What is Submandibular Gland

The submandibular gland is one of the three major salivary glands(submandibular, sublingual, parotid). It is about the size of a walnut and located below the jaw on either side.

The submandibular salivary gland produces saliva. Saliva helps in lubrication, swallowing, and digestion of food.

What are Submandibular Gland Sidorders?

• SIALADENITIS- Infection in salivary gland
• SIALOLITHIASIS- Stones in salivary gland
• SIALADENOSIS- enlargement of the salivary gland
• VIRAL INFECTIONS-
• SJOGREN'S SYNDROME- Autoimmune disorder of Salivary glands and lacrimal glands. People with Sjogren's syndrome face problems related to teeth and gums due to dry mouth.
• BENIGN TUMOURS- Non-cancerous tumors
• MALIGNANT TUMOURS- Cancerous tumors
• CYSTS- Tiny fluid-filled sacs

Diagnosis of Salivary Gland Disorders-

• SIALOGRAPHY
• BIOPSY
• ULTRASOUND
• MRI SCAN
• CT SCAN
• FNAC
• BLOOD TEST
• X-RAY
• SALIVARY FUNCTION TEST
• EYE TEST

Treatment of Salivary Gland Disorders-

The treatment varies, depending upon the type of salivary disorder:

• Sialolithiasis. If the sialolith(stone) is located near the duct(Wharton's duct), your doctor may gently press it out. Deeper stones can be removed with surgery.
• Sialadenitis.

Treatment includes:

• Drinking fluids
• Intravenous fluids
• Antibiotics
• Warm compresses
• Chewing sour candies

If these methods don't work in curing the infection, surgery is the only option.

• Viral infections – These infections are mostly self-healed. Following methods relieve symptoms:
  o Taking rest
  o Drinking fluids
  o Taking medication to relieve pain and fever.
• Cysts. SMALL CYST- A small cyst may drain on its own without treatment. LARGE CYST- Larger cysts can be removed using surgery or laser treatment.
• Benign tumors- These are Noncancerous tumors and are removed surgically. In some cases, radiation therapy is given following surgery to prevent the
  recurrence of cancer.
• Malignant tumors – Small, early-stage, low-grade tumors can be treated with surgery alone. However, large, high-grade tumors require surgery followed by radiation therapy.
• Sjogren's syndrome- In Sjogren's syndrome, the salivary glands' main symptom is a dry mouth. Options include:
  o Medication(pilocarpine) to stimulate more saliva secretion.
  o Sugarless gum and candy help to stimulate saliva production.
  o Avoiding medications that can worsen dry mouth.
  o Avoid smoking (as smoking can worsen dry mouth)
  o Maintain good oral hygiene.
• Sialadenosis – Treatment is aimed at correcting any underlying cause. Once the underlying cause gets fixed, the salivary glands will shrink to standard size.

Submandibular Gland Surgery

INDICATIONS-

• Benign salivary gland tumors.
• Malignant salivary gland tumors
• Chronic sialadenitis
• Chronic sialolithiasis
• Ranula
• Sialorhoea(Drooling)

TWO WEEKS BEFORE SURGERY:
Avoid all non-steroidal anti-inflammatory drugs ("NSAIDs") because these medications may increase bleeding during surgery.

DAY BEFORE SURGERY-
You may eat a regular diet the day before surgery, but nothing will be taken after midnight. Clear liquids like water, tea can be taken up to four hours before surgery. If you are taking medicines, please check with your physician to see which should be continued.

Procedure-

• The procedure will be performed under general anesthesia.
• The surgeon will give an incision in a crease of your neck below your jawline.
• The surgeon will dissect the gland away from surrounding muscles, blood vessels, and nerves.
• The submandibular gland, along with the duct, is excised.
• The incision is closed with sutures.
• In most cases, a drain will be placed in the wound.

Generel Post-Operative Instructions/Care

• Activity: Light activity
• Diet: General diet as tolerated is recommended.
• Medicines: Pain medications and antibiotics are typically prescribed and are to be taken as directed.
• Bathing: Generally, showering is allowed 24 hours after the surgery, after the drain is removed, an incision is healed.
• Post-operative follow-up: Sutures may be removed a week after surgery. A post-operative follow-up is typically scheduled in about a week following surgery. Still, it may be scheduled sooner in case if you leave the hospital with a surgical drain in place.