The submandibular gland is one of the salivary glands that sits just below the jawline. There is one submandibular gland on either side of the jaw. The submandibular duct conveys saliva from the gland to the submandibular opening (submandibular papilla) in the mouth, under the tongue.
The submandibular gland may become enlarged for various reasons. The most common cause is the presence of a stone in the submandibular duct. The stone causes mechanical obstruction of the salivary duct, causing recurrent glandular swellings during or after meals, or may cause bacterial infections accompanied by fever, purulent discharge at the papilla and painful glandular swelling. Other causes of enlarged submandibular glands include benign or malignant tumours of the gland.
If your submandibular gland is enlarged, your doctor may recommend its removal, depending on how much trouble it is causing you or if the cause of the enlargement requires treatment.
The procedure is usually carried out under a general anaesthetic. An incision is made and curved along the lower aspect of the jaw, approaching the midline of the neck. The length of the incision is approximately 4-6 cm. The gland is carefully dissected out and removed, together with part of the submandibular duct and any stones it may contain. A drain will be inserted into the operative site and this usually remains in place for 24 hours, depending on the amount of drainage.
The submandibular gland lies next to important nerves that pass close by and the surgeon will take every precaution to avoid damage to these nerves. The nerves include the nerve that supplies the muscles of your lower lip, the nerve that supplies sensation and taste to your tongue, as well as the nerve that controls the movements of the tongue. Any damage sustained to these nerves is usually temporary and function tends to return after the swelling in the area has subsided. However, as with any operation the risk of permanent damage though small is possible and the patient should be aware of this if he/she decides to go ahead with surgery.
There might be a moderate degree of discomfort following the operation but this is easily controlled with some painkillers. Most patients are able to go home one or two days after the operation.
Please note that the details in this section are for general information only. You should always discuss the risks, limitations and complications of your specific operation with your surgeon.