Consultant ENT, Head and Neck and Thyroid Surgeon

Submandibular Gland Excision

What is the submandibular gland?

The submandibular glands are a pair of salivary glands under the jaw bone. Each gland produces saliva which goes through a long duct to its opening under the tongue at the front of the mouth. The production of saliva increases when we eat. The saliva secreted by the submandibular gland is a bit thicker than that produced by other salivary glands. Because of its thickness this saliva can sometimes form little stones.

What problems can you have with the submandibular gland?

The commonest problem is blockage of the salivary duct. This can be caused by the presence of stones or simply a narrowing of the salivary duct. Blockage of the salivary duct can cause a painful swelling of the gland when you eat. Sometimes the swelling may settle on its own. When the blockage is severe, it can lead to persistent inflammation of the gland.
Occasionally, a painless lump may develop within the submandibular gland. Those lumps are often benign but need thorough checking, as up to half of them may be or become cancerous. Even benign lumps can get gradually bigger.

What investigation are you likely to have?

An X-ray or CT scan of the submandibular gland:
This is to see if there are stones inside the gland or the duct.

Sialogram:
The doctor fills the duct at the front of the mouth with some contrast liquid and then takes x-rays. This will show up stones or narrowing inside the duct.

Ultrasound:
This test uses sound waves to detect any lumps inside the gland.

Fine needle aspiration:
This can help to find out the nature of the lump. The doctor uses a fine needle to draw some cells out from the lump. The cells are sent to the laboratory for analysis.

Why operate on the submandibular gland?

If stones inside the duct do not come out, the gland may swell up when you eat. These stones can be removed. This procedure is done through the mouth either under a local or general anaesthetic. Your consultant will discuss the options with you.
If stones are stuck inside the submandibular gland, the gland can become permanently inflamed and swollen. If it gives you undue discomfort over a longer time, your specialist may advise to have the gland removed.
If a lump has developed in the submandibular gland, your surgeon may recommend removing the gland. As a fairly high number of submandibular lumps can be cancerous the whole gland should be removed. By removing the gland we can find out whether it is benign or cancerous.