.
• Bleeding could occur and may require a return to the operating room.
• Small areas of the lung can collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
• Increased risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
• Heart attack or stroke could occur due to the strain on the heart.
• Blood clot in the leg (DVT) causing pain and swelling. In rare cases part of the clot may break off and go to the lungs.
• Death as a result of this procedure is rare but possible.

Specific risks

• Facial weakness or paralysis. The nerve controlling the muscles of the lower lip travels close to the submandibular gland and may be injured temporarily or permanently. This results in weakness or paralysis of the lower lip on that side which may be permanent. A tumour that is cancerous, may invade the nerve requiring the nerve to be divided or cut to ensure removal of the cancer
• Tongue paralysis. The nerve controlling the muscles of the tongue travels close to the submandibular gland and may be injured temporarily or permanently. This results in weakness or paralysis of the tongue on that side which may be permanent
• Taste change, pain and / or numbness of the tongue. The nerve controlling tongue sensation and taste travels close to the submandibular gland and may be injured temporarily or permanently. This may result in numbness or pain of the tongue on that side which may be permanent. There may also be taste change which usually improves but which may be permanent.
• A salivary stone may be left behind. This may need further surgery.
• Bleeding. This may result in the formation of a blood clot (hematoma) in the wound, which will require another operation to remove it.
• Wound infection. This may require treatment with antibiotics.
• Abnormal scar tissue formation (keloid). This may result in a wide thickened red scar or an unsightly scar, which may require further surgery.
• Salivary fistula or leakage of saliva through the wound. This usually settles but may require further surgery.
• Numbness/discomfort in sensation to skin on the side of the neck extending to the lip. This is usually temporary but may be permanent.