Recurrent canine cervical sialocele is most often caused by incomplete excision of the mandibular–sublingual gland complex, leading to anatomical distortion and concealment of residual tissue. This case describes the multimodal management of a repeatedly recurrent cervical sialocele in a young, small-breed dog following multiple previous revision surgeries. A stepwise bridging strategy was adopted before definitive salvage surgery. Oral phenobarbital was instituted, resulting in partial reduction in fluid accumulation and improved comfort. Ultrasound-guided intracavitary sclerotherapy with OK-432 was then performed, inducing a localized fibrotic response but without durable cure. Final resolution was achieved only after salvage ventral paramedian (VPM) sialoadenectomy, which provided wide exposure for complete excision of deeply concealed sublingual remnant tissue within a fibrotic pseudocapsule. Histology confirmed a cervical sialocele. Transient neuropraxia resolved within 3 weeks, and no recurrence was observed at 6 months postoperatively. To the authors’ knowledge, this is the first report describing intracavitary OK-432 sclerotherapy as part of a staged multimodal strategy for canine cervical sialocele. This case illustrates the feasibility of integrating medical salivary suppression and minimally invasive sclerotherapy as bridging measures before salvage VPM surgery for refractory cervical sialocele.

Re-examination of the juxta-oral organ in domestic chicken (Gallus gallus domesticus) using immunohistochemistry and micro-computer tomography techniques.

Pharyngeal sialoceles are a rare form of salivary mucocele in dogs and may present with upper airway obstruction. Limited data are available regarding their clinical presentation and optimal management. The objectives of this study were to describe the clinical signs, diagnostic findings, surgical treatment, and outcomes in six dogs with pharyngeal sialoceles. Medical records of six dogs diagnosed and/or surgically treated for pharyngeal sialoceles were retrospectively reviewed. Data collected included signalment, clinical signs, diagnostic procedures, surgical approach, and follow-up outcomes. Dogs ranged in age from 1.5 to 5 years (median 3.5 years), with a predominance of males (83%). Clinical signs included hypersalivation, cervical swelling, stridor, and dyspnea. Four cases were left-sided and two right-sided; three dogs had concurrent cervical sialoceles. Cytology confirmed the diagnosis in all cases. Radiography was performed in three dogs and computed tomography was performed in one. All underwent mandibular and sublingual sialoadenectomy via a ventral approach, with partial excision of the pharyngeal wall. No postoperative complications or recurrences were observed during follow-up (12-48 months). Pharyngeal sialoceles, while rare, should be considered in dogs presenting with upper airway signs. Complete surgical excision of the mandibular and sublingual glands, along with partial removal of the sialocele, appears to be effective and associated with a favorable prognosis.

A ranula is a pseudocyst resulting from mucous extravasation secondary to damage of the sublingual gland, showing variability in its growth rate and a high recurrence rate. The lack of consensus regarding a standard treatment stems from the diversity of clinical presentations and the range of available surgical techniques. The complex anatomy of the sublingual gland plays a decisive role in the formation of the ranula, which can be classified as oral, plunging, or mixed. Diagnosis is based on clinical examination and may be complemented by imaging exams, especially for plunging ranulas. Therapeutic modalities include conservative and surgical approaches, with micromarsupialization recommended for oral ranulas and radical excision of the sublingual gland being the most effective technique for recurrent or plunging cases. It is concluded that therapeutic choice should consider lesion extent, risk of recurrence, and the anatomical characteristics involved.

