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Excision Submandibular Gland
Procedure
A blocked submandibular gland is a benign floor of mouth process (similar to a benign cyst), which results from an obstructed salivary gland. Typically, blocked submandibular glands are removed through a 5 cm (2 1/2 inches) incision in the submandibular crease (neck). The blocked area as well as the submandibular gland is removed to prevent recurrence. You will have general anesthesia so you will be asleep for the surgery. You will have a drain that the nurses will monitor and empty. This procedure requires that you be observed for approximately one day in the hospital. You will receive IV fluids until you can maintain your hydration needs. As soon as the drainage is minimal, the drain will be removed. You will have steristrips (little bandaids) on your incision line, which must be kept intact for two weeks.
Risks
As with any surgical procedure certain risks must be discussed before obtaining surgical consent.
Bleeding
Some bleeding is expected with any surgery, however abnormal postoperative bleeding occurs in about 1% of cases. If it does occur, bleeding usually occurs within the immediate postoperative period. Hematoma, a collection of blood under the skin, is caused by a break in a blood vessel, and is drained at the hospital.
Infection
Infection is rare due to the excellent vascularity of the tissues. A prescription for preventative antibiotics is provided for use in the postoperative period.
Fistula
A fistula is a leak from the oral cavity through the skin of the neck. This is usually a temporary condition and can be treated with rinsing and medication.
Neuroma or Seroma
A neuroma, a bundle of nerve endings, can develop as a result of surgery. This would present as hypersensitivity in the surgical area. These take years to develop and can be removed if they persist. If a seroma (a collection of tissue fluid) develops, it can be drained in the office.
Numbness or Weakness
The lingual nerve is identified and protected. Typically the lingual nerve is not involved in the excision of the submandibular gland, but still it is a risk. If there is numbness of the lingual nerve resulting from damage to the lingual nerve, it will present as numbness to the teeth, tongue and lip if harmed. If the facial nerve is stretched, weakness of the lower lip may present as a temporary or permanent risk. This side effect is most commonly temporary due to surgical swelling or stretching of the nerve.
Anesthesia
Complications from anesthesia are known to exist. These complications (anything from nausea to stroke or death) are quite uncommon since patients are usually young and healthy.
Pre-Operative Instructions:
- Nothing to eat or drink after midnight the evening prior to your surgery. This includes all foods, liquids, water, candy, mints or gum. You may brush your teeth the morning of surgery. Your procedure will be cancelled if you do not follow these instructions.
- Notify us of all routine medications and significant health history. Take medications as directed with just a sip of water.
- Please avoid aspirin, ibuprofen or any products containing these medications for one week prior to your surgery. If you are on any medications that affect bleeding, please notify the nurse at this time.
- Do not bring valuables (cash, credit cards, jewelry) to the Surgery Center.
- Remove all make-up and nail polish prior to arriving at the Center.
- Please contact the hospital on the business day prior to your surgery to confirm your arrival time.
Post-Operative Instructions
Written post-operative instructions will be provided at the time of hospital discharge.
Diet
When the procedure is completed and the effects of the anesthesia have worn off, you may be started on clear liquids, advancing to a full diet as tolerated. Take care to avoid extremely hot beverages or food.
Medications
While in the hospital, postoperatively you may be given Peridex rinse for oral care. Prescriptions, which will be given to you at the time of discharge, may include preventative antibiotics and a pain medication. Patients who have undergone this procedure have stated that any discomfort is well managed by the prescription pain medications provided.
Activity
Please avoid any heavy lifting, bending or straining for two weeks following surgery. You may shower as long as you keep the steristrips dry. You may brush your teeth with care.
For an emergency please call our professional answering service at 585-258-4840.
Please notify the office 585-256-3550 for any concerns. We are here to help in any way we can.
Dr. John U. Coniglio and Staff
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