• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.464-472
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• 1994

Surgical removal of the submandibular gland via intraoral approach was performed. The surgical procedure to be used for removal of submandibular gland had been performed via extraoral approach for many centuries. Disadvantages of extraoral technique are the esthetic distress due to an external scar, residual inflammation in Wharton's duct, and neurological complications. Indications of intraoral approach are unlimited in surgical cases of submandibular gland. Advantages of intraoral approach are esthetic satisfaction due to no remaining scars, preservation of adjacent anatomical structures and preservation of lower facial contour. This paper describes the surgical technique of the submandibular gland excision through an intraoral approach and variable incision lines tried. In 7 cases, excellent results were obtained after removal of the submandibular gland through an intraoral approach.

• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.111-115
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• 2010

Purpose: A plunging ranula is relatively uncommon and represents a mucus escape reaction occurring from a disruption of the sublingual salivary gland. It is a common condition found in young adults, even though the reported age range is 2 - 61 years. We report our experience of a complete excision of a plunging ranula via the intraoral and submandibular approach. Methods: A 23-year-old man had a large protruding mass in the right submandibular area. Initially, the protruding mass appeared bilaterally but the left side disappeared spontaneously. The MRI findings revealed a homogenous fluid attenuation mass in the submandibular space, suggesting a ranula. The sublingual gland was extirpated through the intraoral approach and the ranula excised totally via the submandibular approach. Results: The patient had an uneventful postoperative course without infection, paralysis and tongue sensory changes, etc. The pathology findings were characteristic of a pseudocyst without a lining epithelium or endothelium but with a vascular fibro-conective tissue wall filled with mucinous fluid. No recurrence was observed on the submandibular area during the 8 month follow-up period. Conclusion: The combined intraoral approach and submandibular approach is an effective and highly recommended method for sublingual gland extirpation and complete excision of a plunging ranula.

• 대한치과마취과학회지
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• 제14권4호
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• pp.227-232
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• 2014

The indication for submandibular intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasotracheal intubation. Thus, We reported 2 cased of endotracheal intubations via submandibular approach that is applicable in patients with skull base fractures for a reliable general anesthesia. Endotracheal intubation via submandibular approach was applied during general anesthetic procedures for open reduction in three patients with Le Fort II, III or nasoorbitoethmoid (NOE) fractures. No complications due to submandibular intubation, such as infection, postoperative scarring, nerve injury, hematoma, bleeding, or orocutaneous fistula, were observed following submandibular intubation. Endotracheal intubation via submandibular approach is effective in patients with skull base fractures. In our method, the tube connector is removed in orotracheal intubation in order to avoiding the tube removal or displacement. The advantages of this method are very simple, safe, and to provide the good operation field.

• Archives of Plastic Surgery
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• 제43권4호
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• pp.374-378
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• 2016

Submandibular gland ptosis is a common impediment to obtaining superior surgical aesthetic results in neck lift surgery. Techniques for suspending the submandibular gland have been proposed, but these procedures have the drawbacks of disturbing the floor of the mouth mucosa and periosteum. We present an approach of submandibular gland suspension for the treatment of gland ptosis by employing a platysma and hyoid bone fascia cradle. Our technique was performed on cadaveric models. The platysma muscle and hyoid bone cradle for submandibular gland ptosis was created on the left side of the neck in two cadavers. A submental incision with sharp dissection was performed to raise a supraplatysmal flap. A subplatysmal plane was developed until the submandibular gland was identified. Sutures were used to pexy the platysma to the hyoid bone periosteum and deep cervical fascia, tightening the overlying muscle and in turn elevating the submandibular gland. Submandibular gland ptosis must be corrected in order to achieve exemplary aesthetic results. Our approach of creating a cradle with the platysma and hyoid bone avoids the potential complications of previously described sling procedures, while still maintaining the integrity of the gland and surrounding tissues.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.180-184
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• 2011

The mucocele is a mucus extravasation cyst arising from the salivary gland. Although it is a common?lesion of the minor salivary gland, it is uncommon when it originated from the submandibular gland. The ranula is a form of mucocele which specifically occurs in the floor of the mouth and the sublingual gland is generally accepted as the origin of ranula. They can be classified into two types based on extent: simple ranula are confined to the sublingual space and plunging ranula extend into the adjacent space. It is difficult to differentiate the submandibular gland mucocele from the plunging ranula because both of them can occupy the submandibular space. A 37-year old male visited our clinic with the chief complaint of left facial swelling. The patient's history revealed that he had suffered from a cystic lesion on the left side of the floor of the mouth 10 months previously. He supposed the cystic lesion had come from trauma at other dental clinics. Using CT and MRI, we diagnosed a simple ranula on the sublingual space and a submandibular gland mucocele. We then excised the mucocele with the submandibular gland by an extraoral approach and the sublingual gland by an intraoral approach under general anesthesia. We report a rare case of an enormous submandibular gland mucocele which extended into the pterygoid plate and parapharyngeal space with good surgical results.

• 대한두경부종양학회지
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• 제32권1호
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• pp.25-28
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• 2016

A 54-year-old female presented with a 4cm sized painless, submandibular gland area mass. Vascular lesion was suspected in computed tomography scan. Surgical excision was performed via retroauricular approach for its excellent cosmetic outcome. The vascular mass with peripheral focal calcification was clearly resected without complication such as bleeding or neural damage. Histopathological examination of the specimen revealed an arteriovenous malformation(AVM) with abnormal communications between arteries and veins without the normal intervening capillary bed. We report a successful excision of AVM in the submandibular space via retroauricular approach.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.548-552
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• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

• 대한두경부종양학회지
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• 제32권1호
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• pp.41-44
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• 2016

The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

• Journal of Korean Neurosurgical Society
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• 제39권3호
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• pp.231-233
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• 2006

The C2 level is the transition zone between the cranial and cervical spine. Because of its high position and anatomic relationship to vital structures, exposing C2 is challenging and the surgical approach is controversial. We report a of a recurred chordoma in C2 portion, occupying the osseous intraspinal portion. The patient underwent total corpectomy of C3 and gross total removal of tumor by right submandibular approach 3 years previously. We performed a lateral extrapharyngeal approach from contralateral left side with resection C2 central portion followed by gross total removal of mass and placement of graft bone. Although there was transient hypoglossal nerve palsy postoperatively, the patient had full recovery.

• 대한두경부종양학회지
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• 제37권1호
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• pp.29-32
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• 2021

Benign submandibular gland tumor is a common disease in the head and neck region and can be completely removed by transcervical approach. Typical submandibular gland resection can lead to neurological complications. The most common complications are damage to the marginal mandibular branch of the facial nerve and weakening of the lower lip. We report a case of ipsilateral lower lip twitching occurring 3 months after surgery. There was no difficulty during the operation, and there were no neurologic complications immediate after surgery. However, in the present case, the patient experienced lower lip twitching paradoxically after surgery which has not been reported in the literature yet. Therefore, we reported this case with a review of relevant literature.