Dental caries, a dysbiotic biofilm disease driven by polymicrobial acidogenesis, often coexists with type 2 diabetes (T2D). Previous studies suggest covarying relationships between circulating and salivary metabolites in patients with T2D. However, the role of hyperglycemia-induced saccharide migration from plasma to saliva in caries pathogenesis remains unclear. Here, we developed a novel method for untargeted metabolomics profiling of trace saliva from sublingual and submandibular glands, comparing this profile with those of plasma and whole saliva in participants with T2D (n = 31) and those with normoglycemia (n = 30). This comparison aimed to determine how circulating saccharide migration into the oral cavity and its subsequent microbial consumption are linked to dental caries. Additionally, shotgun metagenomic sequencing was combined with this analysis to investigate the cariogenic impact of circulating saccharide migration on the composition and function of supragingival biofilm using MetaPhlAn4 and HUMAnN3 pipelines. The metabolomics profiles of glandular saliva showed intermediate dissimilarity between plasma and whole saliva, reflecting cardiometabolic traits more sensitively than whole saliva. Glucose and fructose showed a decreasing positive correlation with glycemic parameters in the order of plasma, glandular saliva, and whole saliva, suggesting systemic-to-oral migration and subsequent microbial consumption. Saccharide migration was more pronounced in participants with dental caries and plaque accumulation, coinciding with shifts in supragingival microbiota, including depletion of Streptococcus sanguinis, Corynebacterium durum, and Rothia aeria, and enrichment of Streptococcus mutans, Veillonella parvula, and Actinomyces sp. oral taxon 448. Glycolytic potential increased at the community level. Improved glycemic control reduced fructose migration and mitigated dysbiosis, decreasing fructose phosphotransferase abundance and shifting the S. mutans-S. sanguinis balance. Experimental validation demonstrated that fructose promotes S. mutans dominance over S. sanguinis in dual-species biofilms. This study establishes saccharide migration as a metabolic driver of supragingival dysbiosis in T2D. The findings highlight the role of both glucose and fructose in caries pathogenesis and suggest that glycemic control could serve as an effective strategy as part of caries control. Video Abstract.

Durable partial response of pulmonary metastases from primary sublingual gland squamous cell carcinoma after pembrolizumab failure: Salvage therapy with paclitaxel plus cetuximab

Diabetes is a significant risk factor for bisphosphonate-related osteonecrosis of the jaw (BRONJ), a severe oral complication with limited treatment options. Salivary testing offers a noninvasive approach for monitoring BRONJ risk; however, few studies have investigated salivary biomarkers in BRONJ. This study screened salivary biomarkers that reflect the progression of BRONJ under diabetic conditions. A diabetic BRONJ rat model was established to screen for diabetes-related biochemical biomarkers in saliva. Streptozotocin (STZ) administration elevated blood glucose and glycated albumin levels and altered lipid and renal function markers, confirming diabetes induction. Subsequent zoledronic acid (ZA) administration and extraction of the maxillary first molar delayed epithelialization, inflammatory cell infiltration, bone exposure, and necrosis in extraction sockets, indicating successful establishment of a diabetic BRONJ model. This model showed reductions in submandibular and sublingual gland size, as well as in acinar cell number. Although salivary secretion volume was reduced, saliva samples were successfully collected from all groups. Screening identified elevated urea nitrogen (UN) and total ketone bodies (T-KB) in the STZ + ZA group. These findings suggest that salivary UN and T-KB may reflect disease progression and serve as potential biomarkers for predicting BRONJ risk under diabetic conditions.

This narrative literature review is an evaluation of the cosmetic, perioperative, and clinical outcomes of alternative approaches to submandibular gland excision, including conventional and robotic transoral excision, as well as endoscopic and robotic retroauricular excision, in comparison with the traditional transcervical approach. We intend to compare the cosmetic impact of each procedure based on the type of scar and location. PubMed and Google Scholar identified studies published between January 2000 and May 2025 which reported the outcomes of submandibular gland excisions performed using a transcervical, transoral, or retroauricular technique. Our analysis showed that the transcervical approach provides reliable access but carries risks of marginal mandibular nerve injury (18.7%) and visible cervical scarring. Conventional transoral excision avoids external scars and reduces the risk to the marginal mandibular branch and hypoglossal nerves but increases the risk of lingual nerve neuropraxia, with transient sensory deficits reported in 25–43% of patients. Robotic transoral excision preserves the sublingual gland and may improve completeness of resection, but operative times remain prolonged (<190 min). Endoscopic and robotic retroauricular excision can hide scars in the hairline and provide improved cosmetic satisfaction scores, with limitations including longer operative times and learning curves. Alternative approaches to submandibular gland excision provide improved cosmetic outcomes with comparable safety profiles to the transcervical approach.

