Removal of Parotid, Submandibular, and Sublingual Glands

Department of Oral and Maxillofacial Surgery, Boston Medical Center, Boston University, Boston, MA 02118, USA.
Oral and maxillofacial surgery clinics of North America (Impact Factor: 0.58). 02/2012; 24(2):295-305, x. DOI: 10.1016/j.coms.2012.01.005
Source: PubMed


Surgical removal of the major salivary glands is a common task for the oral and maxillofacial surgeon. The major salivary glands have complex anatomic relationships with the surrounding neurovascular structures, and a thorough understanding of the surgical anatomy is essential for any surgeon involved in the management of salivary gland disease. This article reviews the indications, surgical anatomy, diagnostic evaluation, and surgical techniques for removal of the major salivary glands.

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    ABSTRACT: Wharton's duct is dissected in a retrograde direction from the orifice of the duct to the hilum of the submandibular gland when the gland is being excised conventionally. Here we describe an anterograde technique, in which Wharton's duct is dissected in an anterograde direction from the hilum of the submandibular gland to the orifice of the duct. This prospective clinical study included 50 consecutive patients with ranulas who had anterograde excision of the sublingual gland between May 2012 and January 2015. The intraoral incision was similar to that for conventional excision. Wharton's duct and other important anatomical structures located in the space behind the sublingual gland were all identified at the beginning of the procedure, followed by anterograde dissection of Wharton's duct. After the glandular tissue lateral to the duct had been incised completely, the duct was exposed and the gland cut into two parts. Finally, the two parts were removed, and the ranula ruptured. The patients were followed up was from 6 months-2 years. There were no complications. Anterograde excision of the sublingual gland is based on the anatomy, and this reduces the risk of complications after removal of a ranula. © 2015 The British Association of Oral and Maxillofacial Surgeons.
    No preview · Article · Jan 2016 · British Journal of Oral and Maxillofacial Surgery