European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 4, pp 1441–1446 | Cite as

Submandibular gland excision: long-term clinical outcome in 139 patients operated in a single institution

  • Line Kanstrup SpringborgEmail author
  • Martin Nue Møller
Head and Neck


In transcervical resection of the submandibular gland for benign lesions, only a limited risk of damage to neural structures can be accepted and a cosmetically satisfactory result is mandatory. In this retrospective case series, we evaluated 139 patients operated over a 10-year period and completed long-term clinical follow-up of 113 of these patients after a median of 81 months. In all patients, the operation was effective. We found a 4.3 % risk of reoperation for wound infection or postoperative hematomas and an 18.7 % risk of early paresis of the marginal branch of the facial nerve, which decreased to 2.7 % on long-term follow-up. We found a 4.4 % risk of permanent lingual nerve paresis, and no patients had damage to the hypoglossal nerve. Xerostomia was found in 22.1 % of the patients and could be quantified by the easily performed biscuit test. Only 2.5 % reported an unsatisfactory cosmetic result and all scars were ≤6 on the Vancouver Scar Scale. Problems with scarring were more common if there had been postoperative infection. We continue to use the lateral transcervical approach as standard in our institution for patients who cannot be managed by gland-sparing procedures.


Submandibular gland excision Surgical outcome Benign lesions 


  1. 1.
    Hald J, Andreassen UK (1994) Submandibular gland excision: short and long-term complications. ORL J Otorhinolaryngol Relat Spec 56(2):87–91PubMedCrossRefGoogle Scholar
  2. 2.
    Winkel R, Overgaard TI, Balle VH, Charabi S (2000) Surgical results of submandibular gland excision. Ugeskr Laeg 162(40):5354–5357PubMedGoogle Scholar
  3. 3.
    McGurk M, Makdissi J, Brown JE (2004) Intra-oral removal of stones from the hilum of the submandibular gland: report of technique and morbidity. Int J Oral Maxillofac Surg 33(7):683–686PubMedCrossRefGoogle Scholar
  4. 4.
    Milton CM, Thomas BM, Bickerton RC (1986) Morbidity study of submandibular gland excision. Ann R Coll Surg Engl 68(3):148–150PubMedGoogle Scholar
  5. 5.
    Rallis G, Mourouzis C, Zachariades N (2004) A study of 55 submandibular salivary gland excisions. Gen Dent 52(5):420–423PubMedGoogle Scholar
  6. 6.
    Ichimura K, Nibu K, Tanaka T (1997) Nerve paralysis after surgery in the submandibular triangle: review of University of Tokyo Hospital experience. Head Neck 19(1):48–53PubMedCrossRefGoogle Scholar
  7. 7.
    Preuss SF, Klussmann JP, Wittekindt C, Drebber U, Beutner D, Guntinas-Lichius O (2007) Submandibular gland excision: 15 years of experience. J Oral Maxillofac Surg 65(5):953–957PubMedCrossRefGoogle Scholar
  8. 8.
    Kukuckova B, Svec M (2011) Surgical management of submandibulary gland diseases: 10 years of experience. Bratisl Lek Listy 112(5):264–268PubMedGoogle Scholar
  9. 9.
    Vercelli S, Ferriero G, Sartorio F, Stissi V, Franchignoni F (2009) How to assess postsurgical scars: a review of outcome measures. Disabil Rehabil 31(25):2055–2063PubMedCrossRefGoogle Scholar
  10. 10.
    Sullivan T, Smith J, Kermode J, McIver E, Courtemanche DJ (1990) Rating the burn scar. J Burn Care Rehabil 11(3):256–260PubMedCrossRefGoogle Scholar
  11. 11.
    Beahm DD, Peleaz L, Nuss DW, Schaitkin B, Sedlmayr JC, Rivera-Serrano CM et al (2009) Surgical approaches to the submandibular gland: a review of literature. Int J Surg 7(6):503–509PubMedCrossRefGoogle Scholar
  12. 12.
    Marchal F, Dulguerov P, Becker M, Barki G, Disant F, Lehmann W (2002) Submandibular diagnostic and interventional sialendoscopy: new procedure for ductal disorders. Ann Otol Rhinol Laryngol 111(1):27–35PubMedGoogle Scholar
  13. 13.
    Møller MN, Sørensen CH (2012) Risk of marginal mandibular nerve injury in neck dissection. Eur Arch Otorhinolaryngol 269(2):601–605PubMedCrossRefGoogle Scholar
  14. 14.
    Cunning DM, Lipke N, Wax MK (1998) Significance of unilateral submandibular gland excision on salivary flow in non-cancer patients. Laryngoscope 108(6):812–815PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Line Kanstrup Springborg
    • 1
    Email author
  • Martin Nue Møller
    • 1
  1. 1.University Clinic of Oto-rhino-laryngology, Head and Neck SurgeryCopenhagen University Hospital RigshospitaletCopenhagenDenmark

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