Submental intubation offers a safe and less invasive alternative to tracheostomy in maxillofacial trauma patients when oral or nasal intubation is contraindicated. This study aimed to assess the safety, complications, and long-term outcomes of submental intubation over a five-year period (2018-2023), with a novel emphasis on salivary gland evaluation using ultrasonography. A retrospective cohort study was performed on 31 patients who underwent submental intubation between 2018 and 2023 at Sina Hospital, Tehran University of Medical Sciences. Clinical assessments included intraoperative and postoperative complications, scar outcomes, and lingual nerve function. Ultrasonographic examinations of submandibular and sublingual glands were conducted to detect volumetric and echoparenchymal changes, with comparisons made between the incision and contralateral intact sides. Statistical analysis employed paired t-tests and Wilcoxon signed-rank tests. Submental intubation was successfully performed in all patients with a mean operative time of 7 ± 2min. No major intraoperative or postoperative complications such as bleeding, hematoma, or infection were observed. Scar appearance was acceptable in all cases, with only two patients developing widened scars and none exhibiting hypertrophic scars. Ultrasonography revealed normal echoparenchyma in 90.3% of cases. Three patients showed hyperechoic parenchyma with reduced gland volume on the incision side, potentially attributable to previous trauma rather than the intubation procedure. No significant differences in gland volume were detected between the incision and intact sides (p = 0.165). Submental intubation is a safe, effective, and minimally invasive airway management technique for maxillofacial trauma patients, associated with minimal complications and favorable cosmetic outcomes. This five-year study provides new ultrasonographic evidence confirming the safety of salivary gland function. Further studies with extended follow-up are recommended to exclude rare late-onset complications such as mucoceles or ranulas.

The submandibular glands (SMGs), along with the parotid and sublingual glands, generate the majority of saliva and play critical roles in maintaining oral and systemic health. Despite their physiological importance, long-term therapeutic options for salivary gland dysfunction remain limited, highlighting the need for a deeper molecular understanding of SMG biology, particularly in humans. To address this knowledge gap, we have performed transcriptomic- and epigenomic-based analyses and molecular characterization of the human SMG. Our integrated analysis of multiorgan RNA-sequencing datasets has identified an SMG-enriched gene expression signature comprising 289 protein-coding and 75 long non-coding RNA (lncRNA) genes that include both known regulators of salivary gland function and several novel candidates ripe for future exploration. To complement these transcriptomic studies, we have generated chromatin immunoprecipitation sequencing (ChIP-seq) datasets of key histone modifications on human SMGs. Our epigenomic analyses have allowed us to identify genome-wide enhancers and super-enhancers that are likely to drive genes and regulatory pathways that are important in human SMG biology. Finally, comparative analysis with mouse and human SMG and other tissue datasets reveals evolutionary conserved gene and regulatory networks, underscoring fundamental mechanisms of salivary gland biology. Collectively, this study offers a valuable knowledge-based resource that can facilitate targeted research on salivary gland dysfunction in human patients.

High-fat diet (HFD) consumption induces metabolic diseases, which lead to salivary gland alteration. However, the alteration in salivary gland remains inconclusive, and the potential protective effect of simvastatin is limited. Therefore, our study aimed to investigate the effect of HFD consumption and the protective effect of simvastatin on submandibular and sublingual glands in rats.Eighteen male Wistar rats were divided into three groups (n = 6 per group): a control group (C) fed a standard diet, a HFD group (H), and a HFD with simvastatin group (S). After 12 weeks, blood was collected for lipid parameter analysis. Submandibular and sublingual glands were stained with hematoxylin and eosin (H&E), Masson's trichrome, periodic acid-Schiff, and alcian blue to evaluate gland architecture, fibrosis, and mucin content. Image analysis was done using imageJ software.Parametric data were analyzed using one-way ANOVA followed by Tukey's post hoc test. Nonparametric data were analyzed using the Kruskal-Wallis test, followed by Dunn's test. A p-value <0.05 was considered statistically significant.The low-density lipoprotein cholesterol (LDL-C) level significantly increases in the H group compared with the C group (p = 0.004). Acinar cells in both submandibular and sublingual glands were significantly smaller in the H and S groups compared with the C group (p < 0.05). Vacuole-like clear structures were more frequent in the H group. Collagen deposition in the submandibular gland was significantly higher in the H and S groups compared with controls (p = 0.005 and p = 0.011, respectively). Slightly altered mucin staining is seen in both glands.HFD increased LDL-C levels and induced acinar atrophy and fibrosis in the submandibular and sublingual glands. Simvastatin did not protect against salivary gland damage from HFD consumption.

Surgical management of the enlarged sublingual gland in mandibular posterior dental implant rehabilitation.

