View FLASH Surgery Presentation
Pictures of Stone in
Case Report #1
Case Report #2
Removal of the submandibular gland (also called the submaxillary gland) is a
relatively uncommon operation which is done for the following reasons:
Treatment of a benign or malignant
tumor. Most tumors of the submandibular gland are benign with the
most common being a pleomorphic adenoma. The submandibular gland
is the second most common location for a pleomorphic adenoma, the most
common being the parotid gland. Malignant tumors are rare
and have a poor prognosis, the most common is an adenocystic carcinoma.
Removal of large salivary gland
Salivary gland stones most commonly occur in the submandibular
gland's duct (Warthin's Duct) because of its more mucoid secretion and
uphill flow. Large stones are usually removed surgically.
Either an external
or intraoral approach can be used. In cases with
marked inflammation, an external approach gives better exposure and aids
in the preservation of nervous structures. Small stones,
less than 5 mm, can be extracted by dilation of the duct and the use of
Extracorporeal shock wave lithotripsy has been used to
remove stones with a median size of 6.76 mm .
al., found lithrotripsy most useful in the treatment of parotid stones
less than 7 mm.
Below is a presentation on the surgical
technique of removal. Usually this can be performed on an outpatient
basis. Complications include injury to various nerves:
Paralysis of the lower lip (injury to the marginal mandibular branch of
the facial nerve.
Lingual Nerve with numbness of the
tongue (loss of sensation of touch).
Paralysis of the tongue (injury to the hypoglossal nerve.
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