Located just along the underside of the jaw, on either side of the neck, are the submandibular glands. These glands are responsible for producing saliva and are susceptible to a variety of maladies, ranging from more manageable infections to the presence of stones. Benign tumors and cancer are also common diseases affecting the submandibular gland.
The severity of the disease or infection is diagnosed through both observation, palpation, and tests including x-ray or CT exam. When antibiotics and other methods of treatment, including minimally invasive sialoendoscopy and laser treatment for breaking up salivary stones, is not able to fully resolve the issue, it may be necessary to recommend a course of treatment for any one of these diagnoses that result in the need for removal of the gland.
Like most outpatient surgeries, the patient will have been given a list of directives for preparation before the surgery. The patient checks in early the morning of the surgery at the medical center where the resection is taking place. Once the patient is in the administrative system, they are prepped for the procedure, including the administration of general anesthesia. Nurses, who are assigned to the patient for the duration of their stay, will handle going over and recording patient history, write down the results of any vitals that need to be taken, make careful note of medications the patient is currently taking and any medications the patient is allergic to, and start an I.V. to administer saline and other medications, as needed. The operating physician will visit briefly with the patient to perform a cursory exam, reverify where the surgery is to take place, and often highlight the area with a marker.
Once the patient is taken into the operating room, sedation will take place. The surgeon will make a small incision in the neck, usually horizontal to the jaw line. Once the patient’s skin has been opened to reveal the inner structures of the neck, the submandibular gland is identified just under the jaw. The surgeon will proceed with the resection using careful, precision strokes with a thin blade to free the gland and as much of the surrounding tissue as has been deemed necessary. The resulting wound is thoroughly cleaned and stitches are used to close the skin with minimal scarring.
After surgery, the patient is taken to recovery where they will stay until the effects of the anesthesia have worn off well enough that they can safely move about and dress themselves. A family member or friend will have accompanied the patient and is responsible for driving the patient home after discharge, usually just a few hours after surgery when things have gone smoothly, with no unexpected complications. The patient will finish recovering at home, finishing any antibiotics or other prescriptions they have been given and will return for scheduled follow-ups at a time deemed appropriate by his or her doctor.
Because of the relatively uncomplicated and straightforward nature of the submandibular gland resection, both surgeon and patient should be confident that there will be no lasting effects, barring unforeseen complications in medication, anesthesia, or recovery.