Oral and plunging ranulas require effective treatment strategies to minimize recurrence; yet no consensus exists on the most effective approach. This systematic review evaluated several treatments for the recurrence of oral and plunging ranulas. A comprehensive search was conducted in five bibliographic databases and gray literature. Randomized and non-randomized studies were included if they investigated treatment approaches for oral or plunging ranulas. Two independent reviewers screened studies, extracted data, and assessed the risk of bias. The primary outcome was recurrence of (1) oral and (2) plunging ranula. For each type of ranula, a random-model frequentist network meta-analysis (NMA) was established for seven treatment strategies: enucleation, micromarsupialization, marsupialization, marsupialization with packing, partial sublingual gland excision, sublingual gland excision, and sublingual gland excision plus submandibular gland excision. A minimal important difference (MID) and the GRADE approach for NMA were used for interpretation of data. Eighteen studies were included (all non-randomized-14 for oral ranula and six for plunging ranula). No treatment demonstrated clear superiority in preventing recurrence. Certainty of evidence was low to very low for oral ranulas and very low for plunging ranulas, primarily due to the risk of bias, imprecision, and intransitivity. Given the low certainty of evidence, no single treatment can be considered superior to others. Future research should prioritize longer follow-up randomized controlled trials.

PurposeGiven the indolent nature of mucosa-associated lymphoid tissue (MALT) lymphoma, immediate intervention is not always necessary, and a consensus on the optimal treatment modality remains elusive. This study aimed to evaluate survival outcomes of different initial treatments for early-stage (stage I–II) salivary gland MALT lymphoma.MethodsUsing data from the Surveillance, Epidemiology, and End Results program, we included patients diagnosed between 2000 to 2021. Initial treatments included surgery alone, radiotherapy alone, surgery combined with radiotherapy, chemotherapy alone, or observation. The chi-square test, Kaplan-Meier method, and multivariate Cox proportional-hazards models were used for statistical analyses.ResultsA total of 892 patients were included. Tumor location was known for 859 patients, with 740 (86.1%) located in the parotid gland, 116 (13.5%) in the submandibular gland, and 3 (0.3%) in the sublingual gland. Of the patients, 237 (26.6%) underwent surgery alone, 202 (22.6%) received radiotherapy alone, 170 (19.1%) underwent surgery combined with radiotherapy, 53 (5.9%) received chemotherapy alone, and 230 (25.8%) with observation. Submandibular gland tumor patients were more likely to receive radiotherapy alone, chemotherapy alone, or observation, while parotid gland tumor patients preferred surgery or surgery combined with radiotherapy (P<0.001). Over time, the proportion of observation cases increased (P=0.004). The median follow-up time was 92 months. The 8-year cancer-specific survival rates for patients undergoing surgery alone, radiotherapy alone, surgery combined with radiotherapy, chemotherapy alone, and observation were 96.1%, 94.9%, 97.0%, 92.1%, and 95.5%, respectively (P=0.827). The 8-year OS rates for these groups were 79.7%, 84.5%, 86.3%, 77.7%, and 79.5%, respectively (P=0.132). Multivariate analysis showed that initial treatment modality did not significantly affect survival outcomes. Sensitivity analyses also showed similar outcomes for the five treatment groups across different subgroups. Age and gender were independent prognostic factors associated with survival outcomes.ConclusionOur study highlights that early-stage salivary gland MALT lymphoma is characterized by a female predominance and an increasing trend toward observation as a management strategy. The lack of significant survival differences across treatment modalities suggests that the choice of initial treatment may be less critical than patient-specific factors such as age and gender. These findings advocate for personalized treatment approaches and underscore the importance of further research to better understand the underlying mechanisms driving gender disparities and the long-term outcomes of conservative management strategies.

Application of sublingual gland flap in the surgical treatment of early medication-related osteonecrosis of the jaw.

Adenoid cystic carcinoma of sublingual gland is a rare malignant tumor. When adenoid cystic carcinoma metastasizes to the acetabulum, it is highly challenging to choose a minimally invasive surgery. The treatment of acetabular metastatic tumors needs to not only maintain the original tumor treatment plan but also relieve pain and reconstruct the acetabular structure and mechanical stability. Therefore, the treatment of acetabular metastasis from sublingual gland adenoid cystic carcinoma is a complex issue. We treated a 72-year-old Han Chinese woman with acetabular metastasis from sublingual gland adenoid cystic carcinoma. She underwent percutaneous acetabuloplasty. The operation was safe and effective, taking 47min. The patient could walk freely 2h after operation and was discharged 2days later. During the 3-month follow-up, there was no complication and no recurrence. Percutaneous acetabuloplasty for the treatment of acetabular metastasis from sublingual gland adenoid cystic carcinoma is satisfactory. It not only has the advantages of minimally invasive surgery but also does not interfere with the original tumor treatment plan.

