Disorders of the salivary glands
Christopher Bulstrode, B.V. Praveen in MCQs and EMQs in Surgery: A Bailey & Love Companion Guide, 2010
The submandibular gland consists of two lobes which communicate around the posterior border of mylohyoid. The gland is drained by the submandibular duct, which drains against gravity up to the sublingual papilla in the floor of mouth. The facial vessels are closely related to the gland. On the glands’ deep surface, the lingual and hypoglossal nerves are in close proximity. The marginal mandibular nerve is also at risk during surgery on the gland, due to its position in relation to the skin incision. The inferior alveolar nerve enters the mandible and is protected during surgery on the submandibular gland (see Fig. 47.3).
1 Submandibular, sublingual and minor salivary gland surgery
John Langdon, Mohan Patel, Peter Brennan in Operative Oral and Maxillofacial Surgery Second edition, 2011
Open surgical biopsy of a suspected submandibular gland tumour is contraindicated. If the tumour is contained within the capsule of the gland, open biopsy will spill tumour cells into the surrounding tissue planes. As the majority will be benign pleomorphic adenomas, their simple excision will be compromised. If the tumour is malignant, then the hope of cure will have been compromised. Fine needle aspiration biopsy appears to be safe but is unreliable in salivary gland pathology, but fine needle core biopsy is useful if available.
Salivary Gland Tumors
Dongyou Liu in Tumors and Cancers, 2017
Tumors of the salivary glands comprise a heterogeneous group of neoplasms with more than 24 different histologic subtypes. The salivary glands are relatively small organs involved in the making of saliva, which is composed of water, electrolytes, digestive enzymes, proteins, and metabolic wastes. Risk factors for salivary gland tumors include exposure to ionizing radiation, rubber product manufacturing, asbestos mining, plumbing, and woodworking. Patients with salivary gland tumors often present with a lump in the area of the ear, cheek, jaw, lip, or inside the mouth; trouble swallowing; drainage from the ipsilateral ear, dysphagia, and trismus; facial paralysis; and persistent facial pain. Complete surgical resection and/or radiotherapy represent the current mainstay treatment options for salivary gland tumors. Early stage tumors in the parotid gland can be usually treated by surgery alone and have a more favorable prognosis than those in the submandibular gland and the sublingual and minor salivary glands.
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
Background: We aimed to preserve parotid function in patients with buccal carcinoma by applying a new surgical protocol based on reconstruction of parotid ductal defect with submandibular gland ductal. Aims/Objectives: The aim of this study is to introduce the method of autologous submandibular gland duct reconstruction for the treatment of parotid duct defect in buccal carcinoma, and to evaluate its clinical application in follow-up. Material and methods: A total of 28 patients with buccal carcinoma who underwent buccal and neck combined with radical surgery and vascularized flap transplantation were enrolled. Function of the reconstructed duct was reviewed in 6 months after surgery. Results: Both groups achieved good short-term results within 1 month after surgery. The 6-month postoperative angiography examination of the submandibular gland duct showed that 6% of patients in the submandibular gland duct graft group had a blockage or was not smooth. At the same time, 45% of the patients in the vein graft group had failure or obstruction, and the VAS score of pain was higher than that of the submandibular gland ductal graft group (p
Metastasis to the submandibular gland in oral cavity squamous cell carcinomas: Pathologic analysis
Published in Acta Oto-Laryngologica, 2009
Hyung Kwon Byeon, Young Chang Lim, Bon Seok Koo, Eun Chang Choi
Conclusion. This study demonstrates that the incidence of submandibular gland metastasis in oral cavity squamous cell carcinoma (SCC) is extremely rare and its involvement is through direct extension from a primary lesion. Therefore, if the primary lesion of the oral cavity carcinoma is not in close proximity and hence does not provide suspicion of direct extension, it may be safe to preserve the submandibular gland. Objectives. Radiotherapy may lead to injury to the salivary glands resulting in xerostomia. This study aimed to determine whether and how the submandibular gland is involved in metastases of SCC of the oral cavity and to provide an oncological basis for preservation of the submandibular gland. Patients and methods. This study reviewed the records and pathologic specimens of 201 patients who were diagnosed as having oral cavity SCC and underwent surgery at our institution, from 1991 to 2006, and pathologic metastasis to submandibular gland was evaluated. Results. In all, 44 cases (21.9%) were found to show ipsilateral level I metastasis on pathologic examination. Only two cases (1%) had carcinoma involvement in the submandibular gland. Both these two cases had direct extension from a primary lesion (retromolar trigone and floor of mouth) and no submandibular glands showed pathologic evidence of isolated metastasis or local extension of metastatic lymph nodes.
Expression and Localization of Hepatocyte Growth Factor in Rat Submandibular Gland
Published in Growth Factors, 1994
Osamu Amano, Kunio Matsumoto, Toshikazu Nakamura, Shoichi Iseki
By combination of in situ hybridization and immunohistochemical techniques, the expression of hepatocyte growth factor (HGF) was demonstrated in the submandibular gland of rats. Both the mRNA signal and immunoreactivity for HGF were localized exclusively to the epithelial cells of granular convoluted tubules, whereas they were absent from the other components of the submandibular gland. In the granular convoluted tubule cells, HGF-immunoreactivity was localized to the apical secretory granules, which was further substantiated by immunoelectron microscopy. These results added HGF to the list of many growth factors that are produced in the rat submandibular gland and secreted into the saliva.
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