Partial Submandibular Gland Resection With Ultrasonic Dissector vs Electrocautery.

Abstract

Background: The superficial aspect of the submandibular gland can be removed to improve the aesthetic appearance of the face and neck. This study describes a novel surgical technique to resect part of the submandibular gland during a deep neck or facelift.

Objectives: Describe the technique to remove the superficial lobe of the submandibular gland using an ultrasonic dissector. Analyze the association between the uses of ultrasonic technology and reduced postoperative complications. Compare rates of postoperative complications between standard electrocautery and ultrasonic dissection.

Methods: Experimental and control groups were established. A Sonicision ultrasonic dissector (Covidien, Dublin, Ireland) was used for resection in the experimental group, whereas electrocautery was used for resection in the control group. Postoperative outcomes of neuropraxia, hematoma, seroma, and sialocele formation were collected. Statistical analysis was performed using a Fisher's exact test in RStudio.

Results: Control patients (n = 32) experienced 1 hematoma, 3 seromas, 3 sialoceles, and 3 neuropraxias. Experimental patients (n = 48) experienced 2 seromas with no hematomas, sialoceles, or neuropraxia. No association of statistical significance between reduced risk of complications and use of ultrasonic dissection was found.

Conclusions: This novel technique has the potential to improve the safety and efficacy of partial submandibular gland resection. However, a follow-up study with a greater sample size and without confounding variables, such as intraoperative injection of Botulinum toxin, is necessary.

Level of evidence 3: (Therapeutic).