Surgery for Submandibular Gland Diseases: 14-years of Experience of a Single Tertiary Center

Abstract

Objective: Surgical removal is a valid option in the treatment of submandibular gland diseases but there are still operative and diagnostic pitfalls. We aimed to review and investigate the long-term clinical, surgical, and pathologic outcomes of our cases that had undergone submandibular gland removal. Materials and Methods: Retrospective analysis was conducted on patients who underwent submandibular gland excision via the transcervical approach with minimal skin incision between January 2007 and April 2020. Demographic data, preoperative FNA cytology results, clinical findings, surgical procedure, postoperative histopathological diagnosis, and postoperative morbidity were reviewed and analyzed. Results: 66 patients (41.7%) had sialolithiasis, 47 patients (29.7%) had chronic sialadenitis. Pleomorphic adenoma was found in 30 of the 44 patients that been operated on for submandibular mass. Gland derived carcinoma was found in 9 patients. The sensitivity of FNA biopsy in our case series was 83.3% (10/12), specificity was 78.1% (25/32), positive predictive value was 71.4% (10/14), and the negative predictive value was 96.1% (25/26). Permanent facial nerve marginal mandibular branch palsy was found in two patients (1.2%). Conclusion: The transcervical approach to the submandibular gland offers safe and reliable removal of the submandibular gland with a minimal risk of complications. FNA cytology was found to be useful in the preoperative evaluation of the submandibular masses.