Ultrasound (US) has been supported as a preferred imaging technique to evaluate neck masses suspicious for plunging ranula, but to date, there have been no reports addressing the role of adjunctive sonopalpation. In this proof-of-concept technical case series, we describe the technique of sonopalpation and provide surgical and pathological correlates. Patients with surgically-treated plunging ranula were identified from the senior author's case log. Three patients were included in a retrospective chart review targeting imaging results, surgical findings, and final pathology results. US with sonopalpation identified anatomy consistent with plunging ranula in all 3 cases. These findings were confirmed surgically and pathologically. US with sonopalpation was effective in demonstrating anatomic abnormalities consistent with plunging ranula. Sonopalpation helped define relationships between the sublingual gland, ranula fluid, and the frequently-associated mylohyoid dehiscence. Sonopalpation is a useful adjunctive technique to standard US in the evaluation of plunging ranula. Additional investigation into this technique may be helpful in further evaluating its use in the diagnostic process.

Background and purposeRadiotherapy of head and neck cancer may cause detrimental late side effects such as fibrosis and hyposalivation. We investigated mouse salivary glands after fractionated irradiation, with the aim to elucidate cellular plasticity and potential regeneration.Methods12-week-old female C57BL/6JRj mice were irradiated with X-rays to a total dose of 66 Gy, given in 10 fractions over 5 days. The radiation field covered the oral cavity and major salivary glands. The submandibular (SMG), sublingual (SLG), and parotid glands (PG) were dissected at day 100 after finishing irradiation. Using different histological staining techniques, morphological, cellular, and molecular changes were investigated in irradiated and control SMG, SLG, and PG.ResultsAtrophy of acinar cells was observed in irradiated SMG and SLG, but not in PG. Surprisingly, the acinar atrophy was confined to one region of each irradiated gland. These atrophic regions showed distinct cellular and molecular compositions compared to non-atrophic regions and control glands. Increased expression of the ductal cell markers keratin 5 and 19 (K5 and K19), along with increased percentages of proliferating myofibroblasts, fibroblasts, leukocytes, and acinar cells (Nkcc1+) were observed in the atrophic regions compared to controls. In addition, some of the K19+ and K5+ duct-like cells also co-expressed Nkcc1.InterpretationThrough a detailed histological assessment of the cellular and molecular changes in the major salivary glands of irradiated mice, we observed signs of cellular plasticity where ductal cells adopt an acinar cell phenotype upon irradiation. This suggests a regenerative potential of salivary glands after irradiation.

Background: Ancient schwannoma is a rare, benign peripheral nerve sheath tumor exhibiting degenerative changes. Its presentation in the submental region is extremely uncommon and may be clinically mistaken for a salivary gland tumor. Case Presentation: We report the case of a 51-year-old female who presented with a painless, progressively enlarging swelling in the submental region over four months. Clinical and imaging evaluation suggested a lesion arising from the sublingual gland, and FNAC raised suspicion of malignancy. The mass was excised under general anesthesia, and histopathology revealed an ancient schwannoma. Postoperative recovery was uneventful, and the patient remained asymptomatic on follow-up. Conclusion: Ancient schwannoma should be considered in the differential diagnosis of submental masses. Histopathology remains critical for accurate diagnosis and appropriate management.

Ultrasonography is a non-invasive imaging technique based on the emission and reception of high-frequency sound waves, enabling real-time analysis of examined tissues. In dentistry, its application has expanded to include the diagnosis of soft tissue alterations in the head and neck region, such as inflammatory processes, superficial lesions, and temporomandibular disorders. The technique allows differentiation between cystic and solid lesions in the mandible, as well as precise evaluation of the submandibular and sublingual salivary glands. Intraoral examinations are also feasible with this technology. The sensitivity for detecting zygomatic fractures is 88.2%, with a specificity of 100%. In periapical lesions, ultrasonography distinguishes cysts from granulomas, especially when using color Doppler, which identifies vascular structures and assesses blood flow and resistance. Beyond its diagnostic value, ultrasound has therapeutic potential, being used as an adjuvant in pain, inflammation, and edema control, and in promoting healing. Being painless, accessible, radiation-free, and low-cost, ultrasonography stands out as a promising tool in dental practice.