Recurrent intraoral access to the submandibular gland. An uncommon aesthetic approach

Recurrent sub-maxillary gland disorders are relatively common. They are mainly caused by obstructive gland diseases. Other aetiologies are malignancies, autoimmune, or degenerative diseases. The traditional treatment of the submandibular gland is the surgical excision by a cervical approach. The advantages of this approach are: its simplicity, direct surgical vision, and speed of the procedure. The most important disadvantages are: unsightly cervical scar, and injury risk of the marginal branch of the facial nerve.

This paper presents and discusses the intraoral approach to the submandibular gland. The advantages over the conventional approach are: the elimination of the scar and the risk of injury to the marginal branch. The main disadvantages are: the technical difficulty, reduced vision, the longer surgical time, and the possibility of lingual nerve injury.

A total of 6 patients, 4 women and 2 men aged 25–60 years, underwent a sub-maxillectomy by intraoral approach in the Hospital Universitario de Canarias (Tenerife, Spain). In all cases, the aesthetic and functional results were very satisfactory, with only mild self-limited lingual nerve dysesthesia being observed at two months.

We present an alternative to the cervical approach for the submandibular glands; the intraoral approach. The major advantage of this technique is to eliminate the cervical scar.