Transoral Submandibular Gland Excisions: Avoiding the Unsightly Neck Scar in Select Patient Populations.

Background: Submandibular gland (SMG) excision is traditionally performed using a transcervical approach, which, although effective, carries risks such as visible neck scarring and nerve complications. The transoral approach presents a cosmetically favorable alternative, yet its adoption remains limited. This case series was done to evaluate the safety, efficacy, and complication profile of the transoral approach for SMG excision in patients with benign pathologies.

Methods: This retrospective case series was conducted at a single tertiary-care institution and included 30 patients who underwent transoral SMG excision between the ages of 7 and 80 years, performed by a single surgeon. Patients included in the case series had benign conditions such as chronic sialadenitis, ranulas, and a pleomorphic adenoma. Outcomes of interest included conversion to open surgery, avoidance of cervical scarring, intraoperative duration, and postoperative complications.

Results: All 30 patients avoided a transcervical incision and no conversions to an open approach occurred. The average operative time was 95 min, transient tongue paresthesias occurred in three patients, resolving within 6 weeks. No cases of hypoglossal or marginal mandibular nerve injury were observed. Two postoperative infections were recorded, one of which required hospitalization and intravenous antibiotics. No hematomas or seromas were identified.

Conclusion: The transoral approach for SMG excision is a viable, cosmetically favorable alternative for select patients with benign glandular disease.