Bhubaneswar: Surgeons in the Institute of Medical Sciences and SUM Hospital,
faculty of the SOA Deemed to be University here, have successfully removed the submandibular gland (SMG) in two persons using a new technique, which spared the patients from living with big scars on the face for the rest of their lives. Submandibular gland is one of the major three glands that provide the mouth with saliva. The two other types of salivary glands are parotid and sublingual glands.
“The recent advent of endoscopic procedures has prompted both ENT and head and
neck surgeons to reconsider the conventional methods by which the removal of SMG is classically achieved,” Dr. Radhamadhab Sahu,an expert in ENT and Skull Base surgery said.
Dr. Sahu, who conducted the surgery for the first time in Odisha, said humans have one
pair of submandibular gland in their body, that lies just below and in front of the lower jaw.
The main function of this particular gland is to secrete saliva, which helps to moisten and digest food.
If the saliva flow is obstructed due to formation of stone in the duct, it leads to enlargement of the gland and infection. Conventionally, SMG is removed by trans-cervical approach, which leaves a big scar on the face and sometime leads to lower lip
weakness.
“This latest technique is anatomically safe and can be done with minimal morbidity while a trans-cervical incision is avoided,” he said adding specific instruments and anatomical
knowledge with skills are needed to perform such a tricky endoscopic excision.
The surgical steps essential for the procedure included careful identification of the
Wharton duct and lingual nerve, retraction of the mylohyoid muscle, protection of
SMG and lingual nerve, extra oral manipulation of SMG, obtaining intra-oral protrusion and careful dissection of the posterior third of the gland while avoiding injury to the facial artery and vein.
The patients, who underwent the new surgery, were very pleased with the results since there were no complications, Dr. Sahu said adding that with availability of advanced endoscopic instruments, new surgical technique and experience of the surgeon, endoscopic intra-oral excision of SMG could be the method of choice in a variety of ailments.
