Gastrointestinal tract and salivary glands
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
The parotid glands are the largest of the salivary glands and lie just below the zygomatic arch in front of, and below, the ear. The parotid duct (Stenson’s duct) is about 5 cm in length and runs forwards over the masseter muscle opening on the surface of a small papilla on the inner surface of the cheek, opposite the second upper molar tooth. The submandibular glands are paired and lie on either side of the neck, forming part of the soft tissues on the medial margin of the mandible, between the body of the mandible and the hyoid bone. The submandibular duct (Wharton’s duct) is about 5 cm in length and runs forward, medially and upwards, beneath the mucous membrane of the floor of the mouth and opens at a small papilla at the base of the frenulum of the tongue. The two sublingual glands are the smallest of the salivary glands and lie on the anterior part of the floor of the mouth, on the surface of the mylohyoid muscle. The glands secrete directly into the oral cavity through multiple ducts (ducts of Rivinus), which may open adjacent to the frenulum of the tongue or may join to form a single duct (Bartholin’s duct) that empties into the submandibular duct.
Drooling and Aspiration
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
Another common complication from submandibular duct transfer is swelling of the submandibular gland, which may be transient or persistent. It occurs in 2–22% of cases59,60,61 and the gland may need to be excised if the swelling is troublesome. Careful handling to prevent injury or twisting of the duct during surgery helps to reduce the incidence. Dry mouth is rare in most series but has been reported to occur in 10% by one author who also reported dental caries in 3% after surgery.29 Aspiration pneumonia after surgery can be disastrous but should be rare if patient selection has been appropriate and aspiration excluded, although it certainly does still occur.62,63 Tongue swelling, lingual nerve injury and troublesome bleeding have also been reported.62
Submandibular, sublingual and minor salivary gland surgery
John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan in Operative Oral and Maxillofacial Surgery, 2017
The submandibular salivary gland can now be pulled downwards revealing the V-shaped lingual nerve (Figure 44.15). The apex of the V is the point at which the parasympathetic fibres tether the lingual nerve to the salivary gland. Occasionally, the sublingual ganglion can be identified on the surface of the gland. It is very important to identify the V of the lingual nerve and its parasympathetic fibres as the latter must be transacted to free the gland. As these fibres are cut, the lingual nerve springs upwards. Finally, the submandibular duct is clamped, divided and ligated as far forward as possible with just enough remaining to drain the sublingual gland. A thin layer of loose connective tissue remains in the gland bed overlying the hypoglossal nerve (Figure 44.16).
Preliminary application and evaluation of autograft reconstruction of parotid duct defect with submandibular gland duct for buccal cancer
Published in Acta Oto-Laryngologica, 2020
Ruohuang Lu, Zhiqiang Xiao, Xincheng Guo, Pingping Gan
Group B (submandibular gland duct transplantation group): In the radical surgical treatment of buccal cancer, the submandibular gland duct is separated into the sublingual gland in the cervical lymphatic submandibular triangle. Where the end of the duct separates into the submandibular gland, we separate 3 to 4 cm of the duct for reconstruction. The duct is placed in physiological saline, and after the buccal tumor is removed, the reconstructed flap is sutured to the lower edge of the buccal defect, the length of the parotid duct defect is measured, and the epidural catheter is inserted into the submandibular duct according to the defect length. At the end, the submandibular gland duct and the parotid duct are sutured with an 8-0 suture line for 4 to 6 times. Finally, the submandibular gland duct is fixed obliquely to the lower part of the oral cavity as previously mentioned, and the epidural catheter is fixed to the oral mucosa.
A critical review of incobotulinumtoxinA in the treatment of chronic sialorrhea in pediatric patients
Published in Expert Review of Neurotherapeutics, 2021
Wolfgang H. Jost, Armin Steffen, Steffen Berweck
Submandibular duct ligation was more effective than submandibular injection of onabotulinumtoxinA for reducing measures of drooling in one randomized study in 53 children, although the BoNT/A injections were associated with fewer adverse events and complaints [19]. Prospectively collected data from a single center study showed that drooling was reduced by both onabotulinumtoxinA (n = 5) and rimabotulinumtoxinB (n = 11) when injected into the submandibular and parotid glands, but reductions were greatest with the botulinum neurotoxin B formulation [54]. However, in a randomized parallel-group trial comparing these botulinum formulations in 30 children with neurological disorders, both were similarly effective for reducing drooling at 4 weeks after the first injection and following repeated injections [53].
Related Knowledge Centers
- Genioglossus
- Hyoglossus
- Mouth
- Muscle
- Mylohyoid Muscle
- Parotid Duct
- Sublingual Gland
- Submandibular Gland
- Saliva
- Salivary Gland